Quality Improvement & Performance Management
Need technical assistance? The MDH Center for Public Health Practice can help: Help and Technical Assistance Available to Local and Tribal Public Health.
What is Quality Improvement?
Quality improvement (QI) is the use of a deliberate and defined improvement process and the continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality that improve the health of the community.
- What are we trying to accomplish?
- How will we know the change is an improvement?
- What changes can we make that will result in an improvement?
Guiding principles of QI: develop a strong customer focus, continually improve all processes, involve employees, mobilize both data and team knowledge to improve decision making.
What is Performance Management?
Performance management uses data for decision-making, by setting objectives, measuring and reporting progress toward those objectives, and engaging in quality improvement activities when desired progress toward those objectives is not being made.
The MDH performance management cycle (above) can help you walk through using performance management to, for example, monitor and revise your community health improvement plan.
- Results and Standards: Where do we want to be? Strong community health improvement plans have clear goals and SMART objectives.
- Measurement: How will we know? Community health improvement plans require measurement to monitor progress.
- Monitoring & Communicating Progress: How well are we doing? Community health boards should monitor their plans, document progress, and communicate with stakeholders to monitor progress.
- Quality Improvement: How will we improve? Change course as needed, based on monitoring progress.
Customer Focus: Customer focus addresses how an organization listens to the voice of its customers, builds customer relationships, determines their satisfaction, and uses customer information to improve and identify opportunities for innovation or improvement.
Public Health and QI Toolbox: MDH has compiled nearly 40 quality improvement tools, giving step-by-step instructions on using each tool to assess a situation, make a decision, and plan a project.
QI Projects: The Public Health Quality Improvement Exchange, or PHQIX, hosts a number of quality improvement projects from local health departments in Minnesota. If you would like to explore projects completed by your neighbors, or have a project of your own to submit, visit: PHQIX: Public Health Quality Improvement Exchange [non-MDH site].
Training and Webinars: QI and Performance Management: The MDH Center for Public Health Practice hosts a number of online and in-person training and technical assistance sessions throughout the year, on topics like assessment and planning, QI and performance management, reporting, and more.
More QI Resources
Email Lists and Newsletters
- NNPHI Newsletter Subscription Request Form, National Network of Public Health Institutes (NNPHI)
- PHAB Newsletters, Public Health Accreditation Board (PHAB)
- PHQIX Quality Matters Newsletter Archive, PHQIX
- Clear Impact Email Signup (formerly Results-Based Accountability)
- Welcome to the Minnesota Office of Continuous Improvement!, Minnesota Office of Continuous Improvement (scroll to "Subscribe to our CI newsletter")
Webinars and Training
- Model For Improvement Clip 1 (2:54), Institute for Healthcare Improvement
- Model For Improvement Clip 2 (3:00), Institute for Healthcare Improvement
- Whiteboard: PDSA in Everyday Life (4:45), Institute for Healthcare Improvement
- Whiteboard: The PDSA Cycle (Part 2) (3:48), Institute for Healthcare Improvement
- Mike Davidge on Measurement for Improvement (9:52), NHS Institute for Innovation and Improvement
- ASQ (American Society for Quality): ASQ is a global community of people dedicated to quality who share the ideas and tools that make our world work better. ASQ provides the quality community with training, professional certifications, and knowledge to a vast network of members of the global quality community.
- Centers for Disease Control and Prevention: National Public Health Performance Standards (NPHPS): NPHPS helps health departments identify areas for system improvement and strengthen state and local partnerships.
- Institute for Healthcare Improvement (IHI): Resources: IHI, an independent not-for-profit organization based in Cambridge, Massachusetts, is a leading innovator, convener, partner, and driver of results in health and health care improvement worldwide.
- Michigan Public Health Institute Office of Accreditation and Quality Improvement: The Office of Accreditation and Quality Improvement is dedicated to working with public health agencies and other organizations to help them implement best practices in quality improvement (QI) and translate current QI research into practice through training, technical assistance, and project consultation and management. (Formerly Michigan Local Public Health Accreditation Program.)
