Public Health Foundation: Getting Started

Performance Management & Quality Improvement Resources

Getting Started

If you're ready to focus on results and unleash the quality you know your team can deliver, you have come to the right place! Where to start depends on what you want to do. Watch a 5 minute tutorial on finding QI information through our resource center. (Takes a minute to load.)

Innovative Solutions.
Measurable Results.

What do you want to do?

Learn more about performance management or QI techniques.
Generate team interest in performance and quality.
Use QI methods to solve a problem, improve quality, or get better results in a specific area.
Manage performance in your program or unit, or among its contractors.
Conduct audits or site visits to verify that systems and processes conform to standards, are effective and continually improve.
Manage performance throughout your entire organization or "public health system."
Sustain momentum for QI in your public health system.

If your goal is to...	To start, you can...	Here's how:

1. Learn more about performance management or QI techniques.	Create on-site learning opportunities for you or your staff Get involved in professional associations and networks devoted to quality, where you can learn from other government, service, healthcare, or business groups Attend a course or seminar Self-study online concepts and current practices in public health	Convene "lunch and learn" or team meetings to discuss a performance management DVD or a case example Request a PHF seminar Attend QI or performance management conferences Find courses on TRAIN Browse the "Getting Started" toolkit resources Explore basic concepts (ASQ) Join the American Society for Quality and local sections Learn about metrics, sampling and statistical control (ASQ) to manage performance Sign up for PHF's "Improving Performance" newsletter

2. Generate team interest in performance and quality.	Demonstrate leadership support Share and discuss public health case examples with your team Pilot small QI projects in 1-2 areas, then spread them	Complete the Performance Management Self-Assessment with leaders Make the case for quality with leaders; share the PHF brief and ASQ white paper Engage teams in discussion questions on case examples Follow the approach of the Orange County Health Department to empower employees and start small

3. Use QI methods to solve a problem, improve quality, or get better results in a specific area. You need to achieve a project objective (enroll more clients, increase restaurant compliance) or fix a task or process gone awry (reduce lab report errors, reduce time to issue alerts).	Organize a team for performance improvement Prioritize areas for action Explore "root causes" of performance issues Develop and implement improvement plans Regularly monitor and report progress	Find QI methods and tools online Equip your team with the Public Health Memory Jogger II Use the Plan-Do-Check-Act model, as described in the National Public Health Performance Standards (NPHPSP) User Guide Use relevant program standards to set targets Review evidence-based resources for ways to improve Employ benchmarking (ASQ) to achieve best practices

4. Manage performance in your program or unit, or among its contractors. You want to focus on results and meet quality standards in a division or program such as STD, environmental health, policy development, clinical services, or health education.	Identify gaps in the way you manage performance now, as well as the "root causes" (so you fix only what needs fixing) Involve staff or vendors to identify performance measures that align with priorities, relevant standards, and requirements Create or designate a group to steer improvements Check early whether the new system makes a difference Secure leadership support	Take the Performance Management Self-Assessment Review how New Hampshire easily selected measures for programs and contractors Base measures on national performance standards Check out the Guidebook for Performance Measurement and examples of public health measures

5. Conduct audits or site visits to verify that systems and processes conform to standards, are effective, and continually improve.	Recruit knowledgeable peers who can assess performance and spread best practices Offer pre-audits or self-assessment tools Re-engineer site visits to focus on quality improvement Provide training in auditing methods Learn how other industries audit process or system requirements	Find how Florida used peer reviewers for QI Learn how North Carolina and Missouri use site visits and self-assessments for accreditation See how New Hampshire focused program visits on QI Use a checklist of strategies to build QI into accreditation Build staff knowledge based on the Certified Quality Auditor (CQA) competencies Read the ASQ Auditing Handbook in other industries Join the ASQ Audit Division

6. Manage performance throughout your entire organization or "public health system." You want to drive better results in everything from health outcomes and preparedness to your workforce and financial systems.	Identify the gaps in the way you manage performance now, as well as their "root causes" Craft a short set of performance measures (a "dashboard") aligned with your mission and priorities Designate a group to steer improvements Work with a few units to tie their unit and employee performance measures to the organization's Check early whether the new systems make a difference	Take the Performance Management Self-Assessment Assess system performance using the National Standards Read From Silos to Systems (Turning Point) for public health adaptations of the Baldrige criteria & Balanced Scorecard Compare other popular organization-wide approaches (ASQ) Select options on organizing for performance improvement from the NPHPSP User Guide Review how Florida and South Carolina approached performance management Read how Missouri and other states built accreditation initiatives Get ideas from the "Getting Started" toolkit resources Search tools for specific needs

7. Sustain momentum for QI in your public health system	Form a Quality Improvement Collaborative to involve multiple sites or partners in creating measurable change Regularly report progress in tandem with relevant, priority health indicators Feed improvement efforts into larger public health initiatives Assign staff to support teams and spread success	Read about IHI's Breakthrough Series Collaborative model and how public health groups have used it to save lives Use the tips on reporting progress in the NPHPSP User Guide Use the MAPP model and tools to sustain community efforts Brush up on managing teams and models to spread change


General Resources
	IHI - PHF Public Health Page - PHF has partnered with the Institute for Healthcare Improvement (IHI) to create a public health page on IHI's site. This page provides access to a special collection of resources and content from IHI's work in health care quality improvement that can help public health leaders and staff bring quality improvement to their programs and organizations. This page was made possible by a PHF grant from the National Library of Medicine (NLM) as part of the Partners for Information Access project.

	American Society for Quality: Basic Concepts - The American Society for Quality (ASQ) offers this webpage explaining basic terms and concepts in quality improvement. The section includes links to case examples from a variety of industries and other ASQ resources to get started with improvement processes.

	Institute for Healthcare Improvement: How to Improve - This Institute for Healthcare Improvement (IHI) section covers how to improve, featuring an explanation of the Plan-Do-Study-Act (PDSA, also called Plan-Do-Check-Act or PDCA) cycle. Tools on the site include downloadable PDSA worksheets and project planning forms to get your quality improvement project started.

	Making the Economic Case for Quality - This white paper from the American Society for Quality (ASQ) reviews what is known from a variety of industries (business, education, government, etc.) about the economic impact of an organizational focus on quality and quality improvement. According to the author, "The review reveals an impact of quality management practice on almost every area of organizational performance, including bottom-line measures, market measures, and internal operating measures. It clearly reinforces the conviction that quality does pay." The paper also addresses gaps in the quality literature and questions raised by critics.

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This page was last edited on Dec 02, 2009.