Fishbone Diagram

CGCDPH
Completed
Impact Statement:
The number of flu vaccines provided by Cerro Gordo County Department of Public Health (CGCDPH) has risen greatly, with many flu vaccination sites around the rural county. As the number of vaccines rose, the ability to enter the vaccines into the state immunization registry fell, and 57% of flu...
SCHD
Completed
Impact Statement:
Charting errors increased in Scott County Health Department's (SCHD's) STD clinic when a new electronic database was introduced. Anticipating the transition to the new database, the STD team implemented a QI effort to identify and correct problems with the charting process before they...
TCPH
Completed
Impact Statement:
Tarrant County Public Health’s (TCPH’s) North Texas Regional Laboratory (NTRL) decreased the cost of a specific HIV test by 40% by testing and adopting an alternative control test method. NTRL has received level funding for a few years while laboratory expenses have continued to grow. Achieving...
Completed
Impact Statement:
The Boston Public Health Commission worked across departmental areas to improve the invoice payment process for their vendors. Timely payment contributes to improved relationships with these partners to collectively meet the community's health needs.
BCPHD
Completed
Impact Statement:
Butte County Public Health Department (BCPHD) in California used QI to expedite the annual medical review (AMR) process for eligibility into the California Children's Services (CCS) program. More children and their families now have improved access to these specialty health care services.
Completed
Impact Statement:
Kendall County Health Department implemented successive PDSA cycles to better protect their population from West Nile Virus. The QI activities eventually led to a nearly 200% increase in the number of mosquito tests performed. Moreover, the implementation of a GIS management system has led to...
CCHD
Completed
Impact Statement:
Cecil County Health Department (CCHD) redesigned the onboarding process for new staff. As a result, most new staff reported that they understand their role at CCHD and found the onboarding process to be informative and useful. Onboarding education can improve staff members’ ability to meet...
KHI
Completed
Impact Statement:
Kansas Health Institute (KHI) strengthened their ability to share information with clients by increasing the efficiency of its publication process and reducing staff stress associated with it.
Lake County Health Department
Completed
Impact Statement:
By using the Six Sigma DMAIC method, Lake County Health Department streamlined their billing process for the Dental Program. This change resulted in a significant decrease in lost revenue, from an average of $5,354 per quarter down to an average of $2,076. The quarterly losses decreased steadily...
DOH-Seminole
Completed
Impact Statement:
The Florida Department of Health in Seminole County (DOH-Seminole) improved the timeliness of filing Client Service Records (CSRs), positively affecting customer service and access to care.
CG Health
Completed
Impact Statement:
Cerro Gordo Health Department decreased fear levels of bed bug exposure among field staff. The implementation of a risk reduction plan minimized staff discomfort and facilitated a more effective intervention to bed bug exposure in the community.
CGCDPH
In Progress
Impact Statement:
Cerro Gordo County Department of Public Health (CGCDPH) worked to improve immunization rates for both types of pneumococcal vaccine recommended for seniors. Through a multifaceted approach that emphasized increased awareness of the vaccine, CGCDPH raised the rate of immunizations with the newest...
TCPH
Completed
Impact Statement:
The Tarrant County Public Health (TCPH) Tuberculosis (TB) Division in Texas improved completion rates for latent TB infection (LTBI) treatment focusing on three targeted populations: homeless shelter residents, refugees, and people exposed to TB cases. Quality improvement of the process and a new...
DCHS
Completed
Impact Statement:
Staff at Deschutes County Health Services (DCHS) recognized that they had so many different programs in operation that it was difficult for staff to make all the appropriate referrals for clients. They did a QI project, and their improvement hypothesis targeted three areas: knowledge, workflow, and...
HCHD
Completed
Impact Statement:
Harford County Health Department (HCHD) in Maryland increased the percentage of morbidity reports for chlamydia submitted by county health care providers, thus facilitating improved trend monitoring, ensuring proper treatment, and ultimately helping to reduce the spread of disease.
KCHD
Completed
Impact Statement:
Developing effective public health communications via social media is very much a work in progress. One critical success factor is the ability to converse with a broader audience and to create messages that allow interaction between the messenger and the audience. During the test phase of Kane...
FCHD
Completed
Impact Statement:
Franklin County Health Department (FCHD), a small local health department (LHD) in Kentucky, needed to improve the completion and timeliness of restaurant inspections to meet regulatory requirements. By using the Kaizen process and involving leaders from the LHD, the QI project team identified root...
