Public health agencies are increasingly challenged to adopt Quality Improvement (QI) strategies to enhance performance. Many of the functional and structural barriers to effective use of QI can be found in the organizational culture of public health agencies. The purpose of this study was technical assistance for QI interventions on the organizational culture of public health agencies in Georgia.
According to Dr. Gulzar Shah, “A major goal of QI is to move beyond individual QI projects to a change in the organization’s culture that reflects ongoing and pervasive application of QI principles and practices throughout the organization.”
An online survey of key informants in Georgia’s districts and county health departments was used to compare perceptions of characteristics of organizational QI culture between PBRN supported QI districts and non-PBRN supported districts before and after the QI interventions. The primary outcomes of concern were reported increases in QI culture as measured by items assessing organizational QI practices from a validated instrument on QI Collaboratives. Survey results were analyzed using Multi-level Mixed Effects Logistic Model, which accounts for clustering/nesting.
Agency culture, considered by many QI experts as the main goal of QI, is different than use of specific QI methods, such as Plan-Do-Study-Act (PDSA) cycles or root-cause analyses. The specific use of a QI method does not necessarily reflect culture change. Attempts to measure QI culture are newly emerging. This study documented significant improvements in characteristics of organizational culture and demonstrated the potential of PBRNs to support agency QI activities.
“Comparison of practice based research network based quality improvement technical assistance and evaluation to other ongoing quality improvement efforts for changes in agency culture,” was published in BMH Health Services Research.
Dr. William C. Livingood, Center for Health Equity & Quality Research, UF College of Medicine (formerly the academic lead for the GA PBRN), was the lead author. Ms. Angela H. Peden, Jiann-Ping Hsu College of Public Health Georgia Southern University (JPHCOPH), Dr. Gulzar Shah, associate dean for research at the JPHCOPH were co-authors along with many of their colleagues.