- Performance Excellence Network (PEN): To help you achieve your goals and navigate your way to excellence, the Performance Excellence Network is your GPS—your navigation tool for guiding you through the options available and making your passage to achieve excellence as direct as possible. (Founded as Minnesota Council for Quality)
- National Association of County and City Health Officials (NACCHO): Quality Improvement: NACCHO's members are the 2700 local health departments across the United States. NACCHO's vision is health, equity, and security for all people in their communities through public health policies and services.
- National Network of Public Health Institutes (NNPHI): Public Health Performance Improvement Network (phPIN): The Public Health Performance Improvement Network (phPIN) is a learning community and peer exchange network for those of you providing leadership in performance improvement in public health. phPIN offers a forum for innovative performance improvement practitioners in public health to network, access just-in-time resources, and share emerging practices on the topics of most interest to you:
- PHQIX: Public Health Quality Improvement Exchange: An online community designed to be a communication hub for public health professionals interested in learning and sharing information about quality improvement (QI) in public health.
- Public Health Foundation: Performance Management and Quality Improvement: The Public Health Foundation, a private, non-profit, 501(c)3 organization based in Washington, DC, improves the public's health by strengthening the quality and performance of public health practice.
- USAID Assist Project: The objective of the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project is to improve the quality and outcomes of health care and other services by enabling host country providers and managers to apply the science of improvement.
- Washington State Department of Health: Continuous Improvement: Our programs and services help prevent illness and injury, promote healthy places to live and work, provide education to help people make good health decisions and ensure our state is prepared for emergencies.
Performance Management Resources
- Balanced Scorecard Institute
- Balanced Scorecard (3:59) (note: video will autoplay), Intrafocus
- Baldrige Performance Excellence Program, National Institute of Standards and Technology (NIST)
- Performance Management and Quality Improvement, Centers for Disease Control and Prevention (CDC)
- Access the Performance Management Self-Assessment, Public Health Foundation
- Performance & Quality Improvement, National Network of Public Health Institutes (NNPHI)
- Detailed Crosswalk of 2011-12 Malcolm Baldrige Criteria to PHAB Measures (PDF), Supported by Robert Wood Johnson Foundation
- Performance Management Tools and Resources, Washington State Department of Health
- Fiscal Policy Studies Institute
Examples of Performance Management Policies
- Performance Management at MDH (PDF), MDH Health Partnerships Division
- Agency Performance Management (PDF), Minnesota Dept. of Health
- Flathead City-County Health Department: Performance Management System (PDF), Flathead City-County Health Department (MT)
- Norwalk Health Department Policies and Prcoedures: Performance Management System (PDF), Norwalk Health Department (CT)
- Deschutes County Health Services: Quality Management Policy - Public Health (PDF), Deschutes County Health Services (OR)
- Performance Management Primer, Michigan Public Health Institute Office of Accreditation and Quality Improvement
- Welcome to Embracing Quality in Public Health: A Practitioner's Performance Management Primer, Michigan Public Health Institute Office of Accreditation and Quality Improvement
- Roadmap to a Culture of Quality Improvement, National Association for City and County Health Officials (NACCHO)
- Guide to Communicating about Performance Improvement (PDF), NACCHO
Developing QI Plans
- Characteristics of a Good Quality Improvement Plan (PDF), MDH Public Health Practice Section
- Quality Improvement Plan (PDF), MDH Public Health Practice Section
- Developing a Health Department Quality Improvement Plan, Public Health Foundation
- Quality Improvement (QI) Plan Toolkit, Association of State and Territorial Health Officials (ASTHO)
Examples of QI Council Charters
- Kitsap Public Health District Quality Council Charter 2-1-2011 (PDF), Kitsap Public Health District (WA)
- Fillmore-Houston Community Health Service Quality Improvement Council Charter (PDF), Fillmore and Houston Counties (MN)
- Kandiyohi County Public Health Quality Council Charter (PDF), Kandiyohi County Public Health (MN)