Partnering for Systems Improvement: The Role of Public Health Institutes

1

• Partnering for Systems Improvement The Role of
  Public Health Institutes
• in Quality Improvement and Accreditation

Call in Number [phone] Code 3019823
December 4, 2008
2

• Please mute your line by
• pressing 6
• You can un-mute your line by
• pressing 7
• Do not put your phone
• on hold.

3

• Partnering for Systems Improvement The Role of
  Public Health Institutes
• in Quality Improvement and Accreditation
• December 4, 2008

4
Background on NNPHI

• Established in 2001 to enhance the capacity of
  the nations public health institutes
• Vision Fostering Innovations in Health
• Mission To promote multi-sector activities
  resulting in measurable improvements of public
  health structures, systems and outcomes

5
NNPHI Members
visit www.nnphi.org for links to members websites

6
Attributes of PHIs

• Complement governmental public health system
• Convene multi-sector partners
• Support health systems change and improvement
• Source of reliable health information
• Nimble - able to leverage new resources
• Rework boundaries and form creative
• alliances

7
Competencies of Public Health Institutes

• Population-based health programs
• Health policy development
• Training/Technical assistance
• Research and evaluation
• Health informatics
• Fiscal/administrative management
• Social marketing / health communications

8
NNPHI Programs

• Member Services
• Fostering Emerging Institutes
• National Programs (PHLS and NPHPSP)
• Multi-State Projects
• BT Collaborative
• Preparedness Modeling Collaborative
• Multi-State Learning Collaborative Lead States
  in Public Health Quality Improvement

9
Brief History of Accreditation and QI in Public
Health

• 2003 IOM Report called for a national committee
  to examine the benefits of accrediting public
  health departments
• 2005 - 2006 Exploring Accreditation Project
• 2007 Public Health Accreditation Board
  established
• 2011 Projected launch of National Voluntary
  Accreditation Program

10
What is NNPHI doing to support accreditation QI?

• Co-coordinate NPHPSP partnership and promote use
  of NPHPSP
• Manage the Multi-State Learning Collaborative
  Lead States in Public Health Quality Improvement
  Project
• Recently supported Public Health System Research
  Grants on Accreditation

11
Why is NNPHI involved in QI and Accreditation?

• Session at 2005 NNPHI Conference and additional
  collaboration with PHIs identified that PHIs are
  working in partnership with state and local
  public health agencies to support their efforts
  to
• Assess performance
• Prepare for accreditation
• Create a culture of quality improvement

12
How are the institutes partnering and
collaborating with local, state and national
partners to prepare for accreditation and conduct
quality improvement?
13
Supporting Use of NPHPSP

• Institutes in New Hampshire, Maine, Texas and
  Illinois have supported the completion of state
  and local NPHPSP instruments by providing the
  following types of support
• Orientation to public health and the assessment
  process
• Facilitation of assessment and priority setting
  sessions
• Analysis and presentation support
• Assistance in writing public health improvement
  plans

14
Supporting Accreditation Related Efforts

• Illinois
• Kansas
• Florida
• Michigan
• Missouri
• New Hampshire
• North Carolina
• Oklahoma
• Wisconsin

15
Convening stakeholders and building momentum for
accreditation

• Illinois Public Health Institute staffs the
  Illinois Accreditation Task Force (IATF)
• Goal improve the performance of local health
  departments in Illinois through accreditation
  strategies and quality improvement activities.
• IATF Members includes the Departments of Public
  Health and Human Services, SACCHOs, IL
  Association of Boards of Health, UIC, IPHA
• Careful process of building will for
  accreditation at the local and state level

16
Conducting research and evaluation of
accreditation and quality improvement

• Missouri Institute of Community Health
• Annual evaluation of Missouris voluntary
  accreditation program for local health
  departments
• Michigan Public Health Institute
• Research Examining the Costs of Preparing and
  Applying for Accreditation Developing Cost
  Measures
• North Carolina Institute of Public Health
• Evaluation of NC Local Public Health
  Accreditation
• Research on Incentives for Public Health
  Accreditation
• Research on Public Health Quality Improvement
  Initiatives

17
Participating in PHAB Workgroups

• Assessment Process
• Janet Canavese (Missouri)
• David Stone (North Carolina)
• Equivalency
• Rachel Stevens (North Carolina)
• Research and Evaluation
• Mary Davis (North Carolina)
• Laura Landrum (Illinois)

