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

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

Many of the key factors presented in the four-dimensions framework overlap with those emphasized in the public health quality improvement literature. For instance, in their qualitative study of 51 quality improvement initiatives in various public health departments in the US, Riley et al. emphasized leadership and appropriate performance measures, which are also highlighted in the strategic and technical dimensions of CQI (Riley et al. 2012) . Resource inadequacy was a key barrier in McLees et al.' s (2014) study of 74 public health agencies involved with the National Public Health Improvement Initiative in the US, as it is in the strategic dimension of Shortell et al.' s framework. The importance of training and education in quality-improvement concepts and techniques is also stressed in both the public health literature and the technical dimension (Corso et al. 2010) . Knowledge transfer and exchange, supportive organizational cultures and the influence of implementers in decision-making outlined in the structural, cultural and strategic dimensions were factors that did not appear to have extensive profiles in the public health literature.