Preliminary Findings from an Interventional Study using Network Analysis to Support Management in


Management is the core service that integrates and coordinates essential public health services.

The Issue:

Managers of local health departments (LHDs) are experts in practice but may not have expertise in organizational management.

These researchers conducted an evidence-based training intervention in 10 LHDs in Florida to support managers’ decision-making on organizational integration and coordination. They deployed a standard survey to collect organizational network measurements pre- and post-intervention. They presented results as evidence-based performance feedback and interviewed managers to document how they used the results in the context of each organization.

Key Finding:

Post-intervention they found unexpected, significantly higher network centralization in daily work. They attributed this increase in hierarchical communication to preparations for a statewide accreditation initiative.


When QI initiatives are undertaken globally within a state, managers and leaders need to be alert for possible impact on autonomous decision-making of professionals at the point of service which could affect service delivery.