Realizing transformational change through quality improvement in public health.

OBJECTIVE

This article discusses the specific components necessary to achieve transformational change within public health departments as a means for creating sustained performance improvement and better outcomes in the health of the community.

DESIGN

This article provides a review of transformation change concepts and application to public health departments.

RESULTS

Transformational change for public health departments must be intentionally designed to achieve high performance. While all improvement requires change, not all change results in improvement.

CONCLUSION

The successful transformational change effort always occurs from the top-down, while the process improvement occurs from the bottom-up. Transformational change is possible in public health departments when small incremental improvements are linked with large-scale management changes to continually improve public health performance resulting in better population outcomes.