• Quality Improvement Maturity Tool

    Staff members engaged in quality improvement (QI) activities and other leaders in local and state health departments can use this tool to assess their health department's "quality improvement maturity," or the extent to which the department operationalizes QI best practices.

    Staff members engaged in quality improvement (QI) activities and other leaders in local and state health departments can use this tool to assess their health department’s “quality improvement maturity,” or the extent to which the department operationalizes QI best practices.

    Developing a culture of quality in a health department goes beyond conducting individual quality improvement (QI) projects, and typically takes place over time. This assessment can help a health department identify key areas for quality improvement, determine if staff and leadership could benefit from additional QI education or training, and measure QI progress over time.

    Instructions

    Consider the most effective way your department can go about using this assessment. Options include:

    1. This assessment survey is given to all staff at the health department. This option is recommended to give the best data regarding the health department’s culture of quality.
    2. A QI oversight team, or other sub-set of staff, completes this assessment survey.
    3. A key leader at the health department completes this assessment survey.



    If multiple staff from a health department are completing this assessment (options 1 and 2 above), an administrator or lead should initiate the assessment by creating a “team login.”* Click the “Team login” button to register, and then share the user name and password with other team members taking the assessment. All participants must use these login credentials in order for their scores to be aggregated with the whole team's scores, and for a median team score to be generated.


    Your QI Maturity score results will be displayed as they correspond to the phases of the NACCHO Roadmap to a Culture of Quality Improvement.

    It is recommended that this tool be used to track a health department’s QI Maturity over time. For example, a health department may choose to save their QI Maturity score, and then re-take this assessment in a year to see if QI Maturity has changed.


    *Please note that the University of Kentucky Coordinating Center, and the researchers of this tool, have access to the raw data of anyone utilizing the assessment. If you wish for your team’s data to not be associated with your specific health department, we recommend creating a team log-in that does not name your health department or region.

    Related resources

    Miner Gearin KJ, Gyllstrom M, Joly BM, Frauendienst RS, Myhre J, Riley W. Monitoring QI Maturity of Public Health Organizations and Systems in Minnesota: Promising Early Findings and Suggested Next Steps . Front Public Health Serv Syst Res 2013; 2(3).

    Joly BM, Booth M, Mittal P, Shaler G. Measuring quality improvement in public health: the development and psychometric testing of a QI Maturity Tool. Eval Health Prof. 2012 Jun;35(2):119-47.

    Joly BM, Booth M, Shaler G, Mittal P. Assessing quality improvement in local health departments: results from the Multi-State Learning Collaborative. J Public Health Manag Pract. 2012 Jan-Feb;18(1):79-86.

    Minnesota Department of Health: How To Develop a QI Plan

    NACCHO Roadmap to a Culture of Quality Improvement

    Citation

    The questions on this survey are drawn from a 50-question QI maturity survey developed to evaluate the Robert Wood Johnson Foundation Multi-State Learning Collaborative (MLC). This select set of 10 questions was developed by the Minnesota Public Health Research to Action Network to represent the key domains of QI maturity.

    Contact information for the tool researchers:
    Kim Gearin, PhD
    Phone: 651-201-3884
    Email: kim.gearin@state.mn.us

    Beth Gyllstrom, PhD, MPH
    Phone: 651-201-4072
    Email: beth.gyllstrom@state.mn.us

    Contact Information

    Kim Gearin, PhD
    Phone: 651-201-3884
    Email: kim.gearin@state.mn.us

    Beth Gyllstrom, PhD, MPH
    Phone: 651-201-4072
    Email: beth.gyllstrom@state.mn.us

    Developing a culture of quality in a health department goes beyond conducting individual quality improvement (QI) projects, and typically takes place over time. This assessment can help a health department identify key areas for quality improvement, determine if staff and leadership could benefit from additional QI education or training, and measure QI progress over time.

  • Administrative Evidence-Based Practices Assessment Tool

    Front-line public health professionals and managers need evidence-based information to make decisions on how to best improve public health performance and health outcomes in the communities they serve. Past studies have shown that health departments can improve their performance by adopting certain administrative practices. These administrative evidence-based practices, or A-EBPs, can help local health departments build competencies for agency accreditation, identify opportunities to improve efficiency, and improve the community health by adopting practices that been shown to work in other settings.

