The Influence of Management and Environment on Local Health Department Organizational Structure and Adaptation

Public Health Nurse from Kansas City Health Department.

The effects of organizational network analysis on managerial decision-making at LHDs found that supporting managers with evidence-based management strategies can improve function and service delivery.


The Issue:
Local health departments (LHDs) deliver most health services across the United States. Optimizing LHD service delivery is possible through management strategies that improve their function as organizations.  

As a result of management decisions based on evidence provided in network analysis, the following key findings were identified:

Key Findings

  • Communication density, resource availability, knowledge and task redundancy increased.

  • New positive population health outcomes occurred, including increased adaptability to H1N1.

  • A newly formed cross-divisional outbreak investigation team addressed outbreaks.

Network analysis gives LHD managers usable evidence, based on the structure of their own LHD, that can improve its function. However, few LHDs have used this technique, possibly due to lack of staffing or funds to carry it out.

About the Study:
The authors conducted longitudinal network analysis–examining ties between employees and their work–in a LHD with between 102 and 115 employees (fluctuations due to staff turnover). Researchers collected survey data at baseline, month 8 and month 34. The researchers presented analysis after baseline data collection as an intervention, giving LHD managers feedback and management strategies, and documenting managers’ resultant decision-making at months 8 and 34.