Quality Improvement Efforts of Local Health Departments: Findings from the 2005 National Profile of LHDs Study

1
Quality Improvement Efforts of Local Health
Departments Findings from the 2005 National
Profile of LHDs Study
2
2005 National Profile of Local Health Departments
Study

• Collaboration with CDC
• Fourth in the Profile series
• Prior studies in 1989, 1992-3, and 1996-7
• Census design includes all LHDs in U.S.
• First National Profile to be conducted as
  Web-based survey
• Source of all data in this presentation

3
Topics in Profile Core

• Activities and services provided
• Community health assessment improvement
• Information technology

• Governance
• Population served
• Finances
• Characteristics of top executive
• LPHA workforce

4
Topics in Profile Modules

• Detailed information on
• Finances
• LPHA workforce
• Community health assessment improvement
• Information technology

• Additional Topics
• Performance improvement
• Emergency preparedness
• Partnerships
• Policy-making and advocacy
• Addressing health inequities

5
Descriptive Statistics from 2005 Profile of LHDs

• Community Health Assessment (core)
• Community Health Improvement Planning (core)
• Performance Improvement (module)
• Accreditation (module)

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Community Health Assessment

• Definition A community health assessment is the
  process whereby a local health agency and its
  community engage in assessing the health needs of
  their community and investigate adverse health
  effects and health hazards to create a
  snap-shot of a communitys health.

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LHD Participation in Community Health Assessment
(CHA)
CHA completion or plans Percentage
Completed CHA in past three years 51
Plans to complete CHA in next three years 65
Either completed CHA in past three years or plans to complete in next three years 79
Both completed CHA in past three years and plans to complete in next three years 38
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Participation in CHA Comparison with 1999 Study
Population size 1999 2005
All LHDs 55 51
lt25,000 44 42
25,000 49,999 63 53
50,000 99,999 65 57
100,000 499,999 66 61
500,000 72 67
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Community Health Improvement Planning

• Definition a series of timely and meaningful
  action steps that define and direct the
  distribution of health services and resources to
  improve your communitys health, or definite
  strategic action steps to improve health status
  in the community
• HP 2010 Target 80 of LHDs have a health
  improvement plan

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LHD Participation in Community Health Improvement
Planning (CHIP)
Percentage
Participated in CHIP 54
CHIP based results of CHA 86
CHIP linked to states health improvement plan 68
Participation in past three years Of those LHDs
that have participated in CHIP
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Participation in CHIP Comparison with 1999
Study
Population size 1999 2005
All LHDs 53 54
lt25,000 41 45
25,000 49,999 59 55
50,000 99,999 68 59
100,000 499,999 69 61
500,000 76 68
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Participation in CHA by State Version 1
completed CHA in last 3 years
13
Participation in CHA by State Version 2
completed CHA in last 3 years OR plan to
complete in next 3 years
14
Participation in CHA by State Version 3
completed CHA in last 3 years OR plan to
complete in next 3 years
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LHD Participation in Quality or Performance
Improvement Efforts
Population size Percentage
All LHDs 71
lt25,000 63
25,000 49,999 67
50,000 99,999 73
100,000 499,999 73
500,000 89
n423 involvement in past three years
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Performance Management Components

• Has LHD established Performance Standards?
• Does the LHD use Performance Measures?
• Does the LHD Report Progress?
• Does the LHD have a Quality Improvement Process?

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LHD Performance Management Activities
n427
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Components of LHD Performance Management
Activities
Combination of Elements Combination of Elements Combination of Elements Combination of Elements Combination of Elements
Area of Focus All four components QI process only Performance standard only Report progress only Standard, measure, report
Human resources development 42 21 21    
Data and information systems 38 22 23    
Financial management 42   26 21  
Management practices 47 17 30    
Customer focus and orientation 60 24 21    
Public health capacity 48   27 20  
Health status 64   22 29 22
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LHD Use of Performance Standards and Performance
Measures
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Percentage of LHD Programs with Evaluation or QI
Efforts
n228 to 418
21
LHD Participation in Accreditation Programs
Population size Percentage
All LHDs 16
lt25,000 7
25,000 49,999 12
50,000 99,999 25
100,000 499,999 30
500,000 47
n420
22
LHD Participation in Specific Accreditation
Programs
Accreditation program Percentage
State-established accreditation program 9
Laboratory accreditation program 9
JCAHO (Joint Commission on Accreditation for Healthcare Organizations) 2
n395
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Relationships among Activities
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What do LHDs mean by Quality Improvement?

• Probably a lot of different things!
• NACCHO plans to explore this in a survey about
  LHD quality improvement efforts
• Directed to all LHDs who reported some PI/QI
  activity in the last three years on the 2005
  Profile survey

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Follow-up QI Survey Topics

• Frameworks for performance improvement
• Resources for performance improvement
• Extent of QI activities (Agency-wide? Several
  program areas?)
• Proactive initiative or grant requirement?
• Elements of QI programs
• Training for LHD staff

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For more informationCarolyn Leep, Senior
AnalystNational Association of County City
Health Officialscleep_at_naccho.org2005 Profile
Web sitehttp//www.naccho.org/topics/infrastruct
ure/2005Profile.cfm