1. Increase % of staff in upper stages of NACCHO’s QI culture framework Use findings to refine QI strategy Design QI culture survey and conduct survey periodically Use as reference NACCHO’s QI culture framework Alvaro M Tinajero, MD, MPH, ScM, Center for Health Data and Analysis; Magaly Angeloni, DrPH, Performance Improvement and Accreditation Program Quality Improvement does every body good Assessing HEALTH’s Quality Improvement Culture Domain 9 Evaluate & improve health department processes, programs and interventions By March 2015: increase the number of questions (from none to 16) for an QI annual survey, determine the proportion of staff in each one of the phases 1-6 of NACCHO’s QI culture framework, and establish baseline for monitoring progress PLAN: Find Opportunity for Conducting Periodic Assessments of QI Progress In 2012, the Rhode Island Department of Health (HEALTH) introduced a quality improvement (QI) initiative and since then has applied for national accreditation through the Public Health Accreditation Board (PHAB). In the same year, HEALTH started training its workforce in QI tools and methods. Trainees identify a program performance issue and then develop and complete an outcomes-based QI project eight-ten months after training completion. Public health agencies are required to develop and cultivate a culture of quality improvement (QI). A staff survey is one of HEALTH’s strategies to track institutional QI progress. What is the problem? There is currently no mechanism to determine where HEALTH is –as an organization- along the process towards a culture of quality improvement. Why a survey about QI? Most cost-effective and quick way to obtain information Can be repeated periodically for year comparisons What information is needed? Staff characteristics (time at HEALTH, position title, primary work area) QI awareness, knowledge/skills, attitudes and practices How future trainings and QI activities can be better targeted and planned QI is now a recognized term and concept at HEALTH Predominant view is that QI represents a means to improve individual and team work Every three in ten employees have QI knowledge/ skills and 1 in 11 has experience as QI trainer About half the staff with knowledge about QI tools and methods received training from source other than HEALTH All HEALTH staff needs to go through QI training to learn QI skills and build QI internal networks Training refreshers may enhance the QI process Approximately, half of HEALTH’s staff has been involved at least once in activities that use QI tools and methods The QI initiative needs to be continuously assessed and refined Continuous and consistent work and leadership’s support are required to build a QI culture HEALTH’s QI is an useful tool for conducting QI culture determinations and will be used annually AIM Statement ACT: Improvement Theory IF… THEN… ACT: Lessons Learned So Far STUDY: Barriers to a QI Culture STUDY: Current QI Culture at HEALTH DO: Study Design and Implementation A 16-item questionnaire was developed based on the National Association of County and City Health Officials’ (NACCHO) QI Culture Framework. The framework describes organizational characteristics for each of six phases towards this goal, from agencies with no QI knowledge or practice to those with fully integrated performance management systems. The survey addressed individual (QI awareness, perceptions, knowledge/skills, use of data, performance management practices) and agency-level (training and sources, staff/time allocation to QI activities) characteristics. Survey were piloted from mid-December 2014 to mid-January 2015. HEALTH staff was surveyed via Survey Monkey during the first three weeks of February 2015. Response rate was 46% (209 out of 450).