National Public Health Improvement Initiative

Key points

  • The CDC National Public Health Improvement Initiative (NPHII) improved quality and performance across many U.S. health departments.
  • NPHII provided support and investments for strengthening health organizations that was not available from other funding sources at the time.
  • Learn about NPHII's accomplishments, impact, and lessons learned.
Advancing Public Health, The Story of The National Public Health Improvement Initiative

Overview

The National Public Health Improvement Initiative (NPHII) was an innovative program started by CDC to infuse quality and performance improvement methods in health departments across the United States. During 2010–2014, NPHII provided funding and technical assistance to health departments in:

  • 48 states and the District of Columbia
  • 9 cities or counties serving large populations
  • 4 U.S. territories
  • 3 U.S.-affiliated Pacific Islands and 1 Pacific Island organization
  • 4 federally recognized tribes and 4 tribal organizations that support 250 federally recognized tribes

Why it's important

Most federal public health funding supports programs that focus on specific diseases, health issues, or population segments, known as categorical funding. Health departments often struggle to identify adequate resources for building a strong organization that can be nimble in the face of emerging issues and handle the public health responsibilities not covered by categorical funding.

NPHII complemented CDC's categorical investments by allowing agencies to strengthen organization-wide capacities, systems, and processes. NPHII's major objectives and activities included:

  • Accelerating public health accreditation readiness activities
  • Improving organizational efficiency and effectiveness through quality improvement activities
  • Increasing performance management capacity

What was accomplished

NPHII's four years of support helped awardees integrate performance improvement into their organizations' culture in an unparalleled way that better positioned them to sustain these efforts.

Through NPHII, agencies increased their ability to make data-driven decisions for priority setting, program planning, and implementation; eliminated siloes through partnerships and collaborations; strengthened the culture for performance improvement; and institutionalized these practices within the agency.

Accreditation Readiness - 40% of the U.S. population is served by NPHII-funded agencies that achieved accreditation. 97% of agencies strengthened their readiness for accreditation by engaging in activities such as designating an accreditation coordinator, establishing a roadmap to submit an application, conducting a gap analysis, completing the PHAB checklist, communicating with leaders and staff about accreditation, and creating a document management system. The majority of agencies completed or made progress toward completing the Public Health Accreditation Board (PHAB) prerequisites (Organizational strategic plan - 93%, Health Assessment - 94%, Health Improvement Plan- 85%). 86% of agencies increased the efficiency and/or effectiveness of a program, operation, or service through quality improvement projects (time saved, quality enhancement of a service and/or system, costs saved or avoided, improved customer satisfaction, increased reach to a target population, and increased preventive behaviors). More than half of agencies used NPHII funds to provide mini-grants and/or nonmonetary support (i.e., technical assistance, training, workshops to other health agencies within their jurisdictions to conduct performance improvement activities). 68 public health agencies received mini-grants and 433 received nonmonetary support for performance management, 144 public health agencies received nonmonetary support and 434 received mini-grants for quality improvement, 199 public health agencies received nonmonetary support and 697 received mini-grants for accreditation readiness. 76% of agencies will sustain activities for two or more focus areas - accreditation readiness, quality improvement, and/or performance management. 75% of agencies with a performance improvement office will maintain it and 88% of agencies maintaining these offices will sustain activities for all three focus areas.
NPHII resulted in significant improvements.

Resources

Spotlight‎

Advancing Public Health: The Story of the National Public Health Improvement Initiative

This compendium describes NPHII's accomplishments, impact, and lessons learned. It also includes 71 stories from state, tribal, local, and territorial health departments that illustrate how NPHII funding improved their efficiency and effectiveness.