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Performance Improvement Program


Performance Improvement Programs

Contact Information
Performance Improvement Program
County of Los Angeles – Department of Public Health
Karen Swanson, PhD, ScM
241 N. Figueroa Street, Suite 275
Los Angeles, CA 90012
Phone: 213-989-7236
Fax: 213-240-8626

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Quality Improvement in DPH

Quality improvement (QI): is an integrative process that links knowledge, structures, processes and outcomes to enhance quality throughout an organization. The intent is to improve the level of performance of key processes and outcomes within an organization.

Performance Improvement (PI): PI is the set of changes an agency makes, based on available evidence, to address gaps in capacity, systems, and health outcomes. PI can occur system-wide as well as within individual organizations that are part of the public health system (Office of the Chief of Public Health Practice, National Public Health Performance Standards Program, 2008).

Performance Improvement Project Teams: program-level teams that carry out PI activities, namely Plan-Do-Study-Act (PDSA) cycles. PI Project Teams, with assistance from the Quality Improvement Division, are charged with developing, implementing, evaluating and reporting on formal PI projects.

Quality Tools: are designed to assist a team when solving a defined problem or project. Tools will help the team get a better understanding of a problem or process they are investigating or analyzing. A list of basic QI tools (along with an Information Sheet, Template and Example) can be found on the QI e-line page (The Public Health QI Handbook, Bialek, et al).

Quality Assurance and Quality Improvement – The difference
Quality Assurance:
  • Reactive; works on problems after they occur
  • Regulatory
  • Led by management
  • One point at a time

Quality Improvement:
  • Proactive – works on processes before problems occur
  • Self-determined
  • Led by staff
  • Continuous
  • Exceeds expectations

Plan-Do-Study-Act (PDSA): is an iterative four-stage problem-solving model for improving a process or carrying out change. PDSA stems from the scientific method (hypothesize, experiment, evaluate). A fundamental principle of PDSA is iteration. Once a hypothesis is supported or negated, executing the cycle again will extend what one has learned. (Embracing Quality in Local Public Health, Michigan’s QI Guidebook)

Performance Management System: The framework diagram displays the process as cyclical and promotes the use of QI (e.g. Plan-Do-Check-Act cycle) in all quadrants. The diagram was modified from a square to a circle and the arrows were added to the circumference to demonstrate there may be multiple starting points to performance management Reporting of Progress: “Analyze data” bullet point was modified to “Analyze and Interpret Data” and “Feed data back to managers, staff, policy makers, constituents” was modified to “Report results broadly” Quality Improvement Process: “Quality Improvement Process” quadrant header was shortened to “Quality Improvement”. Leadership & Culture was added on the periphery to emphasize the importance of organizational leadership and performance culture.

Continuous Quality Improvement System