The Diamond Project: A Quality Improvement Model for Adopting Shared Service Delivery in the Washington Vaccines for Children Program.

Betty Bekemeier,Kylerose Delaney,Stacy Wenzl,Michele Roberts,Dorene Hersh

doi:10.3389/fpubh.2020.00272

Abstract

Context: Increasing federal requirements with no change in the Centers for Disease Control and Prevention budget creates an unsustainable delivery model between states and their local counterparts for programs like Vaccines for Children (VFC).Project: The Washington State Department of Health collaborated with the Washington Association of Local Public Health Officials to identify how best to improve the quality of the VFC program.Approach: Utilizing Quality improvement and Lean Six Sigma methods, the project team was able to adopt a new shared-service delivery model to improve the quality of the VFC program in Washington State.Discussion: Through utilization of quality improvement methods and Lean methodology Washington State Department of Health identified recommendations to adopt a shared-service delivery and implemented those changes.

Highlights

Today’s public health departments operate in environments of chronic fiscal stress from severe cuts to state and local health jurisdiction (LHJ) budgets (1, 2)
This paper provides a useful example of a project between Washington State Department of Health (DOH) and the Washington State Association of Local Public Health Officials (WSALPHO) that identified and utilized quality improvement (QI) models as a framework to improve their Vaccines for Children Program (VFC) program
This paper demonstrates how QI and Lean models, can be used to establish sustainable and improved public health systems and services

Summary

Introduction

Today’s public health departments operate in environments of chronic fiscal stress from severe cuts to state and local health jurisdiction (LHJ) budgets (1, 2). This stress exists as they are responsible for responding to urgent public health issues (2–4) and emergencies and addressing “upstream” prevention activities with consistently inadequate resources. State departments of health are faced with new challenges as federal program requirements change or increase expectations without additional funding (5). In 2011 the CDC increased the site visit mandate from every 4 to every 2 years—essentially doubling the work of site visit facilitators, without a corresponding funding increase (5). LHJs have been working to implement new systems and polices to support

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Discussion

Conclusion