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The goal to improve public health is continuously changing and has become more of a concern over the years after major events in history such as 9/11 and the BP oil spill in the Gulf.

The article “Quality Improvement in Public Health: Lessons Learned from the Multi-State Learning Collaborative” emphasizes how important improvement and evaluation of programs, procedures and policies is.I found it interesting that the article states it has been only recently that QI methods and techniques have been applied to areas of public health, it is hard to imagine that a field as complex as healthcare has developed slowly and mostly over the last few decades. There are a number of focuses within the article. The AcademyHealth’s website highlights subjects such as initiatives that have been a part of the progress of QI in public health, the multi-state learning collaborative, considerations for Implementation and management of QI efforts, and case studies from Minnesota and South Carolina.The first case study speaks on local health departments and implementing QI culture in the state of Minnesota. Seven out of eight projects had positive outcomes. Survey results identified that efforts to build a QI culture were effective.

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Public health departments across the state noted a number of lessons learned in training and implementing QI practices, both at the local and state levels. Some of the lessons learned included: importance of identification of the problem and goal, modifications to previous QI models are sometimes necessary because the models need to keep up with policy and technology changes.QI practices should be based on the audience’s capacity. Evidence-based interventions are highly important (AcademyHealth). The second case study involves South Carolina’s application of the Institute of Healthcare Improvement’s QI model in public health. The South Carolina Department of Health ; Environmental Control (SC DHEC) is one of two states implementing the IHI’s Breakthrough Series model for its QI collaborative, which deals with tobacco use and the effects from secondhand smoke.There was strong evidence that implementing tobacco interventions and tobacco-use screening were highly effective.

Several positive outcomes were noticed from the IHI’s model implementation. Appropriate training and timely technical assistance are a must to make sure the staff has the necessary skills to carry out the QI methods. Policy and procedure changes should be carried out with enough time for staff to fit in and make the changes.It is important for staff members to have independence so they can make sound ethical decisions when there is not clear enough instruction (AcademyHealth).

The MLC has become a big reason that states have noticed the importance of accreditation (AcademyHealth). I think that focusing on accreditation is past due, without proper training and development of professionals, the QI models and procedures cannot accurately be implemented or at least understood. The importance of stakeholders’ involvement in the process has also been noted as next step.

The people leading the collaboration need to be whole-heartedly involved and on board for changes; if they are not it is not likely that those changes and processes will stick in the future. The stakeholders need to be the strong backbone of the efforts. Research on QI in public health needs to continue and grow. Proper information is a must. Public health departments need to be ready for change and improvement (AcademyHealth).

Reference: Quality Improvement in Public Health. Retrieved from: http://www. academyhealth.

org/files/interestgroups/phsr/AH_RI_Quality_Improvement. pdf

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