Creating quality improvement culture in public health agencies

M.V. Davis, E. Mahanna, B. Joly, M. Zelek, W. Riley, P. Verma and J.S. Fisher

American Journal of Public Health, 2014, vol. 104, issue 1, e98-e104

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.

Keywords: article; health services research; human; interview; organization; public health; qualitative research; standard; total quality management; United States; public health; standards, Humans; Interviews as Topic; Organizational Case Studies; Organizational Culture; Organizational Innovation; Public Health; Qualitative Research; Quality Improvement; United States, Humans; Interviews as Topic; Organizational Case Studies; Organizational Culture; Organizational Innovation; Public Health; Qualitative Research; Quality Improvement; United States (search for similar items in EconPapers)
Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301413_3

DOI: 10.2105/AJPH.2013.301413

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