18
Creating tools and resources to help agencies
prepare and conduct QI

• NC Roadmap
• Michigan QI Guidebook

19
Creating a quality improvement culture and field
of practice

• Organizing large and small group QI training
  sessions
• Managing and providing technical assistance for
  QI projects

20
Communicating and Spreading QI Findings

• MPHI and KHI created storyboards that describe
  each step of the QI process
• KHI worked with local partners to share QI
  project findings with policy makers

21
Why is NNPHI involved in QI and Accreditation?
Revisited

• Fits with our strategy to collaborate with
  members and systems partners in effort to advance
  public health
• Feedback/Recommendations for the Exploring
  Accreditation Steering Committee
• NNPHI supports a national voluntary
  accreditation system it the system is able to
  incorporate a strong focus on technical
  assistance supporting continuous quality /
  performance improvement efforts
• Commitment to innovation in health

22
Roles of PHIs in QI and Accreditation

• Examples from the Field
• New Hampshire
• North Carolina
• Kansas
• Michigan

23
Improving the Publics Health in New Hampshire

• A Partnership of the
• Community Health Institute and
• the NH Division of Public Health Services
• December 4, 2008

24
Our Partnership- DPHS/CHI

• Community Health Institute (CHI)
• Established in 1995 by JSI Research and Training
  Institute (JSI), in partnership with the NH
  Department of HHS RWJ Foundation
• Provide community-based providers with expertise
  and resources to strengthen New Hampshire's
  health care system
• Works with health departments, health care
  providers and organizations, community
  organizations, and foundations
• Work with DPHS as contractor, partner, fiscal
  agent

25
MLC preparing for accreditation, measuring
performance, learning collaboratives
CHI
Technical Assistance to local networks for
performance assessment and improvement
Performance Based Contracting
Performance Improvement
CHI
DPHS
National Public Health Performance Standards
Assessment and Planning
Public Health Improvement Team
DPHS
DPHS
26
And now, a brief word about local assessment the
NH Context

• Each of New Hampshires 234 cities and towns are
  statutorily required to have a health officer
• Together with the local administrative body, the
  health officer constitutes the local health board
• Approximately 25 of New Hampshire towns rely on
  volunteer health officers many others utilize
  code enforcement officers
• Only five New Hampshire communities maintain
  public health departments (2 comprehensive) no
  county health departments
• We have been working slowly to strengthen our
  local public health infrastructure

27
Strengthening the Public Health System-Locally

• In 2001, NH began funding 4 local public health
  demonstration programs through the RWJF Turning
  Point Program.
• The Community Health Institute assisted
  communities in the measurement of system capacity
  and performance built into the demonstration
  effort from the beginning as part of the local
  evaluation adapted Turnock-Miller 20 questions
  instrument.
• By 2005, the initiative grew to include 14 local
  public health partnerships covering 70 of the NH
  population.
• Assessment activities continued to be a
  fundamental program expectation graduated to use
  of NPHPS local performance assessment instrument
  and the creation of community public health
  performance improvement plans

28

Strengthening the Public Health System-Statewide

• Assessment of the National Public Health
  Performance Standards - 2005 led by DPHS
• 110 public health stakeholders participated
  attendance
• Led to the development of 6 strategic priority
  areas with work groups and action plans combined
  into a statewide action plan for the public
  health system
• DPHS staffs the legislatively created Public
  Health Services Improvement Council CHI is a
  council member
• CHI leads one workgroup Mobilizing Community
  Partnerships sits on other work groups

29
2007 Quality Improvement Activities for MLC-2

• Articulate measures to monitor improvement for
  New Hampshires performance on our 6 strategic
  priorities and others
• Develop automated data collection, storage and
  reporting processes for the 6 strategic
  priorities and other performance measures
• Improve the quality of public health practice
  using existing standards to create a tiered
  approach to credentialing/ accreditation of local
  public health professionals

30
(No Transcript)
31
MLC-3Lead States in Public Health Quality
Improvement

• To bring state and local stakeholders to together
  in a community of practice to
• Prepare local and state health departments for
  national accreditation contribute to the
  development of national voluntary accreditation
• Advance application of QI methods that result in
  specific measurable improvements, and
  institutionalization of QI practice in public
  health

