Abstract
BackgroundImplementation of quality improvement (QI) practices varies considerably among public health units (PHUs) in Ontario. With the emphasis on continuous quality improvement (CQI) in the revised Ontario Public Health Standards (OPHS), there is a need to understand the level of QI maturity in Ontario’s PHUs. The objective of this research was to establish a baseline understanding of QI maturity in Ontario’s PHUs.MethodsThe QI Maturity Tool - Modified Ontario Version was used to assess the state of QI maturity in 34 PHUs across Ontario. QI maturity was assessed through 23 questions across three dimensions: QI Organizational Culture; QI Capacity and Competency; and QI Perceived Value. QI maturity scores were classified into five stages: Beginning; Emerging; Progressing; Achieving; and Excelling. QI maturity scores were calculated for each of the 34 participating PHUs to determine their stage of QI maturity. Each PHU’s score was then used to determine the provincial average for QI maturity. Participants were also asked to answer three questions related to core CQI organizational structures.ResultsAcross the 34 PHUs, 3503 staff participated in the survey. A review of individual PHU scores indicates that Ontario’s PHUs are at varying stages of QI maturity. The average QI maturity score of 4.94 for the 34 participating PHUs places the provincial average in the “Emerging” stage of QI maturity. By QI dimensions, the participating PHUs scored in the “Emerging” stage for QI Organizational Culture (5.09), the “Beginning” stage for QI Competency and Capacity (4.58), and the “Achieving” stage for QI Perceived Value (6.00).ConclusionThere is an urgent need for Ontario’s PHUs to progress to higher stages of QI maturity. Participants place a high value on QI, but collectively are at less “mature” stages of QI in relation to QI organizational culture and the competency and capacity to engage in QI activities. PHUs should leverage the value that staff place on QI to foster the development of a culture of QI and provide staff with relevant knowledge and skills to engage in QI activities.
Highlights
Implementation of quality improvement (QI) practices varies considerably among public health units (PHUs) in Ontario
No PHU had an average score that would fall within the “Achieving” or “Excelling” stages
A review of individual PHU scores indicates that PHUs across Ontario are at varying stages of QI maturity, but none are in the “Achieving” or “Excelling” stages, despite many having indicated that they have core continuous quality improvement (CQI) organizational structures in place
Summary
Implementation of quality improvement (QI) practices varies considerably among public health units (PHUs) in Ontario. There is a limited body of evidence on QI in public health and a lack of consensus on optimal methods and applications, which creates a gap in the guidance on how to operationalize QI in PHUs [2, 3]. This makes it difficult to share information, learn from one another, and develop common standards of practice. Investigation into the level of QI maturity in Canadian PHUs is warranted as a starting point to fill this gap in the evidence base
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