Laura Holmes


Known for its frugality, New Hampshire government is certainly lean, but it has recently gone even “Lean-er” in a recent initiative launched by our previous Governor and continued by our current Governor, supporting the use of Lean process improvement tools to ensure that public funds are used as efficiently and effectively as possible, eliminate waste, maintaining fiscal responsibility and protect taxpayer dollars. At the Division of Public Health Services (DPHS), we also realize the benefit of making continuous quality improvement part of our day-to-day work and reaping the monetary and personal rewards of saved time, reduced cost, greater results, better performance and ultimately, improved health outcomes in the populations we serve.

I am the Performance Improvement Manager for DPHS within the Bureau of Public Health Systems, Policy and Performance, and since 2011 have been leading quality improvement (QI) initiatives at DPHS. With the awarding of a CDC National Public Health Improvement Initiative grant, we have been focusing on building a quality-driven organization by institutionalizing a performance management system that includes using QI methods such as Plan-Do-Study-Act and Lean to make measurable improvements in both operations and health outcomes. Part of that initiative involves training managers and staff in these methods and tools. With expert instruction by the staff of the Center for Public Health Quality, we were able to conduct five QI projects that included improving the way programs access budget data, improving the level of fluoridation in community water systems, improving the timeliness and accuracy of website content, and improving service delivery to women with a history of gestational diabetes mellitus.

These early wins inspired participants to spread the word about the value of QI and motivate others to take advantage of future training opportunities. The investment in training has paid off in immediate improvements in real day-to-day work, in the ability of staff to use these tools again and again, and in providing a boost in our efforts to foster a Culture of Quality which, for Performance Improvement Managers, is priceless.

-Laura Holmes
Performance Improvement Manager,
New Hampshire Division of Public Health Services


A program of:

Programs supported by:

BlueCross BlueShield of NC FoundatoinCenters for Disease Control and PreventionThe Duke Endowment

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