32
MLC-3 Goals

1. Facilitate development and improvement of local
   public health agencies and systems through
   application of collaborative, evidence-based
   quality improvement processes
2. Prepare the State Health Department for voluntary
   accreditation by piloting national accreditation
   standards and institutionalizing enhanced quality
   improvement processes
3. Incorporate national accreditation standards and
   assessment activities within the cycle of
   performance management and quality improvement at
   the local level
4. Create quality improvement mini-collaboratives
   working toward linking public health capacity to
   population health outcomes
5. Share best practices and lessons learned, and
   disseminate findings across the larger public
   health community

33
Focus on MLC-3 Goal 3

• Incorporate national accreditation standards and
  assessment activities within the cycle of
  performance management and quality improvement at
  the local level
• builds directly upon the work of MLC-2
• advances the process of regionalization and
  developing regional public health infrastructure

34
Public Health Capacity Assessment

• Working with 6 Public Health Regions to capture
  the capacity of regional public health systems
• Requires information about the contributions of
  diverse partners with formal as well as informal
  linkages.
• ? Modification of NACCHO Self-Assessment Tool to
  capture essential characteristics unique to NHs
  regional public health systems

35
Why participate in these assessments?
The findings from these assessments will provide
the evidence that drives public health policy in
NH. This is a unique and valuable opportunity
to register assets, document need, and learn from
one another about the public health services and
functions that exist in your region.
36
Assessment Process

• Identify a lead organization or organizations
  for regions in more formative stages of
  evolution
• Capture perceived contributions of the lead
  organization to the greater region
• Validate perceived contributions of the lead
  organization with regional partners
• Capture additional contributions of regional
  partners
• Capture contributions of the state (Division of
  Public health Services, Division of Environmental
  Services, Department of Education, etc.)

37
Process Part I

• Completed by lead organization
• Occurs at the operational indicators level for
  each standard of each Essential Service.

38
Process Part II

• Completed by a convened group of regional public
  health system partners
• Occurs at the standards level for each Essential
  Service
• Entails answering 3 questions
• Does the group concur with the self-assessment of
  the lead organization?
• Are there additional expertise or services within
  the regional public health system (regional
  partners)?
• How does the State of NH contribute to regional
  public health capacity?

