Public Health Quality Improvement Exchange
The Public Health Quality Improvement Exchange (PHQIX) is a brand new online community designed to be a communication hub for public health professionals interested in learning and sharing information about quality improvement (QI) in public health. PHQIX was created by RTI International and funded by the Robert Wood Johnson Foundation. The key goal of the site is to share national QI efforts by health departments of all sizes so that public health experts can learn from the experience of their colleagues across the country. NewPublicHealth recently spoke with Jamie Pina, PhD, MSPH, PHQIX project director, and Pamela Russo, senior program director at the Robert Wood Johnson Foundation about the new resource and its promise for helping health departments continuously improve their performance and achieve the national standards set forth by the Public Health Accreditation Board.
NewPublicHealth: What’s the vision of PHQIX, and how did it come about?
Pamela Russo: Public health departments are looking for ways to be more and more efficient and to eliminate waste and to make their limited budgets have the maximum possible impact. That’s the major value of QI, to show what works and where you can improve.
In the Multi-State Learning Collaborative (MLC), we asked coalitions of state and local health departments in 16 states to work together on mini-collaborative on QI. As various organizations began collecting QI stories, we ended up with a lot of descriptions of QI projects in different silos. In PHQIX, we’ve developed an online community of practice where practitioners can look across the experiences of their peers in other health departments with QI for projects that are similar or relevant, and ask questions, get feedback, and be inspired. There is also a growing interest in public health around social media and how you might use mobile health or other concepts and technologies to communicate. So there is an opportunity for PHQIX to help people get familiar with using those tools in that framework.
Jamie Pina: One critical goal of PHQIX is to demystify QI for public health practitioners who haven’t taken on these kinds of formal initiatives yet. We want to make it possible for someone who’s new to QI to learn from others with a similar professional background and show them that these methods are not as complicated as they may seem at first. In that way, we can make QI methods more accessible to all public health practitioners.
The value of this collaboration is that you can learn from people who have gone through similar experiences. You can build knowledge as an entire community. Instead of each organization learning and facing challenges alone, public health practitioners can consolidate their efforts and face challenges together. That’s how we came up with the slogan “Quality Improvement Together.”
NPH: How can PHQIX help public health departments move toward accreditation?
Pamela Russo: With the advent of the Public Health Accreditation Board and the interest of a growing number of health departments across the country in becoming accredited, having a QI plan as a critical part of performance management has become a standard and a requirement. We have put a lot of effort over the past seven years into supporting projects to develop capabilities to adopt and apply quality improvement in governmental public health.
There were a lot of initial lessons. People thought you could just transfer health care QI to public health, but you can’t just do that. There are some concepts and methods and tools that work the same way, but the content or the types of things that they’re improving are very, very different. There’s a lot more about organizational excellence and activities that are community-oriented or population health-oriented that are quite different than what a hospital or a health care provider does. The example that people began using for public health QI was why syphilis cases were going up in Florida. The case had been written up and shared widely and there weren’t a lot of other specifically public health-oriented examples available. That case made it easier to understand: What was QI related to public health? What might you use it for? How would you use QI tools in public health?
NPH: Why is QI so critical for public health, especially now?
Jamie Pina: QI is essential because it provides a framework for evaluating change and improving the areas that need work in a community. By specifying measurable outcomes, it also helps to demonstrate the value of public health interventions.
Since we started working on this project, I’ve heard lots of public health practitioners recount stories of satisfaction with their QI efforts. They are pleased with the outcomes, but also pleased to have documentation of the improvement and choices they made to accomplish it. I think it’s very rewarding to see measurable improvement that you can reference at the end of a QI initiative. PHQIX gives public health practitioners a place to share those experiences.
NPH: How do you hope the exchange will have impact the field of public health in both the short and long term?
Pamela Russo: If people are submitting their projects and getting recognition for their projects, and the website is robust and continues to grow, then best practices will begin to emerge. We will develop some benchmarks for good practice in terms of health outcomes. It’s wonderful to have targets at the Healthy People 2020 level, but in fact, in many areas of the country, we’re nowhere near those targets. So, with the QI project, they’re working to get a better notion of where communities really are and what kind of improvement toward that target you could get by doing QI. It will be incredibly valuable to have a real world picture of where we are across the country in terms of those different health indicators.
Jamie Pina: I would like public health practitioners to model their QI work in a way that is, in their view, either easier or more successful because they were able to learn from what their peers shared through PHQIX.org.
I would like to see public health practitioners communicate directly with one another more actively about their QI activities. We want to encourage them to reach out to people who have done similar work through the exchange, to ask questions, and to get input about how they designed their QI initiatives. The public health community has always been very collaborative in spirit. Moving that collaboration online is a natural progression.