Association of Public Health Laboratories (APHL)

Laboratory System Improvement Program (L-SIP)

Jill PowerNew Hampshire Public Health Laboratories

Presented 5/26/09

National Public Health Performance Standards Program (NPHPSP)

Establish & Implement national performance standards for state and local public health systems

Collaborative effort of 7 national public health organizations

NH Public Health Division assessment – 2005

State Public Health Laboratory Systems Performance Standards Program

Collaborative effort that targets improvement of the public health laboratory system

Assess, plan, implement & re-evaluate improvement performance and strategies

NH Public Health Laboratories assessment - 2007

In 2008, the State Public Health Laboratory System changed it’s name to:

Laboratory System Improvement Program a.k.a

L-SIP

Quality Assurance manager – Lab

Quality Improvement committee – Lab

Public Health Improvement Team (PHIT) – Division*

Liaison to PHIT, APHL & other professional organizations - Lab

Internal quality improvement team

Meets regularly to discuss quality issues

Team approach

Multiple state agencies within Public Health

  To establish, within Division of Public Health Services

(DPHS), a process to manage change and achieve quality

improvement in public health policies, programs, and

infrastructure.

Use a Plan, Do, Study, Act approach to performance improvement

Use the Institute for Healthcare Improvement’s Model for Improvement

PHIT Team Tracking Database

Identify a problem

Initiate work plan

Do research

Perform intervention

Measure changes

Name of Program and Person(s) Responsible:Date:Cycle #:Cycle #

Current baseline:

PLAN - Based on problem identification, analysis and root causes described on the PDSA Worksheet

DO –

Try the Change on a Small Scale

STUDY –

Observe/Evaluate the Results of the Change

ACT–

Refine and Spread the Change

   

Problem statement defined:    Performance measure(s) with baseline data:     :  

List change(s) to be implemented:Who, What, When, Where, How?  What is the anticipated change and by when? What data will be collected?  Who, What, When, Where, How? 

Gather the data on the changeAnalyze the date on the change Was the change carried out as planned? Did you obtain the anticipated results? What new knowledge did you gain as a result of this change cycle?   

What actions will be taken as a result of this change and evaluation cycle?If successful how will you spread the change? What systemic changes and training needs to take place for full implementation? What is the plan for ongoing monitoring?Are there incremental improvements to refine the change? What improvement opportunities come next?

MONITOR: QNS OF SPUTUM SPECIMENS

Peggy Sweeney, TB Technical Supervisor

April 2009

Tuberculosis infection is a public health concern

Early Detection = Early Treatment

Early Treatment = Decreases Transmission

Decreased Transmission = Healthy People!

Analyze human specimens in laboratory

Skin testing

Radiological examinations

NH Public Health Laboratories is one of two labs in the state that tests and identifies the TB microorganism

Dependent on providers sending proper specimens

Specimens sent in by mail, courier or hand delivered

Providers can order test kits from NH PHL

Instructions on proper collection provided with each test kit

Providers submit specimens in the NH PHL kit collection containers or submit their own

Respiratory specimens sent in for the

detection, identification and/or

confirmation of Mycobacteria tuberculosis

( the TB bug) does not always have the

appropriate amount of sample submitted

as recommended by the Centers of

Disease Control and Prevention.

INTERVENTIONINTERVENTION

Add label to collection tube

ATTENTION!!

 For SPUTUMS & BRONCHIAL WASHINGS

Minimally place enough specimen to reach GREEN line (3ml)

Specimen will be rejected if less than 3ml

After reviewing the data, it has been determined that our intervention did not improve specimen submission volumes.

When an intervention proved it did not gain improvements, the PHIT team reviews and discusses means to change or alter the intervention often involving participation with stakeholders and partners.

In reviewing the success of findings involving quality improvement, the PHIT team makes recommendations whether to continue the monitor or not, dependent on the criticality of the monitor.

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