Formal QI Activities Implemented in Specific Areas

Executives encourage employees to engage in QI, and most senior leaders hold staff accountable to that expectation. Most teams have staff capable of leading formal QI projects as QI is included in workforce development plans and training and resources are made available as needed. Teams are commonly formed to solve problems and innovate using basic QI techniques. Efforts are made to link organizational performance measures to the organization’s strategic plan, and team performance is measured, monitored, and reported in some parts of the organization. It is possible that a formal governance body meets regularly and a QI plan has been created. However, the results of QI projects are not always documented and improvements do not always spread throughout the organization due to limited peer sharing opportunities. Leaders anticipate, explore, and address staff resistance.

Characteristics

  • Employees in certain areas of the agency have knowledge, skills, and abilities (KSAs) to complete formal QI projects
  • Basic and advanced level QI training/resources are available based on employee needs, i.e., QI training goals in workforce development and QI plans are being met. Opportunities for application exist in many parts of the agency.
  • Employee engagement in QI initiatives is incentivized and successes are celebrated.
  • Performance data are used by supervisors and employees to evaluate individual performance and implement improvements.
  • Employees understand the value of QI but may still view it as an added responsibility.

Transition Strategies

  • Staff are encouraged to identify quality concerns aligned with strategic plan and performance and implement staff suggestions.
  • Leaders grant QI champions and staff authority to make decisions regarding quality issues in their own work processes, as appropriate.
  • Make readily available beginner- and advanced-level trainings and resources to accommodate both new and experienced staff. Establish formal process to orient and train new staff in PM and QI.
  • QI champions continue to advocate for QI, mentor staff, and recruit additional champions throughout the agency.
  • Acknowledge and celebrate all successes around QI.

Characteristics

  • Informal groups are commonly formed throughout the agency for problem solving and innovation through the use of QI techniques (e.g. brainstorming, process mapping).
  • Formal QI project teams are more frequently formed in specific divisions, departments, programs, etc.
  • Teams have clearly defined objectives, performance measures, and consistently meet targets and commitments.
  • One or more formal methods for peer sharing and learning exist within the agency (e.g. learning community, storyboards, lunch & lunch).
  • Best practices and QI successes are shared but may be applied or translated to other parts of the agency.

Transition Strategies

  • QI champions and staff continue to participate in internal and external QI learning communities.
  • PM/QI Council sponsors multiple QI teams across divisions and programs to implement QI projects.
  • QI teams begin to break down silos by sharing results achieved and lessons-learned with staff from other programs or divisions.
  • Create physical space conducive to group innovation (e.g. common areas, conference rooms).

Characteristics

  • Executive leaders expect employees to be trained in QI and engage in QI initiatives as appropriate.
  • Leaders in certain parts of the agency hold staff accountable to QI initiatives.
  • Leaders consistently communicate about QI to staff to create buy-in and alleviate resistance.
  • The local governing entity receives ongoing updates around QI initiatives and progress in the agency.
  • Leaders proactively seek out resources for QI and appropriately budget for staff time, training, etc.

Transition Strategies

  • Leaders continuously provide regular updates on progress and future plans, maintaining an inclusive and transparent process.
  • Leaders continuously assess the quality culture of the agency, including employee commitment and sustainability of progress made through improvement efforts.
  • Executive leaders expect managers and supervisors to hold their employees accountable to QI.
  • Executive leaders develop formal QI policies or procedures.
  • Leaders hold QI and performance discussions at leadership meetings in a standardized way.

Characteristics

  • Internal customers are engaged in decision making and improvement processes.
  • Some leaders consider customer needs in decision making processes.
  • Some areas of the agency have a formal process for assessing customer needs and satisfaction, reporting progress, and making improvements.

Transition Strategies

  • Standardize use of data-collection methods/instruments to multiple programs and services when possible.
  • Standardize department-wide process for assessing customer satisfaction, developing and implementing action plans to continuously improve programs/services offered, and report results. Align this process with the performance management process.
  • Empower employees to take appropriate corrective action on customer issues across the organization.

Characteristics

  • An agency QI plan has been adopted and is being implemented.
  • A formally established, cross-sectional PM/QI Council meets regularly to monitor, oversee, and lead implementation plan for formal agency-wide QI and PM efforts.
  • A strategic plan informed by key stakeholders and data from an environmental scanning process is being monitored and implemented.
  • Some parts of the agency have clearly defined process and outcome performance measures that are linked to program, department, and/or agency level strategic goals.
  • Some parts of the agency have formal processes for data collection, analysis, and reporting against pre-defined objectives and standards. No centralized system for storing and accessing data exits.
  • Data driven decision making is more common and QI projects or improvement initiatives are often identified from existing performance data.

Transition Strategies

  • Leaders and PM/QI Council implement a standardized performance management process to collect, store, monitor, analyze, and report on performance data.
  • Leaders and PM/QI Council work with staff to link the agency strategic plan, QI plan, and all operational plans.
  • Continuously assesses progress against QI plan.
  • Leaders begin to request return on investment data including costs and cost savings resulting from QI efforts.
  • Leaders request data prior to approving changes or making decisions.
  • Adopt and develop an information system for storing, analyzing, and reporting performance data (e.g. spreadsheet(s), database, commercial software) based on a requirements gathering process. Train employees on how to use the system.

Characteristics

  • A formal QI model is commonly used to improve processes in some parts of the agency, and projects are aligned with the steps in the model (e.g. PDCA).
  • Staff are increasingly comfortable with using various basic QI tools and techniques (e.g. flowcharting, Cause-and-Effect Diagram, Brainstorming) for problem solving.
  • Performance data is being used in some areas of the agency but consistency and reliability issues exist.
  • Formal QI projects are more consistently resulting in process improvements, however, successes are not always documented and monitored, or spread to other parts of the agency.

Transition Strategies

  • Hold improvement gains resulting from previous QI projects through quality-control strategies such as documenting and training staff on revised processes, continuing to measure improvements, creating checklists and reminders, and performing audits.
  • PM/QI Council uses performance data to identify and initiate multiple QI projects throughout the organization.
  • PM/QI Council monitors improvements and works with leaders to document and standardize improved processes throughout organization.
  • Identify and use evidence-based practices, when possible, and contribute to the evidence base of public health through national conferences and publications.