39
STANDARD I-B Develop relationships with local providers and others in the community who have information on reportable diseases and other conditions of public health interest and facilitate information exchange. STANDARD I-B Develop relationships with local providers and others in the community who have information on reportable diseases and other conditions of public health interest and facilitate information exchange. STANDARD I-B Develop relationships with local providers and others in the community who have information on reportable diseases and other conditions of public health interest and facilitate information exchange. STANDARD I-B Develop relationships with local providers and others in the community who have information on reportable diseases and other conditions of public health interest and facilitate information exchange. STANDARD I-B Develop relationships with local providers and others in the community who have information on reportable diseases and other conditions of public health interest and facilitate information exchange. STANDARD I-B Develop relationships with local providers and others in the community who have information on reportable diseases and other conditions of public health interest and facilitate information exchange.
FOCUS DISEASE REPORTING RELATIONSHIPS MAKE DATA AND INFORMATION FLOW ROUTINE FOCUS DISEASE REPORTING RELATIONSHIPS MAKE DATA AND INFORMATION FLOW ROUTINE FOCUS DISEASE REPORTING RELATIONSHIPS MAKE DATA AND INFORMATION FLOW ROUTINE FOCUS DISEASE REPORTING RELATIONSHIPS MAKE DATA AND INFORMATION FLOW ROUTINE FOCUS DISEASE REPORTING RELATIONSHIPS MAKE DATA AND INFORMATION FLOW ROUTINE FOCUS DISEASE REPORTING RELATIONSHIPS MAKE DATA AND INFORMATION FLOW ROUTINE
Operational Definition Indicators Operational Definition Indicators Operational Definition Indicators Operational Definition Indicators Operational Definition Indicators Operational Definition Indicators
Operational Definition Indicators Score - Lead organization(s) Score - Lead organization(s) Topic Documents and/or Activities That Demonstrate Indicators Have Been Met Documents and/or Activities That Demonstrate Indicators Have Been Met
LHD staff can be contacted at all times. Preparedness A written policy/procedure exists that describes that assures LHD staff can be contacted at all times. A written policy/procedure exists that describes that assures LHD staff can be contacted at all times.
Providers and other appropriate health care system partners are educated and trained in collecting and reporting data to the LHD. Data Record of presentations, evidence of meetings held, conferences organized (e.g. agenda), and/or educational materials distributed to promote provider and other public health system partner to promote knowledge and disease reporting procedures. Record of presentations, evidence of meetings held, conferences organized (e.g. agenda), and/or educational materials distributed to promote provider and other public health system partner to promote knowledge and disease reporting procedures.
LHD uses a quality improvement process between LHD and providers to make it easy for providers to report. Quality Improvement Written quality improvement process available for evaluation of disease reporting between providers and the LHD. Results of evaluation shared and documentation that the process was improved, if needed, based on a quality improvement process. Written quality improvement process available for evaluation of disease reporting between providers and the LHD. Results of evaluation shared and documentation that the process was improved, if needed, based on a quality improvement process.
Health care providers and other public health system partners receive reports and feedback on disease trends and clusters. Communication Has process for organizing data to determine trends and clusters and for providing the information to health care providers and other public health partners. Log of distribution of reports, topics, to whom and any feedback. Has process for organizing data to determine trends and clusters and for providing the information to health care providers and other public health partners. Log of distribution of reports, topics, to whom and any feedback.
Comments regarding regional partners providing services for this focus area Comments regarding regional partners providing services for this focus area Comments regarding regional partners providing services for this focus area Comments regarding regional partners providing services for this focus area Comments regarding regional partners providing services for this focus area Comments regarding regional partners providing services for this focus area
Using the same criteria as the lead organization, score the existence/availability of the regional contribution to local public health capacity for this standard. Using the same criteria as the lead organization, score the existence/availability of the regional contribution to local public health capacity for this standard. Using the same criteria as the lead organization, score the existence/availability of the regional contribution to local public health capacity for this standard. Using the same criteria as the lead organization, score the existence/availability of the regional contribution to local public health capacity for this standard. Using the same criteria as the lead organization, score the existence/availability of the regional contribution to local public health capacity for this standard.
Please rate the adequacy of state planning, staffing, or other resources applied directly at the regional level for this standard 0 insufficient information to rate the contribution 1 insufficient contribution 2 sufficient contribution Please rate the adequacy of state planning, staffing, or other resources applied directly at the regional level for this standard 0 insufficient information to rate the contribution 1 insufficient contribution 2 sufficient contribution Please rate the adequacy of state planning, staffing, or other resources applied directly at the regional level for this standard 0 insufficient information to rate the contribution 1 insufficient contribution 2 sufficient contribution Please rate the adequacy of state planning, staffing, or other resources applied directly at the regional level for this standard 0 insufficient information to rate the contribution 1 insufficient contribution 2 sufficient contribution Please rate the adequacy of state planning, staffing, or other resources applied directly at the regional level for this standard 0 insufficient information to rate the contribution 1 insufficient contribution 2 sufficient contribution

40
ESSENTIAL SERVICE I Monitor health status and
understand health issues facing the community
STANDARD I-B Develop relationships with local
providers and others in the community who have
information on reportable diseases and other
conditions of public health interest and
facilitate information exchange. FOCUS DISEASE
REPORTING RELATIONSHIPS

• Staff can be contacted at all times.
• Providers other health care system partners are
  educated and trained in collecting and sharing
  data among PH system partners.

• Uses a QI process between to make it easy for
  providers to report.
• Health care providers other PH system partners
  receive reports and feedback on disease trends
  and clusters.

community health institute
41
Scoring Matrices- Lead organization and regional
partners
42
Scoring Matrices-State Contribution

• How does the State of NH contribute to regional
  public health capacity?

43
Continuous Quality Improvement
NACCHO Local Health Department Self-Assessment Tool (Rev.) - Regional Partners Evaluation Tool NACCHO Local Health Department Self-Assessment Tool (Rev.) - Regional Partners Evaluation Tool
1. The pace of the assessment was Too slow Just right Too fast 1 2 2.6 3 4 5 Improved over time
2. The process was Painfully inefficient Extremely efficient Painfully efficient 1 2 3 3.2 4
3. How well did the poster boards keep the process moving? Useless Essential 1 2 3 3.4 4
4. How well did the PowerPoint slides keep the process moving? Useless Essential 1 2 3 3.3 4
6. The scoring methodology was Muddy Crystal Clear 1 2 3 3.3 4
7. Please share which aspect or aspects of this assessment process were most beneficial. Open discussion that was generated , group interaction Clear directions and process support Working the scores out together Slow process Negotiating to consensus PowerPoint, posterboards, and people who came to the meeting 7. Please share which aspect or aspects of this assessment process were most beneficial. Open discussion that was generated , group interaction Clear directions and process support Working the scores out together Slow process Negotiating to consensus PowerPoint, posterboards, and people who came to the meeting
8. Please share your ideas for improving the process. Use survey monkey More diverse/representative group- more participation from region 8. Please share your ideas for improving the process. Use survey monkey More diverse/representative group- more participation from region
44
Other Important Details

