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Advancing the public health workforce to achieve organizational excellence
Assessing, Improving, and Evaluating Unregulated Drinking Water Programs

Date: 10/10/2017 9:05 AM

Related Categories: Quality Improvement

Topic: Performance Management and Quality Improvement

Tag: Accreditation, Case Example, Centers for Disease Control and Prevention (CDC), Community Health Improvement Plan, Environmental Health, Partnerships, Quality Improvement, Water Quality

Approximately 13% of U.S. Households, or about 43 million people, use drinking water systems and sources that are not covered by the federal Safe Drinking Water Act1. These systems are primarily private wells but may also include springs, cisterns, and hauled water systems. Most private well programs are voluntary and require strong outreach activities to encourage well owners to monitor the safety of their drinking water, accept water program services and training offered by government agencies.

The Centers for Disease Control and Prevention (CDC) has addressed this ongoing need with cooperative agreement awards to 14 state and five local health departments. In addition to funding these health departments, CDC partnered with the Public Health Foundation (PHF) to provide quality improvement (QI) technical assistance and training to plan and initiate improvement activities. Technical assistance and training is also available to other environmental health programs through PHF’s Performance Improvement Services. QI has been used previously to address drinking water needs, including raising community awareness and improving customer satisfaction.





 Mouse near an open well cap (courtesy of Madison County (NY)

PHF and CDC have worked with grantees to assess their current programs and create plans to improve their programs, develop, track, and evaluate metrics for improvement, and deliver tools to assess customer satisfaction and service delivery. Following are short stories about three of the grantees and their accomplishments through 2017:
  • Indiana State Department of Health Environmental Public Health Division created a Gantt Chart that was used to help decipher critical vs. non-critical activities, track metrics, and conduct short, medium, and long-term planning.
  • Tacoma-Pierce County (WA) Health Department Drinking Water Program used, and continues to use, a Plan-Do-Check-Act approach to document and assess their standard operating procedures. They created over 40 flow charts, solicited feedback from staff and customers on their processes, and reduced the number and amount of steps in their processes.
  • Tennessee Department of Health (TDH) has been addressing spring water quality by offering spring water testing to residents in a county pilot program, with statewide GIS mapping of drinking water sources, and through atypical partnerships with organizations that are frequently out in the community – such as the state parks and natural area programs, and Communities Unlimited, Inc., a part of the Rural Community Assistance Program.

For more information about this initiative or to share how QI has been helpful for your environmental health program, contact Vanessa Lamers at or (202) 218-4412.



Related Resources



1National Groundwater Association (NGWA). 2016. Groundwater use in the United States of America. Westerville OH: NGWA.


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