title: Realizing transformational change through quality improvement in public health.
abstract: OBJECTIVE
  This article discusses the specific components necessary to achieve transformational change within public health departments as a means for creating sustained performance improvement and better outcomes in the health of the community.
  
  
  METHODS
  This article provides a review of transformation change concepts and application to public health departments.
  
  
  RESULTS
  Transformational change for public health departments must be intentionally designed to achieve high performance. While all improvement requires change, not all change results in improvement.
  
  
  CONCLUSIONS
  The successful transformational change effort always occurs from the top-down, while the process improvement occurs from the bottom-up. Transformational change is possible in public health departments when small incremental improvements are linked with large-scale management changes to continually improve public health performance resulting in better population outcomes.
authors.affiliation: School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA. riley001@umn.edu
authors.forename: William J
authors.initials: WJ
authors.lastname: Riley
authors.forename: Helen M
authors.initials: HM
authors.lastname: Parsons
authors.forename: Grace L
authors.initials: GL
authors.lastname: Duffy
authors.forename: John W
authors.initials: JW
authors.lastname: Moran
authors.forename: Brenda
authors.initials: B
authors.lastname: Henry
mesh_terms: D015279:Organizational Culture; D017063:Outcome Assessment, Health Care; D011634:Public Health / Q000592:standards* / Q000639:trends*; D058996:Quality Improvement