No Knowledge of QI

Executives, senior leaders, and staff are not aware of performance management and QI and their value to public health. As a result, financial and human resources are not typically dedicated to measuring, monitoring, or improving individual, team, or organizational performance. In general, leaders and staff are satisfied with the status quo and resistant to change. Staff rarely collaborate for the purposes of problem solving and innovation, and peer sharing is unusual. Decisions are not driven by data, and customer needs and satisfaction are not prioritized. Processes are undefined, complex, redundant, and varied. Problems tend to be ignored and remain unaddressed for long periods of time. Products, processes, and services might be ineffective and inefficient.

Characteristics

  • Employees are unaware of QI and/or mistake it for quality assurance or quality control. No Knowledge, skills, and abilities (KSAs) necessary to undertake QI exist.
  • No QI trainings, resources, or mentors are available to employees.
  • No desired set of core QI KSAs have been identified for employees.
  • Employees do not have performance measures to track performance and identify opportunities for improvement in their work.
  • No financial resources or staff time devoted to QI.

Transition Strategies

Characteristics

  • Teams are rarely or never formed for the purposes of problem solving or innovation.
  • Existing teams often lack clearly defined roles, objectives, and targets for success.
  • Peer sharing and learning across divisions, departments, programs, etc. rarely occurs.
  • Performance of existing work teams is not tracked for progress and accomplishments.

Transition Strategies

  • Explore already existing external QI learning communities at the local, state, or national level.
  • Identify methods for information sharing (e.g. social media, storyboards, “lunch and learns”).
  • Assess functionality and performance of existing teams.

Characteristics

  • Leaders do not understand QI or principles of quality, or see the value to public health practice.
  • Executive leaders do not dedicate or seek out resources for QI.
  • Leaders do not use data driven decision making to guide the agency’s strategy and activities.
  • Leaders are generally satisfied with the status quo.

Transition Strategies

  • All leaders learn about, understand, and embrace the key principles of QI from a managerial and philosophical perspective.
  • Leaders learn about strategies for championing a QI culture (e.g. change management, QI planning).
  • Leaders begin to assess the current organization culture and readiness for QI (e.g., level of QI knowledge, group dynamics, leadership, communication and decision-making styles, norms, and behaviors).
  • Leaders communicate to all staff and the governing entity the urgency for and benefits of QI, highlighting QI success stories in public health and other industries.
  • Leaders begin to identify members of a PM/QI Council to assist with leading the development of a QI program.

Characteristics

  • Internal and external customers of the agency have not been formally identified.
  • Staff are generally unaware of their own customers’ needs.
  • Customer needs and satisfaction data are not collected or used for decision making and improvements.
  • Internal agency assumptions are prioritized over customer needs/values.

Transition Strategies

  • Incorporate customer focus into agency vision and values.
  • Assess and build knowledge in concepts of customer focus (e.g. customer satisfaction, value streams).
  • Begin to identify all of the agency’s internal and external customers.

Characteristics

  • No staff are responsible for overseeing or governing quality initiatives in the agency.
  • No agency plans or policies address quality.
  • A current agency strategic plan likely does not exist.
  • Existing performance measures are used for purposes of grant reporting (often “widget counting”) and are not linked to strategic goals or performance improvement.

Transition Strategies

  • Leaders identify members of a PM/QI Council with all divisions/departments represented. This group will oversee the implementation of the QI program and/or performance management system (PM system).
  • Leaders work with the PM/QI Council to develop a team charter, outlining the mission and roles and responsibilities of each member.
  • Explore strategic plans, QI plans, and performance management systems of similar agencies, and common processes for developing each.
  • Conduct a performance management self-assessment (e.g. inventory current use of performance measures and data).

Characteristics

  • Agency processes are not clearly defined, unnecessarily complex, and consist of redundancies and variations throughout the agency.
  • Problems are often ignored and remain unaddressed for long periods of time.
  • Processes may result in lower quality products and services than what is possible.

Transition Strategies

  • Explore the different models for continuous process improvement (e.g. Lean, Six Sigma, Rapid Cycle Improvement) and determine the best fit for the agency.
  • Build knowledge on basic QI methods and tools.
  • Explore QI projects implemented in similar agencies.