QUALITY IMPROVEMENT
IN
NORTH CAROLINA PUBLIC HEALTH DEPARTMENTS
In 2002, the North Carolina Division of Public Health and the North Carolina Association of Local Health Directors undertook an initiative to develop a mandatory, standards-based system for accrediting local public health departments throughout the state.
The focus of North Carolina’s Local Health Department Accreditation (NCLHDA) is on the capacity of the local health department to perform at a prescribed, basic level of quality the three core functions of assessment, assurance, and policy development and the ten essential services as detailed in the National Public Health Performance Standards Program. The program focuses on a set of minimal standards that must be provided to ensure the protection of the health of the public, but does not limit the services or activities an agency may provide to address specific local needs. NCLHDA does not create a wholly new accountability system; rather it links basic standards to current state statutes and administrative code, and the Division of Public Health and Division of Environmental Health contractual and program monitoring requirements that are already in place.
In order to support the “basic level of quality” required under NCLHDA, local health departments must evaluate the effectiveness, accessibility and quality of personal and population-based health services in achieving desired outcomes. NCLHDA requires local health departments to employ a quality assurance and improvement process to assess the effectiveness of services and improve health outcomes. Local health departments in NC must develop quality assurance/quality improvement policies and procedures and provide evidence an improvement process is implemented by conducting at least two improvements as a result of the agency’s quality improvement plan activities per accreditation.
In order to meet this accreditation activity, Local Health Departments across North Carolina have access to technical assistance, training and consultation services provided within DHHS via Local Technical Assistance, and Training Branch, Public Health Nursing and Professional Development (PHN&PD) Nursing Consultants and the North Carolina Center for Public Health Quality. PHN&PD Nursing Consultants are available to assist local health departments in developing and implementing a quality improvement plan. The North Carolina Center for Public Health Quality (NC CPHQ), a public-private partnership between the North Carolina Public Health Foundation (NCPHF) and the North Carolina Division of Public Health, collaborates with state and local partners to provide training in quality improvement (QI) methods and tools and develops, leads, and supports strategic QI initiatives for the Division of Public Health and local public health agencies in North Carolina.
NC CPHQ offers the Public Health Quality Improvement 101 (PH QI 101) program, an interactive learning experience designed to help local health departmentsimprove the quality of the services they provide to theircommunities. Participants use the Model for Improvement and Lean principles and tools to improve a specific area within their local agency, while receiving individualized coaching from experienced program faculty. The overall objectives of the program are to help participants:
· Understand, select, and use QI methods and tools in their daily activities to improve the efficiency and effectiveness of services provided within their agency as well as population health outcomes;
· Coach others within their local setting to use QI methods and tools;
· Develop a plan to incorporate QI methods and tools within their local agency so that it becomes “the way we do business.”
If you would like more information on quality improvement or would like technical assistance and consultation related to quality improvement, please contact your DPH Public Health Nursing Consultant (see the link to the Consultants’ Maps). If you are interested in more information about the NC Center for Public Health Quality, please visit them at:
www.ncpublichealthquality.org