    This tool will provide you with an assessment of the extent to which your health department currently supports the adoption of A-EBPs. You will receive a score for five key A-EBP domains: workforce development, leadership, organizational climate and culture, relationships and partnerships, and financial processes. The tool will also allow you to compare your health department to a national, stratified sample of local health departments.

    This tool helps managers and practitioners at local and state public health departments assess the extent to which their departments utilize administrative evidence-based practices (A-EBPs), leading to improved efficiency and public health outcomes, and building competency for accreditation.

    Front-line public health professionals and managers need evidence-based information to make decisions on how to best improve public health performance and health outcomes in the communities they serve. Past studies have shown that by adopting certain administrative practices, health departments can improve their performance. These administrative evidence-based practices, or A-EBPs, can help local health departments build competencies for agency accreditation, identify opportunities to improve efficiency, and improve the public’s health by adopting best practices based on what has been shown to work in other settings.

    This tool will provide you with an assessment of the extent to which your local health department currently supports the adoption of A-EBPs. You will receive a score for five key domains of A-EBPs: workforce development, leadership, organizational climate and culture, relationships and partnerships, and financial processes. The tool will also allow you to compare your local health department to a national, stratified sample of local health departments.

    Instructions

    It is recommended that at least 4 to 5 employees from one state or local health department each take this assessment, so that their scores may be aggregated to create one score for the entire health department. An administrator or lead should initiate the assessment by creating a “team login.”* Click the “Team login” button to register, and then share the user name and password with other team members taking the assessment. All participants must use these login credentials in order for their scores to be aggregated with the whole team.

    You may be interested in comparing your health department’s overall score to scores from specific program areas (e.g., Maternal and Child Health Bureau, Environmental Health Division, Infectious Disease Bureau, Chronic Disease Programs, etc.). To make this type of comparison, staff from one program area should collectively complete one assessment. This tool will then display results for the one collective assessment as well as results for the health department overall.

    *Please note that the University of Kentucky Coordinating Center, and the researchers of this tool, have access to the raw data of anyone utilizing the assessment. If you wish for your team’s data to not be associated with your specific health department, we recommend creating a team log-in that does not name your health department or region.

    Limitations

    The use of the A-EBPs tool can provide a snapshot of your agency. For small sample sizes, the data will not be statistically valid and will only provide a rough estimate of your agency’s progress in these areas. To use this tool for strategic planning or evaluation, you should contact the tool developers along with individuals with expertise in evaluation.

    Citation

    Article Review
    Brownson RC, Allen P, Duggan K, Stamatakis KA, Erwin PC. Fostering more-effective public health by identifying administrative evidence-based practices: a review of the literature. Am J Prev Med. 2012 Sep;43(3):309-19.

    Measurement Development
    Reis RS, Duggan K, Allen P, Stamatakis KA, Erwin PC, Brownson RC: Developing a Tool to Assess Administrative Evidence-Based Practices in Local Health Departments. Front Public Health Serv Syst Res 2013, 3(3): article 2.

    National Applications
    Brownson RC, Reis RS, Allen P, Duggan K, Fields R, Stamatakis KA, Erwin PC. Understanding administrative evidence-based practices: findings from a survey of local health department leaders. Am J Prev Med. 2014 Jan;46(1):49-57.

    Erwin PC, Harris JK, Smith C, Leep CJ, Duggan K, Brownson RC. Evidence-based public health practice among program managers in local public health departments. J Public Health Manag Pract. 2014 Sep-Oct;20(5):472-80.

    Tool Content
    The content for this tool was developed by the Prevention Research Center in St. Louis with funding from RWJF’s grant no. 69964 (Public Health Services and Systems Research).

