Degree Name

DrPH (Doctor of Public Health)


Public Health

Date of Award


Committee Chair or Co-Chairs

Robert Pack

Committee Members

Deborah Slawson, Robin Pendley


Engaging in quality improvement (QI) activities can help local and state health departments improve current processes, develop more effective new processes, increase leadership capacity, and prepare for public health accreditation. Public health organizations that have implemented QI processes have seen improvements in health outcome indicators, delivery of the 10 essential services, patient satisfaction, and performance management.

Quality improvement is the foundation of the Public Health Accreditation Board‟s (PHAB) program and further pushes health departments, at both the local and state level, to adopt QI activities within their organizations. There are numerous potential benefits associated with accreditation in public health, one of the most important being that accreditation sets a benchmark for public health agencies. It also helps create a platform of continuous quality improvement that should increase efficiency, decrease waste, and improve health outcomes.

The purpose of this study was to determine the current status of QI processes in a sample of regional and metro health departments across the state of Tennessee and to assess whether those health departments with a formal QI process demonstrate an increased readiness for public health accreditation compared to those without a formal QI process in place. A survey tool aimed at assessing QI processes and efforts within health departments including the organization‟s: 1) QI culture, 2) QI capacity and competency, 3) QI alignment and spread, and 4) readiness for public health accreditation was used. In addition to the survey tool, respondents were also asked about types of QI processes used within their health department and their associated outcomes.

Initial results revealed that the majority of respondents reported high levels of QI maturity in their respective health department sites. However, further analysis of qualitative data indicated that most sites were engaged in quality assurance (QA) practices rather than true QI processes and activities.

Overall, study results indicate that further training in QI practices is needed in order to enhance performance and align with PHAB standards. The results from this study could be used to help gauge QI processes and accreditation readiness at appropriate intervals following training and education.

Document Type

Dissertation - unrestricted


Copyright by the authors.

Included in

Public Health Commons