Driving a public health culture of quality: how far down the highway have local health departments traveled?

Context: There has been an extensive investment in building public health organizational capacity to improve performance and prepare for accreditation. An evolving perspective has focused not only on the practice of quality improvement (QI) within the health department but also upon the extent the culture of QI is embraced within the agency.

Objective: No studies have examined the current national baseline of QI culture implementation, nor estimated the degree of QI sophistication local health departments (LHDs) have attained.