• Collaboration between CHI and NH Division of
  Public Health Services
• Tool modification
• Shared facilitation of Regional Partner Process
• Supporting Resources
• Modified NACCHO Tool
• PowerPoint
• Poster boards
• Evaluation tool
• Estimated Time to complete
• Lead Organization - 2-4 hours
• Regional Partners 4-6 hours

45
Other collaborative activities

• MLC-3
• Quality Improvement Learning teams addressing
  nutrition and activity, links to Healthy Eating
  Active Living Initiative
• Development of integrated Division of Public
  Health outcome measures Reduction of
  tobacco-related chronic disease
• Re-Assessment of the National Public Health
  Performance Standards (2009-2010)

46
Next steps

• Continue to assess regional public health
  capacity improving the process based on feedback
• Phase 1 will be completed by March 2009
• Synthesis of financial and governance assessments
  data to inform further progression of
  regionalized public health system
• Eventually, each of the 15 public health regions
  will complete this capacity assessment, as well
  as the financial and governance assessments
• Data will be analyzed to provide a complete
  picture of our public health capacity in each
  region, gaps and needs

47
Questions

• Jascheim_at_dhhs.state.nh.us
• Joan Ascheim
• Bureau Chief
• NH Division of Public Health Services
• Bureau of Policy and Performance Management
• [phone]
• http//www.dhhs.state.nh.us/DHHS/DPHS/iphnh.htm
• Lea Ayers LaFave
• NH Community Health Institute/JSI
• [phone]
• Lea_ayers-lafave_at_jsi.com

48
NC Local Health Department Accreditation and the
Role of the NC Institute for Public Health
49
NCLHDA Program Components

• Self-Assessment by the Agency
• Site Visit
• Board Adjudication

50
Accreditation Process

• The Accreditation Administrator notifies health
  departments
• 90 days to submit the Health Department
  Self-Assessment Instrument
• The Site Visit Team reviews the Self -Assessment,
  visits the health department and completes report
• The Accreditation Board meets and hears the
  report, granting a status of Accredited or
  Conditionally Accredited

51
Health Department Self-Assessment Instrument
Standard 1 Agency Core Functions and
Essential Services (CFES) Standard 2
Facilities and Administrative Services (FAS)
Standard 3 Board of Health / Governance 41
benchmarks and 148 related activities
52
Role of the NCIPH

• Serves as the Administrator of the NCLHDA program
• Direct and Oversee the Program
• By Statute, the Accreditation Board is housed
  within the NCIPH

53
Accreditation Partners

• NC Institute for Public Health
• NC Division of Public Health
• NC Association of Local Health Directors
• Partnerships continue with Board membership

54
History - Where have we been?

• Work began on Accreditation in 2001-2002 with a
  joint NCALHD, DPH, NCIPH committee
• First standards were piloted in 6 local health
  departments
• Revised tool - pilot II with 4 local health
  departments
• Legislation to make system mandatory with 8 years
  for all to be accredited
• Commission for Health Services to adopt rules
• Temporary Rules adopted in December, 2006
• Rules final in August, 2007

55
Where are we now?

• 40 Accredited Local Health Departments as of
  October 24, 2008
• 4 more will go before Board on December 19, 2008

56
Accredited Health Departments
Health Departments participating in FY 2009
Health Departments participating in FY 2010
Health Departments participating in FY 2011
Health Departments proposed for FY 2012
http//nciph.sph.unc.edu/accred/
Health Departments proposed for FY 2013
57
Other Support from NCIPH

• Technical Assistance
• Program Evaluation
• Consultation Agency Assessment
• Strategic Planning
• Workforce Development Training
• Maintain Firewall Between Accreditation Other
  Services

58
NCIPH Support for National Accreditation

• Accreditation Road Map
• Research on incentives to encourage participation
• ASTHO toolkit
• PHAB Workgroups

59
Institute Opportunities
Convene Partners
FILL Gaps
Translate Process
PROVIDE TA
60
Questions?
Mute line 6 Unmute line 7
61
Greater than the sum of its parts Challenges and
growth of alliances in the Land of Oz