    Contact information for the tool researchers:
    Katie Duggan, MPH, MS, RD
    Manager, Special Projects
    The Prevention Research Center
    Washington University in St. Louis
    314-935-0125
    kduggan@wustl.edu

    Contact Information

    Katie Duggan, MPH, MS, RD
    Manager, Special Projects
    The Prevention Research Center
    Washington University in St. Louis
    314-935-0125
    kduggan@wustl.edu

    Related resources

    The Prevention Resource Center at Washington University in St. Louis offers additional information, tools, and resources on how to maximize your health department’s adoption of administrative evidence-based practices.

  • Community Health Improvement Plans and Processes Quality Measurement Tool

    Local health departments, boards of health, and others partners can use this tool to measure the quality of their community health assessments and improvement plans and processes, and to identify areas for improvement.

    Local health departments, boards of health, and others partners can use this tool to measure the quality of their community health assessments and improvement plans and processes, and to identify areas for improvement.

    This tool can be used by local health departments, boards of health, and others interested in measuring the quality of their community health assessments and improvement plans and processes. This assessment helps you identify at which steps your community health plans and processes are already of high-quality, and at which steps you may want to focus your efforts for improvement.

    While many of the measures within this tool are based on the Public Health Accreditation Board’s (PHAB) Standards and Measures Version 1.5, note that scoring of items may exceed the minimum standard set by PHAB. Therefore, a perfect score is not necessary in order to become PHAB accredited. This tool is not intended to predict whether a health department will be accredited by PHAB.

    Instructions

    You will be guided through a number of questions under several Action Cycle Steps, such as the extent to which your community health assessment and improvement plan engaged other key stakeholders, assessed needs and resources, was guided by evidence, etc. If you hover your mouse over each statement, you will see an explanation outlining necessary documentation or including further explanation so that responses can be fully informed. When reviewing results, you will see the PHAB reference related to each question.

    When reviewing your results, you will see a score for each question as well as a mean score for the Action Cycle Steps. You can review your scores at different Action Cycle Steps to assess at which steps your community health plans and processes are already of high-quality, and at which steps you may want to focus your efforts for improvement. You may also use this self-assessment tool to measure change over time.

    Your results will be displayed in comparison to the average results of others who have taken this assessment.

    If you would like to preview this self-assessment tool, you may download a PDF copy of the tool measures and explanations here.

    Limitations

    This tool is not endorsed by the Public Health Accreditation Board (PHAB), and is not intended to predict whether a health department will be accredited by PHAB. While many of the measures within this tool are based on the Public Health Accreditation Board’s (PHAB) Standards and Measures Version 1.5, note that scoring of items may exceed the minimum standard set by PHAB. Therefore, a perfect score is not necessary in order to become PHAB accredited.

    Citation

    The content for this tool was developed by researchers at the University of Wisconsin Population Health Institute in collaboration with the Wisconsin Public Health Practice-based Research Network with funding from the Robert Wood Johnson Foundation, Research Implementation Award.

    Contact information for the tool researchers:
    Julie Willems Van Dijk, RN, PhD
    Associate Scientist
    University of Wisconsin Population Health Institute
    610 Walnut Street, WARF 533
    Madison, WI 53726
    willemsvandi@wisc.edu
    608-263-6731

    Contact Information

    Julie Willems Van Dijk, RN, PhD
    Associate Scientist
    University of Wisconsin Population Health Institute
    610 Walnut Street, WARF 533
    Madison, WI 53726
    willemsvandi@wisc.edu
    608-263-6731

    Related resources

    For additional resources on community health improvement, see:

    This tool can be used by local health departments, boards of health, and others interested in measuring the quality of their community health assessments and improvement plans and processes. This assessment helps you identify at which steps your community health plans and processes are already of high-quality, and at which steps you may want to focus your efforts for improvement.

    While many of the measures within this tool are based on the Public Health Accreditation Board’s (PHAB) Standards and Measures Version 1.5, note that scoring of items may exceed the minimum standard set by PHAB. Therefore, a perfect score is not necessary in order to become PHAB accredited. This tool is not intended to predict whether a health department will be accredited by PHAB.

  • Staff Cost of Public Health Services Estimator

    This tool offers managers an easy way to estimate the staff costs of providing specific public health services. These estimated staff costs can be used for budgeting, planning, and quality improvement purposes.

