1. Quality Improvement Efforts of Local Health Departments: Findings from the 2005 National Profile of LHDs Study

2. 2005 National Profile of Local Health Departments Study Collaboration with CDC Fourth in the Profile series Prior studies in 1989, 1992-3, and 1996-7 Census design – includes all LHDs in U.S. First National Profile to be conducted as Web-based survey Source of all data in this presentation

3. Topics in Profile Core Governance Population served Finances Characteristics of top executive LPHA workforce Activities and services provided Community health assessment & improvement Information technology

4. Topics in Profile Modules Detailed information on: Finances LPHA workforce Community health assessment & improvement Information technology Additional Topics: Performance improvement Emergency preparedness Partnerships Policy-making and advocacy Addressing health inequities

5. Descriptive Statistics from 2005 Profile of LHDs Community Health Assessment (core) Community Health Improvement Planning (core) Performance Improvement (module) Accreditation (module)

6. Community Health Assessment Definition: A community health assessment is the process whereby a local health agency and its community engage in assessing the health needs of their community and investigate adverse health effects and health hazards to create a snap-shot of a communitys health.

7. LHD Participation in Community Health Assessment (CHA) CHA completion or plans Percentage Completed CHA in past three years51% Plans to complete CHA in next three years65% Either completed CHA in past three years or plans to complete in next three years 79% Both completed CHA in past three years and plans to complete in next three years 38%

8. Participation in CHA: Comparison with 1999 Study Population size19992005 All LHDs55%51% <25,00044%42% 25,000 – 49,99963%53% 50,000 – 99,99965%57% 100,000 – 499,99966%61% 500,000 +72%67%

9. Community Health Improvement Planning Definition: a series of timely and meaningful action steps that define and direct the distribution of health services and resources to improve your communitys health, or definite strategic action steps to improve health status in the community HP 2010 Target: 80% of LHDs have a health improvement plan

10. LHD Participation in Community Health Improvement Planning (CHIP) Percentage Participated in CHIP54% CHIP based results of CHA*86% CHIP linked to states health improvement plan* 68% Participation in past three years *Of those LHDs that have participated in CHIP

11. Participation in CHIP: Comparison with 1999 Study Population size 19992005 All LHDs53%54% <25,0004145 25,000 – 49,9995955 50,000 – 99,9996859 100,000 – 499,9996961 500,000 +7668

12. Participation in CHA by State: Version 1 % completed CHA in last 3 years

13. Participation in CHA by State: Version 2 % completed CHA in last 3 years OR plan to complete in next 3 years

14. Participation in CHA by State: Version 3 % completed CHA in last 3 years OR plan to complete in next 3 years

15. LHD Participation in Quality or Performance Improvement Efforts Population sizePercentage All LHDs71% <25,00063% 25,000 – 49,99967% 50,000 – 99,99973% 100,000 – 499,99973% 500,000 +89% n=423; involvement in past three years

16. Performance Management Components Has LHD established Performance Standards? Does the LHD use Performance Measures? Does the LHD Report Progress? Does the LHD have a Quality Improvement Process?

17. LHD Performance Management Activities n=427

18. Components of LHD Performance Management Activities Combination of Elements Area of Focus All four components QI process only Performance standard only Report progress only Standard, measure, report Human resources development 4221 Data and information systems 382223 Financial management 42 2621 Management practices 471730 Customer focus and orientation 602421 Public health capacity 48 2720 Health status 64 222922

19. LHD Use of Performance Standards and Performance Measures

20. Percentage of LHD Programs with Evaluation or QI Efforts n=228 to 418

21. LHD Participation in Accreditation Programs Population sizePercentage All LHDs16% <25,0007% 25,000 – 49,99912% 50,000 – 99,99925% 100,000 – 499,99930% 500,000 +47% n=420

22. LHD Participation in Specific Accreditation Programs Accreditation programPercentage State-established accreditation program9% Laboratory accreditation program9% JCAHO (Joint Commission on Accreditation for Healthcare Organizations) 2% n=395

23. Relationships among Activities

24. What do LHDs mean by Quality Improvement? Probably a lot of different things! NACCHO plans to explore this in a survey about LHD quality improvement efforts Directed to all LHDs who reported some PI/QI activity in the last three years on the 2005 Profile survey

25. Follow-up QI Survey Topics Frameworks for performance improvement Resources for performance improvement Extent of QI activities (Agency-wide? Several program areas?) Proactive initiative or grant requirement? Elements of QI programs Training for LHD staff

26. For more information: Carolyn Leep, Senior Analyst National Association of County & City Health Officials cleep@naccho.org 2005 Profile Web site: http://www.naccho.org/topics/infrastructure/2005Profile.cfmleep@naccho.org http://www.naccho.org/topics/infrastructure/2005Profile.cfm