Houston Health Department
In Progress
Impact Statement:
Mobile food units (MFUs) in Houston, Texas, now experience a faster, more efficient inspection process thanks to a Kaizen event held by Houston Health Department. The average time to complete the physical inspection and administrative paperwork has decreased from 3 hours to 30 minutes. Moreover,...
MDH
Completed
Impact Statement:
For health department services that have a major impact on citizens, ensuring high client satisfaction is important to the public’s understanding and support for these services. Three state health departments teamed together to improve the timeliness of death data, using the Kaizen method for...
Missoula City-County Health Department
Completed
Impact Statement:
Missoula City-County Health Department used quality improvement to improve the functionality and satisfaction of its infectious disease after hours response team members, thus ensuring that emerging infectious disease issues in the community would be managed appropriately.
RiverStone Health
In Progress
Impact Statement:
Health Alert Network (HAN) messages provide vital public health information to the community’s health care providers, schools, churches, day care centers, and so on. The RiverStone Health team used a 5-day Kaizen event to improve the HAN process, create job keys, involve more staff, and decrease...
Stratford Health Department
Completed
Impact Statement:
The Stratford Health Department’s aim was to ensure that at least 75% of faith-based organizations (FBOs) were licensed, so they could provide food during public events throughout the year and minimize the risk of food-borne illness. While working through their QI planning project, staff fixed a...
City of St. Louis Department of Health
Completed
Impact Statement:
In becoming ready for PHAB accreditation, the City of St. Louis Department of Health’s performance management team used quality planning to create, test, and install a performance management system. The process included a fishbone diagram of the barriers to a culture of quality, an affinity diagram...
SCDPH
Completed
Impact Statement:
Saginaw County Department of Public Health (SCDPH) conducts strategic planning every 2 years. After noting that not all staff were engaged, the four previous strategic planning groups conducted a PDSA cycle on the strategic planning process. As a result, staff are now more committed to setting and...
North Carolina Department of Health and Human Services
In Progress
Impact Statement:
Recognizing the critical role of timely and accurate death data for local health departments (LHDs) to perform surveillance and make informed decisions, the North Carolina Department of Health & Human Services used quality improvement to decrease the lag in posting identifiable death data from...
HEALTH
Completed
Impact Statement:
How might your health department track the trajectory and evolution of its QI and performance management system? Learn how Rhode Island Department of Health developed a survey tool to assess progress and measure QI uptake.
OCHD
Completed
Impact Statement:
Taking the bite out of labor intensive reporting and delays though community collaboration and use of QI tools and methods to increase the number of animal bite reports submitted to the health department in a timely fashion.
Rhode Island Department of Health
In Progress
Impact Statement:
The Rhode Island Department of Health improved the timeliness of data entry for early intervention (EI) services which enhanced appropriate and prompt preventive health services and follow-up care. Delayed entry of Individual Family Service Plans (IFSPs) by outside agencies into the KIDSNET system...
Marion Public Health
Completed
Impact Statement:
The time participants spend waiting for appointments at the WIC clinic can lead to dissatisfaction with the WIC program and could negate efforts to retain program participants. The Marion Public Health WIC team used a fishbone diagram to determine that the primary root cause of long wait times in...
Marion County Health Department
Completed
Impact Statement:
When a rabies susceptible animal has bitten a human, it is imperative that health departments responsible for the investigation and quarantine of these animals respond a timely manner. A local health department in Oregon used a PDSA approach to reduce the time to process rabies bites reports by 29...
Missoula City-County Health Department
Completed
Impact Statement:
The number of breastfeeding women who have access to a certified lactation counselor soared when Missoula City-County Health Department staff used QI to improve their internal processes.
KCHD
Completed
Impact Statement:
Knox County Health Dept. demonstrates how use of partner developed communication standards can improve communication satisfaction among groups participating in a coalition.
KCHD
Completed
Impact Statement:
Staff are Customers too! How involving all staff in the identification of barriers to completing department offered QI Training resulted in greater acceptance of, participation in, and an increase in the number of staff completing six required training modules.
TCHD
Completed
Impact Statement:
Reducing adolescent tobacco use is a priority for Tooele County Health Department (TCHD) in Utah. Staff recognized the need to improve tobacco compliance check pass rates and identified that clerks who possess a valid permit were less likely to sell tobacco products to minors. TCHD used quality...
