"The Continuum of Quality Improvement in Public Health,” co-authored by PHF quality improvement consultants John W. Moran, Grace Duffy, and Bill Riley, was published in the Quality Management Forum, a Peer-Reviewed Publication of the Quality Management Division of the American Society for Quality, in Winter 2010. The article describes quality improvement in public health as a never ending process that pervades the organization when fully implemented. Top organizational leaders address the quality of the system at a macro level (Big “QI”.) In the middle, professional staff attack problems in programs or service areas by improving particular processes (Little “qi”).  At the individual level, staff seek ways of improving their own behaviors and environments (Individual “qi”).

 

When starting their quality journey, public health organizations tend to embrace Little “qi,”  striving for quality in a limited or specific improvement project or area and accomplishing it by utilizing an integrated set of QI methods and techniques that create a value map, identify the key quality characteristics, analyze process performance, reengineer the process if needed, and lock in improvements. Little “qi” can be viewed as a tactical or micro systems approach to implementing quality and beginning to generate a culture of QI within the organization.