Using a Quality Improvement Process to Improve Actionable Data and Evidence-Based Practices

BACKGROUND:   The public health accreditation process seeks to advance quality and performance by providing a framework for health departments to identify improvement opportunities, improve management, develop leadership, and deepen community relationships. While the Oklahoma State Department of Health (OSDH) was among the first to receive national accreditation status through the Public Health Accreditation Board, the 68 county health departments affiliated with the OSDH must undergo their own accreditation. To begin the process, three key documents are required: Community Health Assessment, Health Improvement Plan, and Department Strategic Plan. An opportunity to improve the use of existing population-based data to identify needs and appropriate community-clinical linkages and health system interventions at the county level was identified.

METHODS:   The methods followed the steps of a quality improvement project to increase the availability and access to actionable data and evidence-based practices:

• Plan (identify opportunity, assemble team, examine current approach. identify potential solutions using a fishbone diagram, and develop an improvement theory),
• Do (test the theory),
• Check (study the results), and

Act (standardize the improvement and establish future plans).

RESULTS:   A focus on chronic disease-related preventable hospitalizations was selected based on agency’s priority issues and core measures. The included system changes among several areas across the OSDH:

• Implement MONAHRQ®, a publically available, web-based analysis system of hospital discharge data,
• Leverage and coordinate resources to develop support products and services, and
• Promote the use of data and evidence-based strategies for health needs assessments and health improvement planning.

Three companion guides were developed to test the solution. Called the Toolkit Trilogy, the three guides provided reader-friendly information on:

• Projected cost savings for chronic disease hospitalizations that could have been avoided through improved clinical and community services,
• Evidence-based strategies, clinical guidelines, and innovative practices proven to improve the health of the population, and
• Data on chronic diseases, risk factors, and populations to identify community needs and target resources.

CONCLUSIONS:   The quality improvement project resulted in the dissemination and usage of data and evidence-based practices in the assessment and planning for health improvement. The Toolkit Trilogy brought together data and evidence-based preventive strategies to support decision-making to improve chronic disease health outcomes. Community partners, county coalitions, and community institutions have come together to discuss the meaning of the data, the use of evidence-based prevention, and the clinical and community perspectives to influence how and where changes are incorporated into the community effectively.