    This tool offers managers an easy way to estimate the staff costs of providing specific public health services. These estimated staff costs can be used for budgeting, planning, and quality improvement purposes.

    This tool can be used by managers of state and local public health departments to estimate the staff cost for providing a specific public health service over a 2-week period. This staff cost estimate can be combined with other variable and fixed costs to estimate the total economic costs of providing the specific public health service. This tool can be used to assess the costs associated with a wide variety of public health services, such as health regulation enforcement, developing solutions to public health challenges, and monitoring public health, as well as others.

    Instructions

    In order to calculate staff-related costs in the delivery of specific public health services, you will need to input several data points.

    1. Select the public health service for which you would like to estimate staff costs. You may choose any type of service. Examples of public health services include:
      1. Monitor health status to identify and solve community health problems.
      2. Diagnose and investigate health problems and health hazards in the community.
      3. Inform, educate, and empower people about health issues.
      4. Mobilize community partnerships and action to identify and solve health problems.
      5. Develop policies and plans that support individual and community health efforts.
      6. Enforce laws and regulations that protect health and ensure safety.
      7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
      8. Assure competent public and personal health care workforce.
      9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
      10. Research for new insights and innovative solutions to health problems.
    2. Determine the series of activities that local public health staff engage in to deliver the selected public health service.
      1. To collect the most accurate data, conduct key informant interviews and focus groups to develop a workflow diagram outlining all staff activities related to the delivery of the selected public health service.
    3. List and define each activity identified in Step 2.
    4. Enter the name (optional) and title of all staff engaged in this task at your local public health department.
    5. Total FTE: Below each staff name / title, enter each person’s total FTE based on a 40-hour work week. This is the person’s total FTE whether within or outside the delivery of the selected public health service. Please use 40 hours / week = 1 FTE, 20 hours / week = .5 FTE, etc.
    6. Lower end of hourly range:
      1. Please enter the LOWER END of the hourly rate.
    7. Higher end of hourly range:
      1. Please enter the HIGHER END of the hourly rate.
    8. Fringe Rate: Next to each staff name / title, if known, please enter the FRINGE RATE for each position as a percent. Do not dedicate too much extra time to finding this data if it is not readily available.
    9. Activities: Please enter your best estimate of the NUMBER OF HOURS DURING A NORMAL 2 –WEEK PERIOD each staff member spends working on each activity. Please enter in hours; for minutes please enter as fractions of time (15 minutes = 0.25, etc.)

    To download an Excel version of this tool, click here. Note: the Excel version of this tool includes options for entering employee compensation as an hourly rate or as an annualized salary.

    Tool Validation

    If you would like to test the validity of your results, you may download a customizable employee time log that can be used to collect data directly from employees on the time they spend on each activity involved in delivering the selected public health service. Click here to download the employee time log:
    Time Log Validation Spreadsheet

    Before using employee time log, you must customize the Cover Sheet:

    1. In Rows 7, 9 and 15, insert the selected public health service you are measuring.
    2. In Rows 19 – 25, Columns A and B, list and define each activity related to the delivery of the selected public health service. Add additional rows if needed.

    Once you have customized the Cover Sheet, distribute the Employee Time Log to all employees who work on the selected public health service, and ask them to use this Log to record their activities daily over a two-week period.

    The “Total Hours” cells in the Employee Time Log can be compared to the “Total Hours” column results from the Manager Tool. Week 1 Total Hours and Week 2 Total Hours from the Employee Time Log should be added together before comparing to the Total Hours entered into the Manager Tool.

    Limitations

    This time log tool is only sensitive to 15-minute increments. Additionally, the manager’s tool is based on the manager’s best judgment of employee time allocation; if a manager wishes to further test the validity of his or her assessment, the customizable employee time log can also be used. In previous studies, the employee time log was used to validate the manager tool, and similar results were generated using both instruments.

    Citation

    The content for this tool was developed by Adam Atherly, PHD and Melanie Whittington, MS at the University of Colorado Anschutz Medical Campus, Lisa VanRaemdonck, MPH, MSW and Sarah Lampe, MPH at the Colorado Association of Local Public Health Officials. Funding was provided by RWJF Grant #: 71153.

