Introducing quality improvement methods into local public health departments: structured evaluation of a statewide pilot project.
OBJECTIVE
To test the feasibility and assess the preliminary impact of a unique statewide quality improvement (QI) training program designed for public health departments.


METHODS
One hundred and ninety-five public health employees/managers from 38 local health departments throughout Minnesota were selected to participate in a newly developed QI training program and 65 of those engaged in and completed eight expert-supported QI projects over a period of 10 months from June 2007 through March 2008.


METHODS
As part of the Minnesota Quality Improvement Initiative, a structured distance education QI training program was designed and deployed in a first large-scale pilot. To evaluate the preliminary impact of the program, a mixed-method evaluation design was used based on four dimensions: learner reaction, knowledge, intention to apply, and preliminary outcomes.


METHODS
Subjective ratings of three dimensions of training quality were collected from participants after each of the scheduled learning sessions. Pre- and post-QI project surveys were administered to collect participant reactions, knowledge, future intention to apply learning, and perceived outcomes. Monthly and final QI project reports were collected to further inform success and preliminary outcomes of the projects.


RESULTS
The participants reported (1) high levels of satisfaction with the training sessions, (2) increased perception of the relevance of the QI techniques, (3) increased perceived knowledge of all specific QI methods and techniques, (4) increased confidence in applying QI techniques on future projects, (5) increased intention to apply techniques on future QI projects, and (6) high perceived success of, and satisfaction with, the projects. Finally, preliminary outcomes data show moderate to large improvements in quality and/or efficiency for six out of eight projects.


CONCLUSIONS
QI methods and techniques can be successfully implemented in local public health agencies on a statewide basis using the collaborative model through distance training and expert facilitation. This unique training can improve both core and support processes and lead to favorable staff reactions, increased knowledge, and improved health outcomes. The program can be further improved and deployed and holds great promise to facilitate the successful dissemination of proven QI methods throughout local public health departments.
Riley
William
W
University of Minnesota, School of Public Health, Minneapolis, MN 55455, USA. Riley001@umn.edu
Parsons
Helen
H
McCoy
Kim
K
Burns
Debra
D
Anderson
Donna
D
Lee
Suhna
S
Sainfort
François
F
D020375:Education, Distance; D005240:Feasibility Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training; D008910:Minnesota; D010865:Pilot Projects; D011635:Public Health Administration; D015980:Public Health Practice; D017749:Total Quality Management
Am J Prev Med. 2007 Aug;33(2):169-71
17673106
Jt Comm J Qual Saf. 2003 Feb;29(2):85-93
12616923
J Public Health Manag Pract. 2004 May-Jun;10(3):186-92
15253514
J Public Health Manag Pract. 2007 Jul-Aug;13(4):342-8
17563621
J Public Health Manag Pract. 2002 Jan;8(1):1-5
11789031
Am J Public Health. 2004 Jun;94(6):1019-26
15249309
Annu Rev Public Health. 2007;28:19-31
17201687
Front Health Serv Manage. 2006 Spring;22(3):23-9; discussion 41-4
16604901
J Public Health Manag Pract. 2007 Jul-Aug;13(4):427-9
17563634
Am J Public Health. 2006 Mar;96(3):410-3
16449601
J Public Health Manag Pract. 2008 Mar-Apr;14(2):150-4
18287921
Health Care Manage Rev. 2007 Oct-Dec;32(4):309-20
18075440
BMJ. 2008 Jun 28;336(7659):1491-4
18577559