1. Using the QI Roadmap to create a culture of Quality Improvement
Public Health in the Rockies 2015
Heather Weir & Rebekah Marshall

2. Acknowledgments
National Association of City and County Health Officials
Pooja Verma
Public Health Foundation
Jack Moran

4. QI Roadmap 1. NO KNOWLEDGE OF QI 2. NOT INVOLVED IN QI ACTIVITIES
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

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

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

7. QI Roadmap Characteristics Strategies for Transition
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

8. QI Roadmap Strategies for Transition Characteristics
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
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
EXIT 4
FORMAL QI ACTIVITIES IMPLEMENTED IN SPECIFIC AREAS ONLY

9. QI Roadmap Characteristics Strategies for Transition
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

10. QI Roadmap Sustainability Characteristics QI CULTURE
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

11. Foundational Characteristics
People:
Selecting employees who are well-suited to learn and teach QI techniques
Collaborative AND learning culture
Data analysis skills AND problem solving skills
Engaged and knowledgeable leadership
Flexibility in decision-making (at all levels)
Supervisors coach to improve processes (rather than fire fighting)

12. Foundational Characteristics
Process:
QI integrated into strategic plan
Theoretical vs. practical balance (50,000 ft and 5 ft view)
Customer focus
QI should be integrated into funder requirements (expected as program work, not “extra”)

13. Report out on one of your top transition strategies
Group Activity
Select what phase you think your organization is in
Move to your phase in the room
Select one person to write on the white paper
As a group discuss:
Why you think you are in this phase? (5 minutes)
What is keeping you from moving to the next phase? (10 minutes)
What transition strategies might work to move to the next phase? (10 minutes)
Report out on one of your top transition strategies

14. Examples Using the Roadmap
Denver Public Health
Annual QI Survey used to inform Departmental strategic plan
Goal 10: Continuous Quality Improvement throughout the department
Strategy: Develop a culture of quality improvement at Denver Public Health
Quality Committee develops
Action items
Implementation strategies
Metrics

15. Examples Using the Roadmap
CDPHE Transition Strategies:
QI Plan
Training
Participation in QI Projects
Communication
Aligning performance measures/dashboards
Implement the customer satisfaction policy

16. QI Roadmap

17. Resources and Next Steps
COQuIP – Social Networking site for CO LPHAs
ECHO Learning Community: QI in Colorado 3
Case-based Learning 2
Expert Presentation 1
Multiple Sessions via Video
Case
Relates to topic
Example from work
Challenges
Peer input
Agenda
Expert :10-15
Case :10-15
Discussion :30
Jan
Feb
Mar
Apr

18. Questions?

19. Contact Information
Heather Weir Director, Office of Planning, Partnerships and Improvement Colorado Department of Public Health and Environment