Creating Quality Improvement Culture in Public Health Agencies
Document Type
Article
Publication Date
1-1-2014
Keywords
Humans, Interviews as Topic, Organizational Case Studies, Organizational Culture, Organizational Innovation, Public Health, Qualitative Research, Quality Improvement, United States
Publication Title
American Journal of Public Health
Abstract
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.
Funding Organization
This research was supported by the Robert Wood Johnson Foundation.
Recommended Citation
Davis, M. V., Mahanna, E., Joly, B., Zelek, M., Riley, W., Verma, P., & Solomon Fisher, J. (2014). Creating quality improvement culture in public health agencies. American Journal of Public Health, 104(1), e98-e104. doi: 10.2105/AJPH.2013.301413
Comments
Human Participant Protection: This evaluation study was declared exempt from review by the non-biomedical institutional review board at the University of North Carolina. Participant confidentiality was ensured throughout the study.