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Quality Improvement in a Large Local Health Department

Quality Improvement in a Large Local Health Department. The San Diego Experience Tamara L.M. Bannan, MPH . Overview. Review of San Diego County Embarking on the Quality Improvement (QI) journey Sustaining QI in a large local health department. 2. San Diego County.

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Quality Improvement in a Large Local Health Department

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  1. Quality Improvement in a Large Local Health Department The San Diego Experience Tamara L.M. Bannan, MPH

  2. Overview Review of San Diego County Embarking on the Quality Improvement (QI) journey Sustaining QI in a large local health department 2

  3. San Diego County • 3.1 million people; ~4,200 sq. miles • 2nd largest in California • 5th largest in the U.S. • 18 municipalities, with several other unincorporated cities • 2010 Census (10% growth): • white – 48%; blacks – 5% • Hispanic – 32% (from 27%) • Asians – 11% • Pacific Islanders – 0.5% • Nat. Am. – 0.9%

  4. County Government • 5 Board of Supervisors • Chief Admin Officer/General Management System • 5 Business Groups • Health and Human Services Agency • Public Health Services • Includes Emergency Medical Service • DEH & Animal Services are separate departments

  5. Accreditation Experience • Identified areas to address before applying for actual accreditation San Diego was a beta test site for national public health accreditation Underwent first 4 steps of accreditation

  6. San Diego’s QI Experience

  7. Getting Started: Identifying the Project • Conducted a Self-Assessment as part of the beta test • Topics considered: • Community Health Improvement Plan • Interpretation Policy

  8. Getting Started: Identifying the Team • Important to include stakeholders in the change process • Public Health Nurse Managers • Statistician • Civil Rights Coordinator • Orient the team to the QI process

  9. The Project: Customer Interpretation Needs Reviewed our draft interpretation policy Analyzed the current process in each of 9 sites Determined to focus on establishing policy as 1st step Next step was to increase staff awareness of the policy

  10. Team engagement • Each site was to draft a clinic flow chart of existing process • Each PHN manager was asked to review policy and provide feedback • Epidemiologist conducted survey and data analysis

  11. Findings and Results

  12. Lessons Learned • Cultivate strong relationships with each team member • Allow enough time for each phase of your project • Try not to bias the process with a pre-identified solution

  13. Sustaining QI in San Diego • Incorporated into current FY goals • Conduct ongoing QI training for staff • Developing a team of staff to use the PDSA process and quality tools • HHSA is conducting green and black belt training in Lean Six Sigma

  14. Thank You Tamara.Bannan@sdcounty.ca.gov

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