Quality Improvement Interventions in Public Health Systems

A Systematic Review

Public health leaders are being challenged to do more with less: to maintain essential public health services and improve population health with diminishing resources. Public health performance measures—which also establish thresholds for accreditation of public health departments—provide a way to evaluate quality improvement interventions.

These investigators examined quality improvement interventions that sought to improve public health service performance and the public’s health. They searched the literature and found 18 studies to examine that fit their criteria. The studies fell into three functional categories: (1) organization-wide quality improvement interventions; (2) program- or service-related improvement interventions; and (3) administrative or management practice improvements.

They identified some common themes among the interventions:

  • Program-specific studies started with the assessment of the current practice in order to establish a baseline for measuring against.
  • Several studies first identified and collected performance measures or indicators that would be useful to mark improvements.
  • Engagement of top-level leaders was key to successful quality improvement initiatives.

Public health still has a way to go in order to demonstrate that improving public health performance improves health outcomes. Economic evaluations of quality improvement efforts, however, could help public health leaders communicate with policy-makers and set public health priorities.