• Gianfranco Pezzino, M.D., M.P.H.
• Kansas Health Institute

62
Outline

• Who we (KHI) are
• What is the KS environment like?
• What about accreditation?
• Lessons learned

63
KHI Basics

• Private, non-profit, 501(c)(3)
• Annual operating budget of 2.4 million
• Kansas Health Foundation core funding
• Additional 4 million in grants since 1999
• Half of grant revenue flows through to other
  research partners
• 20 full-time positions
• Use of experts/consultants ad hoc

64
Kansas Local Health DepartmentsPopulation Served
50,000
10 LHDs w/ gt50,000 people (63 of pop.)
lt
26
7
4
65
15 Regions, 103/105 counties
66
Alliances The broader Public Health System
KS Dept. of Health and Environment
KS Association of LHDs
KS Health Institute
University of Kansas Medical Center
Local
Region
67
Alliances The MLC-3 project
KS Dept. of Health and Environment
KS Health Institute
KS Association of LHDs

• Administer grant
• T.A.

• Solicit proposal for QI projects
• Contract with regions

University of Kansas Medical Center
Curriculum, faculty, C.E.
Provide teams for mini-collaboratives
Local
Region
68
What about accreditation?
69
Some Issues Around Accreditation in a Rural State

• KS public health universe is very diverse
• How to define common levels of standards for LHDs
  with diverse capacity
• Minimum common denominator?
• Technical assistance to weak sites?
• Multiple tiers of accreditation?

70
Focus on Standards and Performance Management

• Everyone, no matter where they live, should
  reasonably expect the local health department to
  meet certain standards
• Define the standards, then discuss how each LHD
  can get there
• Establish performance management system to
  monitor progress towards standards

71
Focus on Standards and Performance Management

• Everyone, no matter where they live, should
  reasonably expect the local health department to
  meet certain standards
• Define the standards, then discuss how each LHD
  can get there
• Establish performance management system to
  monitor progress towards standards

• ? READY FOR ACCREDITATION!

72
Performance Management in Kansas Related
Projects

• NACCHO
• PROPHIT

1
2
4
3

• PROPHIT

• MLC

73
Role for KHI

• Increase capacity in state for applied research,
  assessment, evaluation, technical assistance
• Independent, authoritative entity
• Credible voice
• Mediate among competing needs and resources of
  other partners
• More flexible structure than government agencies
• Manage some projects on behalf of all partners

74
Lessons Learned

• The Blessing
• K.H.I. is not in charge
• The Curse
• K.H.I. is not in charge
• The Solution
• It takes patience, time and consensus building
• Personal relations are paramount

75
Healthier Kansans through informed decisions
76
Embracing Quality in Local Public Health
Michigans Quality Improvement Guidebook

• Michigan Public Health Institute
• - Kanchan Lota, MPH - Julia
  Heany, PhD.

http//www.accreditation.localhealth.net/
77
Michigan Local Public Health Accreditation
Program Partners
MDCH
MDA
MDEQ
Accreditation Program
LHDs
MPHI
78
Embracing Quality in Local Public Health
Michigans Quality Improvement Guidebook
http//www.accreditation.localhealth.net/
79
Guidebook Content and Structure

• Overview of the PDSA approach to Quality
  Improvement (QI)
• Sections on
• Customers Stakeholders
• The Importance of Data
• Writing an Aim Statement
• QI Tools PH Measures of Improvement
• PH Example of PDSA
• Storyboards Case Studies from the 4 MLC-2 QI
  projects at the Local Health Departments
• Program Evaluation, QI Resources, More

80
Why Develop a QI Guidebook for Public Health?
Addressing an ABSENCE in the Marketplace!
81
Coordination Coordination Coordination!

• Managed entire process from development to
  completion
• Set up meetings
• Tracked content development
• Ensured deadlines were being met
• All graphics
• Formatting
• Final edits
• Publishing

82
The Road to Quality
The road to quality is never smooth, but its
the only one that leads to long-term
success. -Author unknown
83
Embracing Quality in Local Public Health
Michigans Quality Improvement Guidebook

• Lessons Learned
• Public health application
• Provide resources
• Build on relationships
• Facilitate collaborations
• Share successes

http//www.accreditation.localhealth.net/
84
Questions?
Mute line 6 Unmute line 7
85
Thank You!