Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare

Price, Alex; Schwartz, Robert; Cohen, Joanna; Manson, Heather; Scott, Fran

This study illustrates the applicability of Shortell et al.' s (1998) four dimensions of CQI as a framework for understanding public health quality improvement. The study also represents one of the first attempts to examine the implementation of a CQI initiative across a complex public health system using an empirically derived and validated framework from the healthcare field. Insight provided by the framework relating to facilitators and barriers of CQI implementation has largely confirmed disparate public health research on the topic (Corso et al. 2010; McLees et al. 2014; Riley et al. 2012; Shortell et al. 1998 ). This confirmation is a promising indicator that the framework may hold value as a tool for public health decision-makers developing and implementing CQI systems. Finally, future research should test the four-dimensions framework in other public health environments and, more importantly, examine the linkages between the framework' s indicated outcomes and attributable facilitators and barriers.