    Detailed contact information for the tool researchers:
    Adam J Atherly
    Chair, Associate Professor
    Department of Health Systems, Management, and Policy
    University of Colorado Anschutz Medical Campus
    Adam.Atherly@ucdenver.edu

    Melanie D. Whittington
    Ph.D. in Health Services Research Student
    Department of Health Systems, Management, and Policy
    University of Colorado Anschutz Medical Campus
    melanie.mason@ucdenver.edu

    Lisa VanRaemdonck
    Executive Director
    Colorado Association of Local Public Health Officials
    Lisa@calpho.org

    Sarah Lampe
    Project Manager
    Colorado Association of Local Public Health Officials

    Contact Information

    Adam J Atherly
    Chair, Associate Professor
    Department of Health Systems, Management, and Policy
    University of Colorado Anschutz Medical Campus
    Adam.Atherly@ucdenver.edu

    Melanie D. Whittington
    Ph.D. in Health Services Research Student
    Department of Health Systems, Management, and Policy
    University of Colorado Anschutz Medical Campus
    melanie.mason@ucdenver.edu

    Lisa VanRaemdonck
    Executive Director
    Colorado Association of Local Public Health Officials
    Lisa@calpho.org

    Sarah Lampe
    Project Manager
    Colorado Association of Local Public Health Officials

    This tool can be used by managers of state and local public health departments to estimate the staff cost for providing a specific public health service over a 2-week period. This staff cost estimate can be combined with other variable and fixed costs to estimate the total economic costs of providing the specific public health service. This tool can be used to assess the costs associated with a wide variety of public health services, such as health regulation enforcement, developing solutions to public health challenges, and monitoring public health, as well as others.

  • PHAST/MPROVE Measures of Local Public Health Service Delivery

    Researchers, state and local health department practitioners, and non-governmental community leaders can use the Measures of Local Public Health Service Delivery to further standardize their own monitoring, reporting, and tracking of public health activities.

    Researchers, state and local health department practitioners, and non-governmental community leaders can use the Measures of Local Public Health Service Delivery to further standardize their own monitoring, reporting, and tracking of public health activities.

    PHAST (Public Health Activities & Services Tracking) aims to develop a standardized information system for tracking public health activities nationwide. Measures were developed as part of the MPROVE (Multi-network Practice and Outcome Variation Examination) study, and have been further refined. These PHAST/MPROVE Measures of Local Public Health Service Delivery characterize volume, intensity, quality, efficiency, and equity of service delivery in three core domains of chronic disease prevention, communicable disease control, and environmental health protection.

    PHAST is a multi-state collaboration of researchers and practice partners examining the outcomes associated with variation and change in public health financing, infrastructure, and service delivery at the local level.

    PHAST is working to:

    • Connect with public health officials to facilitate incorporation of the PHAST/MPROVE measures into state health department reporting systems
    • Support interested states in service data definition, collection, dissemination, and analysis
    • Assure relevance of standardized measures for: accreditation, advocacy, data-driven decision-making, and demonstrating use of resources
    Citation

    To contact the PHAST Team, e-mail: phast@uw.edu

    Tool

    Contact Information

    To contact the PHAST Team, e-mail: phast@uw.edu

    PHAST (Public Health Activities & Services Tracking) aims to develop a standardized information system for tracking public health activities nationwide. Measures were developed as part of the MPROVE (Multi-network Practice and Outcome Variation Examination) study, and have been further refined. These PHAST/MPROVE Measures of Local Public Health Service Delivery characterize volume, intensity, quality, efficiency, and equity of service delivery in three core domains of chronic disease prevention, communicable disease control, and environmental health protection.

    PHAST is a multi-state collaboration of researchers and practice partners examining the outcomes associated with variation and change in public health financing, infrastructure, and service delivery at the local level.

