​Public Health Foundation (PHF) QI Experts provided guidance and training on quality improvement (QI) tools and methods to three counties in Ohio to raise their DTaP series (4 shot series) immunization rates. The project began with a joint QI training in which each health department team analyzed their clinic flow and current immunization practices, and identified improvement opportunities. Throughout the project, the value of the QI tools and methods was evident when unexpected disruptions such as the H1N1 outbreak affected all counties, when Hocking County faced a department merger, and when Franklin County had a server crash. The tools each team used varied based on their needs, but each team improved its immunization rate, learned how to implement QI techniques, and gained the skills necessary to integrate QI into their daily operations. Visit the Diverse QI Methods All Lead to Success: Increased immunization rates in 3 Ohio Counties resources and tools page for more information and to access the case study and storyboards for this project.