It has been a busy year for our Public Health Foundation (PHF) experts who deliver Performance Improvement (PI) Services in performance management, quality improvement (QI), and workforce development. They covered a lot of ground, providing customized on-site technical assistance (TA) and training in 28 states to help build capacity and strengthen public health practice among professionals from 131 health departments.

 
What's Trending? Our experts responded to TA and training needs in more than half of states. The popularity of on-site service topics reflects a focus on public health accreditation as well as dramatic changes to the health care delivery system. In addition to QI training, popular technical assistance topics include aligning accreditation plans, using population health driver diagrams, and leadership and change management. The figure below summarizes health departments’ use of PI Services over a recent 12-month period.

Accreditation has been a major focus of our PI Services in the past several years, and it's paying off; 25% of health departments accredited by the Public Health Accreditation Board (PHAB) as of August 2015 received PHF on-site services prior to being accredited. PHF's accreditation preparation support focuses primarily on Domains 8 and 9, but also includes cross-cutting resources and services.

The public health and healthcare sectors are collaborating to identify both the drivers of positive change and the strategies for achieving health improvement goals. PHF uses population health driver diagrams to inform cooperative mapping of primary and secondary drivers, and improvement planning among diverse community partners. The number of PHF clients who built upon population health driver diagrams increased dramatically over the past year, comprising one in eight services PHF delivered. Scott Meador from the Tulsa (Oklahoma) Health Department, one of 15 sites participating in a vector control program that was informed by a population health driver diagram, said, "because of our participation in the vector control project, we discovered our capacity could be greatly expanded with minimal changes to our program, and these improvements were made possible with our new partnership with PHF."

The Impact. Health departments tell us that the value of PHF's PI Services is significant, practical, and long-lasting, and they credit our experts with setting a tone of excellence. Ty Kane, former Accreditation Coordinator at the Sedgwick County (Kansas) Health Department, reflected that, "The PHAB Site Visit Team cited ‘Evidence of QI Culture’ as a strength, noting the commitment of newer and older employees to QI, employee empowerment to lead QI initiatives, and the focus on customer service, and teamwork. These observations are a direct result of our partnership with Jack Moran and PHF."

From the Frederick County (Maryland) Health Department, Monica Grant reported a similar result: "PHAB cited our use of data informed decision-making and the intentional use of the QI tools as evidence of our strong commitment to quality improvement. Thanks again for setting us on the right path."

The interactive aspects of our approach resonate well with adult learners, as noted by Jason Menchhofer, Environmental Health Director at the Van Wert County (Ohio) Health Department. He shared, "It was great to have so many opportunities for hands-on work that we can actually bring back and use. It was exactly what I had hoped for, and [PHF] delivered it very well."

Finding Funds. Health departments have used creative delivery formats and funding streams to make PHF's services available to their teams and community partners. Delivery options that can expand access to larger audiences include:

• Scheduling regional workshops to train staff from multiple locations across a large geographic area
• Delivering a single service to dozens of local health department representatives during meetings of the state public health association (SPHA) or the state association of county and city health officials (SACCHO) 

Health departments have used a variety of funding options to reduce the burden on their own general funds. These include:

• CDC grant resources, such as the Preventive Health and Health Services (PHHS) Block Grant, Partnerships to Improve Community Health (PICH), Racial and Ethnic Approaches to Community Health (REACH), and ongoing CDC Funding Opportunity Announcements (FOAs)
• Splitting costs across multiple health departments to address common challenges and build similar capacity
• Event sponsored by the SACCHO or SPHA
• Grants from national partner organizations, such as the National Association of County and City Health Officials
• Events sponsored by schools and programs of public health, health professional schools, and other universities and colleges, perhaps as part of an Academic Health Department partnership

Patricia Zerounian, Accreditation Coordinator at the Monterey County (California) Health Department, described the momentum and QI culture growth in her agency: “With PHF’s technical assistance, we trained 103 staff members in QI practices over the past year and now have 24 QI projects underway. We’ve excelled beyond our expectations and have already contracted with PHF to train another 50-60 staff this year.”

I am excited to see health departments all over the country continuing to pursue PI activities and relying on our experts to help them overcome both longstanding and emerging challenges in order to improve the public's health.

Are you seeing the same TA and training needs for your staff? Have you found a way to fund PI services in your organization? Tell us about your experiences by leaving a comment in the section below.

Ready to make PHF a part of your health department's success?
PHF is ready to assist. Contact Margie Beaudry at (202)218-4415 or [email protected]. You can also submit your information online.