Performance management is a relatively new concept for public health compared with other health care systems and even other governmental sectors. While many local and state public health departments in the United States are becoming adept at implementing quality improvement projects to improve service delivery, improve health outcomes and monitor health indicators in specific programmatic areas, fewer public health agencies have been successful in implementing systemwide performance management approaches that have resulted in sustained improvements over time.
This article describes the methods and results of using performance data for quality improvement at the statewide system level, the state health department level and the local health department level.
Washington state used the Multistate Learning Collaborative grants to address improvement opportunities identified through the results of the Standards Performance Review cycles and county-specific local public health indicators. State and local health departments initiated statewide collaboratives to address the high priorities for system and individual health department improvements. Two individual agency quality improvement efforts are highlighted: one in a large local health department and the other in the State Department of Health, with emphasis on the results in establishing an agency quality improvement infrastructure and Rapid Cycle Improvement teams.