    PHAST is working to:
    • Connect with public health officials to facilitate incorporation of the PHAST/MPROVE measures into state health department reporting systems
    • Support interested states in service data definition, collection, dissemination, and analysis
    • Assure relevance of standardized measures for: accreditation, advocacy, data-driven decision-making, and demonstrating use of resources

  • Economic Burden of Chronic Disease in California

    This tool provides public health practitioners and leaders in California with estimates of the number of cases and cost of care of six chronic conditions by ethnicity, age, gender, county and region.

    This web-based application, based out of the University of California Merced, allows users to estimate the cost of chronic diseases in each county or region in California. The website allows you to access estimates of the cost of six chronic diseases by ethnicity, age, gender, county, and region. The six chronic diseases for which cost estimates are available are: arthritis, asthma, cancer, cardiovascular disease (including: congestive heart failure, coronary heart disease, hypertension, stroke, and other heart diseases), depression, and diabetes. Cost estimates are also available for all the chronic diseases combined.

    Data can be downloaded as a .csv file, and the site outlines methodology and data sources used to generate the cost calculations.

    Citation

    Brown PM, Gonzalez M, Dhaul RS. Cost of chronic disease in California: estimates at the county level. J Public Health Manag Pract. 2015 Jan-Feb;21(1):E10-9.

    The website allows you to customize your request. If you want to use the information, please cite the source as:
    Brown P, Gonzalez M, Sandhu R. Economic burden of chronic diseases. Accessed on [insert access date] from http://cbcd.ucmerced.edu/Health/.

    Tool

  • Economic Evaluation Calculator for Latent Tuberculosis Screening and Treatment

    Those who work in tuberculosis control can use this calculator tool to inform cost-effective decision making regarding screenings for latent tuberculosis in local populations.

    This calculator tool is intended to help clinicians responsible for TB control to optimize resources related to TB prevention. The calculator allows cost comparisons between diagnostic methods and treatment options, while estimating the program costs of screening populations for latent tuberculosis infection (LTBI).

    The tool provides additional information on the costs and rates, along with references, used in its calculations.

    Limitations

    The tool is intended to provide general information on which to make general cost comparisons about latent tuberculosis infection (LTBI) diagnostic and treatment regimens within state and local health department settings. It should not be used to provide actual cost data for a specific clinic or situation or be used as a budgeting tool.

    Citation

    Contact information for the tool researchers:
    Erin Carlson, DrPH
    University of North Texas Health Science Center
    School of Public Health
    3500 Camp Bowie Boulevard
    Fort Worth, Texas 76107
    erin.carlson@unthsc.edu

    This project is supported, in part, by funds made available from the Centers for Disease Control and Prevention, Division of TB Elimination, under contract number 200-2012-M-51191.
    The content of this website is that of the authors and does not necessarily represent the official position of or endorsement by the Centers for Disease Control and Prevention.

    Tool
    Contact Information

    Erin Carlson, DrPH
    University of North Texas Health Science Center
    School of Public Health
    3500 Camp Bowie Boulevard
    Fort Worth, Texas 76107
    erin.carlson@unthsc.edu

  • Public Health IT Maturity Index

    The Public Health Information Technology (PHIT) Maturity Index is a tool that local public health agencies may use for assessment, decision support and improvement of IT activities.

    The Public Health Information Technology (PHIT) Maturity Index is a tool that local public health agencies may use for assessment, decision support and improvement of IT activities.

    The Index assesses the common elements of local health departments (HDs) regarding their mission, services, strategies, and target capabilities, enabling HDs to apply the Index to evaluate their information technology deployment decisions. It is recognized that differences health departments (HDs), such as their size, organizational structure, scope of authority, resources, population served, or governance, may make broad comparability of the Index challenging. As benchmark data become available from HDs using the Index, it may enable comparative assessment and linking of IT maturity and multi-agency interoperability to population health outcomes.

    For more information about the PHIT Maturity Index development and resources, go to http://publichealthsystems.org/public-health-and-primary-care-integratio...

    Public Health Information Technology Maturity Index Overview
    Contact

    Contact: Kenyon Crowley, M.B.A., M.S.I.S., Center for Health Information and Decision Systems (CHIDS), Robert H. Smith School of Business, University of Maryland

    Additional Resources