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

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

"I don't know. I think that remains to be seen. I' m hoping it' s more to be used in a combination with evidence to make ongoing improvements to public health programs and policies." -Site-C informant Ministry informants stated that performance information would allow for "discussion" with public health units. Some public health unit informants speculated that these discussions would include questions of what barriers to performance existed. One public health unit interviewee noted that performance information lacked the context to address why the results were the way they were. Meanwhile, several other informants argued that their public health unit would have to provide additional, unsolicited information to explain their performance achievement. One Site-B informant explained: "So, in my earlier interview with you I described some of the vehicles that you can use and that I voluntarily send to the Ministry like our performance report, it' s rare that I would get an acknowledgement, let alone do they read it. So I don't think the Ministry is all that interested in what we are doing apart from the information that we use to populate what I would call to be our financial reports." -Site-B informant In contrast to the provincial initiative, all public health unit interview sites described specific internal processes of quality improvement such as balanced scorecards, evaluation, Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare reporting and strategic planning elements. Only 55% of survey respondents believed the province' s system of accountability and performance management had the intent of providing learning opportunities and improving performance.