School of Public Health, University of Minnesota, Minneapolis 55455, USA.
J Public Health Manag Pract. 2012 Nov;18(6):506-14. doi: 10.1097/PHH.0b013e31825fbb12.
Quality improvement (QI) methods have been used for almost a decade in public health departments to increase effectiveness and efficiency. Although results are rapidly accumulating, the evidence for the science of improvement is shallow and limited. To advance the use and effectiveness of QI in public health, it is important to develop a science of improvement using practice-based research to build an evidence base for QI projects.
This purpose of this study is to advance the science of improvement in public health departments with 3 objectives: (1) establish a taxonomy of QI projects in public health, (2) categorize QI projects undertaken in health departments using the taxonomy, and (3) create an opportunity modes and effects analysis.
This study is a qualitative analysis of archival data from 2 separate large databases consisting of 51 QI projects undertaken in public health departments over the last 5 years.
The study involves 2 separate QI collaboratives. One includes Minnesota health departments; the other is a national collaborative.
We propose a standardized case definition, common metrics, and a taxonomy of QI projects to begin building the evidence base for QI in public health and to advance the science of continuous quality improvement.
All projects created an aim statement and used metrics while 53% used a specific QI model with an average of 3.25 QI techniques per project. Approximately 40% of the projects incorporated a process control methodology, and 60% of the projects identified the process from beginning to end, while 11 of 12 PHAB (Public Health Accreditation Board) domains were included.
The findings provide a baseline for QI taxonomy to operationalize a science of improvement for public health departments.
质量改进（QI）方法在公共卫生部门已经使用了近十年，以提高效率和效果。尽管成果正在迅速积累，但改进科学的证据还很薄弱和有限。为了推进 QI 在公共卫生中的应用和有效性，重要的是利用基于实践的研究来发展改进科学，为 QI 项目建立证据基础。
本研究的目的是通过三个目标来推进公共卫生部门的改进科学：（1）建立公共卫生 QI 项目的分类法，（2）使用分类法对卫生部门开展的 QI 项目进行分类，（3）创建机会模式和效果分析。
本研究是对过去五年中在公共卫生部门开展的 51 个 QI 项目的两个独立大型数据库的档案数据进行的定性分析。
该研究涉及两个独立的 QI 合作组织。一个包括明尼苏达州的卫生部门；另一个是国家合作组织。
我们提出了一个标准化的病例定义、通用指标和 QI 项目分类法，以开始为公共卫生中的 QI 建立证据基础，并推进持续质量改进的科学。
所有项目都制定了目标陈述并使用了指标，而 53%的项目使用了特定的 QI 模型，每个项目平均使用了 3.25 种 QI 技术。大约 40%的项目采用了过程控制方法学，60%的项目确定了从开始到结束的过程，而 11 个 PHAB（公共卫生认证委员会）领域中的 12 个都被包含在内。
这些发现为 QI 分类法提供了一个基线，以便为公共卫生部门实施改进科学。
