TY - JOUR
T1 - Creating quality improvement culture in public health agencies
AU - Davis, Mary V.
AU - Mahanna, Elizabeth
AU - Joly, Brenda
AU - Zelek, Michael
AU - Riley, William
AU - Verma, Pooja
AU - Fisher, Jessica Solomon
PY - 2014/1
Y1 - 2014/1
N2 - Objectives: We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods: The agencies participated in a project conducted by the National Association of County and City Health Officials (2007-2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results: Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n= 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions: Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies' ability to create and sustain a quality improvement culture.
AB - Objectives: We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods: The agencies participated in a project conducted by the National Association of County and City Health Officials (2007-2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results: Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n= 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions: Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies' ability to create and sustain a quality improvement culture.
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U2 - 10.2105/AJPH.2013.301413
DO - 10.2105/AJPH.2013.301413
M3 - Article
C2 - 24228680
AN - SCOPUS:84891699616
SN - 0090-0036
VL - 104
SP - e98-e104
JO - American journal of public health
JF - American journal of public health
IS - 1
ER -