MCHD
Completed
Impact Statement:
A knowledgeable and involved team, subject matter expertise, and the Kaizen improvement method helped the Madison County Health Department reduce their client no show rates in the Family Planning Clinic. Root cause analysis led the team to create standardized process procedures, client scheduling...
CDPH
Completed
Impact Statement:
Untreated chlamydia (CT) and gonorrhea (GC) can lead to serious health problems in men and women. In order to effectively track and treat these two sexually transmitted infections, CDC guidelines require that low-priority CT and GC reports be processed by health departments within 30 days of...
DeKalb County Board of Health
Completed
Impact Statement:
The DeKalb County Board of Health used a kaizen event to decrease the labor time and increase the accuracy of filing death certificate registrations. Improving the process resulted in labor savings, better cash flow and improved performance for customers in providing accurate and timely filing. The...
WCPH
Completed
Impact Statement:
Washington County (OR) conducted a Kaizen Event to improve the volume of childcare facilities that used the LHD for their state required inspections. The agency implemented several new policies and protocols to standardize the entire inspection process. As a result, they anticipate a reduction in...
DHMH
Completed
Impact Statement:
The Maryland Department of Health and Mental Hygiene partnered with its local health departments and WIC clinics to increase the number of WIC clients referred to and receiving appropriate services to meet their needs.
WCHD
Completed
Impact Statement:
A local health department in Washington was not able to serve all of the WIC-eligible clients in its jurisdiction. Process mapping led to three aims for increasing efficiency to make time for new clients: (1) Decreasing the average percentage of no-show appointments; (2) Increasing the WIC...
MDH
Completed
Impact Statement:
Effective tobacco control and prevention outreach is vital to decreasing tobacco use, secondhand smoke exposure, and tobacco-related disease rates. In addition, the loss of significant resources and funding for tobacco control and prevention have made it all the more important to have efficient...
ADHS
Completed
Impact Statement:
Home visiting programs are an important intervention to improve the health of women and children, but they are generally done in programmatic silos. A state health department used QI to improve the process and systematically address both chronic disease and environmental health risk factors...
ECDHD
Completed
Impact Statement:
An example of bridging health and health care in rural Nebraska: In order to improve critical health outcomes of “hard to reach” patients with diabetes and high blood pressure, a local health department and a community health center partnered to use the PDSA model and best practices to provide...
Oregon Health Authority, Public Health Division, Maternal and Child Health Section
Completed
Impact Statement:
Staff from Oregon MothersCare conducted a QI project to improve their processes for prenatal care, which led to decreased errors in tracking and faster flow through the system so that pregnant women received services in a more timely manner. Access to prenatal care was also improved.
PHS
Completed
Impact Statement:
Inadequate documentation of policies and procedures is not just a hassle; it can also create confusion and redundancies that bog down staff’s ability to provide effective public health services and programs to the community. A small, rural local health department used quality improvement methods...
UDOH
Completed
Impact Statement:
This state health department quality improvement (QI) effort sought to improve customer satisfaction and increase use of the Utah state laboratory. The intervention tested was the development of a website for use by local health department (LHD) staff, who achieved both of the QI project goals. In...
SEHD
Completed
Impact Statement:
Vaccinating children is imperative in the prevention and spread of life-threatening communicable diseases. A rural regional health district conducted an improvement project using PDSA at three public health clinic sites to increase immunization rates among 19–35-month-old children seen at their...
Mid-Michigan District Health Department
Completed
Impact Statement:
Michigan’s Maternal Infant Health Program serves low-income families and pregnant women to improve birth outcomes. A local health district in that state used the PDSA cycle to reduce office-related work and increase time for direct client services in order to make the program more efficient and...
Jefferson County Public Health Service
Completed
Impact Statement:
Responding to case reports of Lyme disease, the most common tick-borne infection in North America represented a very large time burden for a local health department in northwest New York state. The department used QI tools to decrease the number of steps and amount of time to respond to case...
Mississippi State Department of Health
Completed
Impact Statement:
The Prentiss County Health Department and Mississippi State Department of Health partnered on a project to reduce wait time in their WIC clinics, reassign staff as needed on higher traffic days, and provide customer service training to frontline staff to assure greater satisfaction and...

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