Similar to the 2007 findings, limited variation was
found in the practice of PM and QI by SHO MPH degree
status in 2010.21 Additional encouragement and
support of staff involvement in QI by all SHOs may be
needed to foster a QI culture at health agencies. Few
agencies have formed a QI committee or recognized
staff for outstanding QI work. The establishment of
performance improvement managers through NPHII
will strengthen the capacity for this performance and
QI role at state/territorial health agencies. However,
without agency leadership support setting the tone for
QI culture, the expectation that agency-wide QI will increase may be unrealistic. Possible exposure or training
in the concepts of performance and QI and accreditation
for the entire leadership of the state and territorial
health agency may be worth exploring. ASTHO is
funded by the Centers for Disease Control and Prevention
to provide direct technical assistance for accreditation
readiness including QI where appropriate. Over
the last 2 years, ASTHO has provided technical assistance
to senior staff in several state health agencies.
Furthermore, through the Centers for Disease Control
and Prevention NPHII funding, 5 public health
partner organizations (ASTHO, National Association
of County and City Health Officials, Public Health
Foundation [PHF], American Public Health Association,
and National Network of Public Health Institutes
[NNPHI]) are providing direct technical assistance on
all aspects of performance management, QI, and systems
development. Other current avenues for training
include courses by the PHF,29 Institute for Healthcare
Improvement,30 State Health Leadership Initiative,31
etc. The School of Public Health at the University of
Minnesota will offer a Graduate Public Health Certificate
in Performance Improvement beginning in Fall
2011 where students will learn basic QI concepts and
skills as appropriate to their role in their organization.
This certificate addresses concerns voiced by the National
Board of Public Health Examiners, the Public
Health Accreditation Board, and the Council on Education
for Public Health to provide more educational
opportunities in performance improvement to working
public health professionals.