Steven Smith


In these challenging times for public health, current discussions with a broad range of internal and external stakeholders inevitably focus on recurring themes like accountability, effectiveness, efficiency, customer service, innovation and performance measurement. Historically, these elements were partially addressed through traditional quality assurance programs which prioritized documentation, standardization of process and financial reporting.  Improvement did occur with the quality assurance process, but it wasn’t necessarily customer focused and it often occurred in a piecemeal fashion.  Outputs and conformance were more important than outcomes and customer experience.

Today’s complex operational environment requires a paradigm shift for accountability and performance.  Shrinking resources, complex service delivery models and customer expectations are driving a new age agenda for quality improvement within public health.  Our vision of public health can no longer rely on individual program outputs.  We must change our perspective and use quality improvement as the “lens” for evaluation of our total community health improvement efforts. 

Our department’s engagement with Quality Improvement 101 through the Center for Public Health Quality provided the means to bridge the gap between traditional quality assurance efforts and the new culture of quality improvement.  Our staff were committed to improvement, but lacked the training, technical support and tools to structure a meaningful process for quality enhancement.  Our project provided the opportunity for all staff to become oriented to quality improvement principles and how positive change could benefit their efforts along with improved outcomes for patients and clients.  The empowerment for staff that accompanies this process is powerful and will shape our quality improvement efforts for years to come as we continue to enhance and define our return on investment for public health.

-Steven Smith, MPA
Health Director, Transylvania County


Programs supported by:

BlueCross BlueShield of NC FoundatoinThe Duke Endowment

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