Roadmap to an Organizational Culture of QI Pooja Verma, NACCHO, APQI pverma@naccho.org Ty Kane, SCHD tkane@sedgwick.gov

Roadmap to an Organizational Culture of QI EXIT 6 EXITS 4-5 6. QI CULTURE 4. SOME FORMAL QI ACTIVITIES 5. FORMAL AGENCY-WIDE QI 3. INFORMAL OR AD HOC QI ACTIVITIES EXIT 3 EXITS 1-2 1. NO KNOWLEDGE OF QI 2. NOT INVOLVED IN QI ACTIVITIES

Roadmap to an Organizational Culture of QI Characteristics Lack awareness/understanding of QI Overwhelmed with other issues Satisfaction with status quo Don’t value/link QI to PH practice Strategies for Transition Marketing QI to leaders Leadership & staff training Share stories of success Incentives for engaging in QI Intentionally manage change “Deselect” resistant leaders EXIT 1 NO KNOWLEDGE OF QI EXIT 1

Roadmap to an Organizational Culture of QI Characteristics Begin to embrace/understand QI Problems are ignored/buried Staff are viewed “hired hands” Data are not available or not used Strategies for Transition Mentorship Integrate QI in agency planning ‘Firefighters’ to problem solvers Task-focus to QI project focus Membership in ASQ Market QI thru successes EXIT 2 Not Involved With QI Activities

Roadmap to an Organizational Culture of QI Characteristics Data not routinely used Discrete QI efforts “Pseudo-QI” QI not part of organization’s strategy Few lessons learned and sharing Anxiety of Doing it wrong or Finding problems Strategies for Transition Share stories organization-wide Build learning communities Performance management Demystify QI Celebrate all improvements Address resistance to change EXIT 3 INFORMAL OR AD HOC QI ACTIVITIES

Roadmap to an Organizational Culture of QI Characteristics Greater reliance on data Fewer ‘firefighter’ supervisors People viewed as critical to success QI is a part of the job In-house QI TA available Strategies for Transition QI division or function Sharing QI results externally Results-sharing is the norm More working across silos Data use/access increases Talk of systematic Performance Management Draft a comprehensive QI plan Join ASQ Report results to local governance EXIT 4 FORMAL QI ACTIVITIES IMPLEMENTED IN SPECIFIC AREAS ONLY

Roadmap to an Organizational Culture of QI Characteristics More data-driven decisions QI plan individualized to setting Integration of measures into “system” QI integrated in operational plans QI becomes more visible Standardization in processes Learning/sharing culture QI in position descriptions Customer-focus Demonstrate ROI QI policies Strategies for Transition QI on all meeting agendas Leadership that walks the talk Supervisors are QI coaches EXIT 5 FORMAL AGENCY-WIDE QI

Roadmap to an Organizational Culture of QI Characteristics Distribution of results to staff, stakeholders and customers QI champions throughout organization Ongoing training and networking Data and tools used daily Customer is front and center Integrate with strategic plan Getting better all the time Self-assessment Problems are “gold” Sustainability Caution: Digression is easier than progression EXIT 6 QI CULTURE

Foundational Characteristics: The following characteristics were identified throughout every phase in the roadmap: Selecting employees who are well-suited to learn and teach QI techniques A Collaborative AND learning culture QI should be integrated into strategic plan Data analysis skills AND problem solving skills (tools) Leadership (including governance) must be engaged and have knowledge Theoretical vs. practical balance (50,000 ft and 5 ft view) Flexibility in decision-making (at all levels) is seen as critical piece to success Supervisors are expected to engage in QI and see their job not as about fighting fires but rather, improving processes Customer focus QI should be integrated into funder requirements (expected as program work, not “extra”)