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Creating a Culture of Quality Improvement Los Angeles County Department of Public Health Division of Quality Improvement.

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Presentation on theme: "Creating a Culture of Quality Improvement Los Angeles County Department of Public Health Division of Quality Improvement."— Presentation transcript:

1 Creating a Culture of Quality Improvement Los Angeles County Department of Public Health Division of Quality Improvement

2 Goal #1: Develop an understanding of what Quality looks like in Public Health 2

3 Quality in Public Health is… The degree to which policies, programs, services, and research for the population increase the desired health outcomes and conditions in which the population can be healthy -PHQF,

4 Quality at LACDPH Quality is the result of Worthy Work Well Done Worthy= We must have a clear direction (Strategic Plan) Work= Our work should have an intelligent direction based on evidence and best practices. Well Done= Our work should be carried out by a skilled and competent workforce and measured to track our performance. 4

5 Goal 2: Develop a clear understanding of Quality Improvement and why it is necessary 5

6 Quality Improvement Quality Improvement (QI) is an integrative process that links knowledge, structures, processes and outcomes to enhance quality throughout an organization. -National Committee for Quality Assurance 6

7 Why QI? In a time of decreased funding and increased demand, QI can help answer key questions in public health: –Are we using our resources (staff, money, time) in the best way? We often hear “work smarter, not harder” –Are we getting the intended outcomes? 7

8 Are we actually improving the health of the public in the most effective and efficient way possible? And if not, how can we do it better? 8

9 QA & QI -They are not the same!!! Quality Assurance: Reactive; works on problems after they occur Regulatory Led by management One point at a time Quality Improvement: Proactive – works on processes before problems occur Self-determined Led by staff Continuous Exceeds expectations 9 Source: Public Health Foundation

10 3 Levels of Quality Improvement 10 TopicOrganization-LevelProgram-LevelIndividual-Level Improvement System FocusSpecific project focusDaily work level focus Quality Improvement Planning Tied to the Strategic Plan Performance Measures tied to program-level Strategic Plan Tied to yearly individual performance Evaluation of Quality Responsiveness to a community need Performance of a process over time Performance of daily work Processes Cut across all programs and activities Delivery of a serviceDaily work Quality Improvement Goals Strategic PlanIndividual Program level Strategic Plans Individual Performance Evaluations

11 Importance of Quality Improvement Quality Improvement positions an agency to achieve: o Customer satisfaction o Efficient use of resources o Measurable outcomes o Community impact 11

12 Goal #3 Connect staff with the benefits of Quality 12

13 Quality in Public Health Benefits Everyone Customers/Clients Employees The Organization 13

14 Benefits of quality to clients Improved services Improved choices Expectations met or exceeded Client oriented employees Friendlier atmosphere 14

15 Benefits of quality to employees Pride in services delivered Job satisfaction Improved communications Streamlined work processes Happier clients Strong client relationships 15

16 Benefits of quality to the organization Improved/expanded services Client oriented employees Improved client relations Improved community relations = better political relations Lower costs/cost contained Improved funding 16

17 Goal #4 Develop a clear structure and framework for quality management 17

18 Continuous Quality Improvement Efforts 18

19 Determine Priorities and Goals 1.What are the healthy behaviors and outcomes we want for people who live in LA County? 2.What would these conditions look like if we could see them?SPA/Program Strategic Plan Strategic Plan DPH Strategic Plan County Strategic Plan

20 Performance Measures 20

21 Results Based Accountability AND Public Health Measures POPULATION INDICATORS (measures of population-level health outcomes) PERFORMANCE MEASURES (measures of program effort and output)

22 Population Indicators Longer life span Increased quality of life Increased health equity Less disease Less premature death Healthier choices Safer environment Healthier homes POPULATION-LEVEL HEALTH OUTCOMES & BEHAVIORS

23 Population Indicators Percent of students who had at least one drink of alcohol in the past 30 days Rate of foodborne illness hospitalizations each year (per 100,000) Percentage of children covered by health insurance Death rate from colorectal cancer

24 Performance Measures Policies Created People Informed Improved Behaviors Surveillance Performed Investigations Completed Increased Access to Services Client satisfaction MEASURES OF PROGRAM EFFORT & OUTPUT

25 Performance Measures Percent of outbreaks (excluding scabies) investigated within standard timeframe Percentage of children under 6 years who participate in fully operational population- based [immunization] registries Number of cities that adopted a policy that prohibits smoking in outdoor areas

26 Reporting of Progress 26

27 Performance Improvement Process 27

28 28

29 Who Manages Quality at DPH? 29

30 Who Manages Quality at DPH Everyone Plays a Role in Quality Management: Director of Public Health Division of Quality Improvement Strategic Directions Council Executive Team Performance Improvement Team Program Directors Managers/Supervisors All Staff 30

31 In order to establish a lasting culture of Quality, you must: Have a clear direction of what quality should look like in your organization Understand Quality 31

32 Goal #5: Clearly communicate your Quality Improvement plan and efforts throughout the organization 32

33 Step 1: Create a Quality Improvement Program Description Document –Give an overview of Quality at the organization –Describe the structure for managing quality throughout the organization –Establish roles and responsibilities for all levels of staff in relationship to Quality Improvement efforts. –List and describe the organization’s QI efforts –Establish QI goals for the organization 33

34 Step 2: Train staff Introduction to Quality Improvement for all employees Incorporate QI into existing trainings Conduct orientation sessions to orient staff to the QI Plan Provide advanced QI training to prepare staff to conduct quality improvement projects 34

35 Step 3: Provide Support Technical Assistance 1:1 Consultation Presentations at program-level meetings 35

36 Summary In order to establish a culture of quality, you must first decide what quality in your organization will look like and communicate that vision to others The structure and process for quality improvement should be visible and easily understood by everyone in the organization Buy-in and support at all levels is essential to successfully establishing a culture of Quality 36

37 Thank you! Emily Peach, MPH, CHES Performance Improvement Manager Quality Improvement Division (213)


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