Table 1.
Description and Preliminary Outcomes of Eight QI Projects
| Project Title | Aim | Location (No. of Counties Involved) | Team Size | Process Type | QI Techniques Used | Preliminary Outcomes | Perceived Overall Success |
|---|---|---|---|---|---|---|---|
| Decreasing clinic “no show” rates | By February 2008, increase the rate of appointments kept at Women, Infant and Children (WIC) clinics | Metro/Rural (9) | 13 | Core | 1, 2, 3, 6, 9, 10,12 | While some counties implemented a reminder protocol and maintained fairly high rates of kept appointments, other counties experienced initial increase but those increases were not maintained. Overall, improvement in rates was not demonstrated | Low |
| Improving reaction time necessary to respond to and deploy health alerts | By March 2008, decrease by 50% the staff time required to respond and deploy a health alert through the Health Alert Network (HAN) | Suburban (1) | 10 | Support | 1, 2, 3, 5, 6, 9, 10, 12 | Several interventions were designed and implemented, resulting in a 70% net decrease in staff time dedicated to HAN testing events | High |
| Improving communication in latent TB clinics | Reduce time spent documenting treatment of patients with latent tuberculosis (TB) by 10% or 8 minutes per patient | Metro/Rural (3) | 9 | Core | 1, 2, 3, 6, 9, 10 | Preliminary assessment of the program shows a reduction in documentation time by 9.7 minutes per patient. Additional testing is under way | High |
| Improving access to children mental health services | Establish program to offer mental health screening to 100% children with mental health needs | Rural (1) | 9 | Core | 1, 2, 3, 6, 9, 10, 12 | From 11/28/07 to 2/23/08 all 254 parents (100%) of children ages 6 months to 16 years were offered screening, 66.5% completed the screening, and 27% of those were diagnosed and referred to treatment | High |
| Improving immunization rates through data integration | By March 2008, improve immunization rates for children enrolled in the Women, Infant, and Children (WIC) Program and born 11/1/05 to 2/28/06 | Metro/Rural (11) | 9 | Support | 1, 2, 3, 9, 10, 12 | Preliminary outcomes show that immunization rates increased significantly from 75% to 83%. Routine medical exams also increased | Medium |
| Overcoming barriers to dental varnishing | Increase use of dental fluoride treatments for children enrolled in the Women, Infant, and Children (WIC) Program. Between 09/01 and 11/30/07, have at least 20 WIC children treated | Metro/Rural/Tribal (7) | 11 | Core | 1, 2, 3, 9, 10, 11, 12 | A new program was designed and established. Between 09/01 and 11/30/07, 104 children treated, largely exceeding initial aim | High |
| Incorporating public health (PH) competencies into staff performance assessments | Develop standardized measures of public health competency and ensure that 100% of leadership council members achieve a minimum rating of 3 on a 1–5 scale | Metro (1) | 12 | Support | 1, 2, 3, 7, 9, 10, 12, 13 | Understanding of public health core competencies and their use in staff development and appraisals increased from 28% to 62%. Aim was not achieved but is well underway | Low |
| Preventing gaps in personal care assistance (PCA) | Increase the percentage of PCA reassessments from 62% to 80% | Metro/Rural (1) | 8 | Core | 1, 2, 3, 6, 9, 10, 12 | The initial goal was exceeded. An initial review shows that 100% of all assessments between 10/1 and 12/31/2007 were on time. Team awaits independent review by the MN Department of Human Services. | High |
Key: 1, Model for Improvement; 2, PDSA Cycle; 3, Process Mapping; 4, Control Chart; 5, Run Chart; 6, Cause and Effect Diagram; 7, Memory Jogger; 8, Radar Chart; 9, Aim Specification; 10, Measure Development; 11, Force Field Analysis; 12, Nominal Group Techniques; 13, Logic Model.