Quality Improvement

The Zanesville-Muskingum County Health Department (ZMCHD) is committed to the concept of continuous quality improvement. Continuous quality improvement is one of the focus areas in the Strategic Plan and is included in individual work plans. This QIP is intended to provide a framework and guidance within the agency to ensure that resources and processes are available for continuous quality improvement. This plan specifically addresses the current and future state of quality within the agency, workforce training, structure of a Quality Improvement Council (QIC), and linkages to other key documents, including the Strategic Plan, the Community Health Improvement Plan, and the Workforce Development Plan. A process for determining QI projects is also included.  This plan will serve as a foundation for enhancing quality in current agency processes and will instill a culture of quality improvement throughout the agency. Implementation of this plan will also be a foundation for ZMCHD’s efforts to become nationally accredited.

Our first quality improvement project was completed in 2009 with assistance provided by the Ohio Voluntary Accreditation Team.  Following this project, ZMCHD has continued to complete atleast 1 project a year.  In 2011 ZMCHD established a Quality Improvement Council (QIC) to oversee the selection of QI projects and to build QI throughout the agency.  Projects ideas are identified through customer feedback or surveys, division meetings, annual employee survey, Community Health Assessment and after action reports.  All employees are also encouraged to submit QI project ideas.


ZMCHD applies the continuous quality improvement process by following the Plan Do Study Act (PDSA) approach.  Trainings and resources have been provided by The Ohio State University College of Public Health.  ZMCHD has also taken advantage of additional training and resources through LeanOhio.



Current Projects

Improve processes for identifying and maintaining an accurate inventory of equipment

Start date: January 2017


Project Goals:

  • Develop a uniform system to manage the equipment inventory
  • Locate items quickly and accurately to prepare for audits
  • Avoid purchasing additional duplicated items
  • Accurate inventory for liability insurance coverage


Streamline Cross Department Processes

Start date: February 2017


Project Goals:

  • Reduce the number of duplicated steps within the process
  • Reduce the number of missed opportunities for visits
  • Reduce the number of times participants do not show up for their schedule apointments


Project Results

Fleet Vehicle Management Team

Project completed in 2016


Plan for improvement:  The process for managing fleet vehicles is time consuming for the fleet manager with challenges that include keeping the vehicle availability calendar updated, staff using personal vehicles when a fleet vehicle is not available, the perception of unfairness on vehicle assignments and staff not requesting vehicles.


The goals of the project included:

  • Reducing the amount of time spent managing the process
  • Increasing staff satisfaction with vehicle requests
  • Increasing the utilization of fleet vehicles
  • Improving the time to confirm or deny a vehicle request


Results: The team decreased the complexity and number of steps to request a fleet vehicle.  The simplification and standardization reduced the amount of time the fleet manager spends on the process. The process improvement reduced the number of steps from 67 to 22.

Fleet vehicles with seasonal duties were made available during the offseason. This better utilized them and increased vehicle availability for staff with daily driving assignments.

The team eliminated a paper driven process to adjust program expenses through the use of a spreadsheet.


Community Health Assessment Project

Project completed in 2016


Plan for Improvement:

  • Increase common CHA indicators and measures by 75% of more by May 30, 2016
  • Complete selection of common electronic dashboard; align administration cycle; and determine viability of a single vendor for 3 or 4 counties conducting the survey by May 30, 2016


Results: As a part of this standardization project, partners have identified a 300% improvement on the number of standardized indicators and a 1,200% improvement on the number of standardized measures. When conducting their upcoming Community Health Assessments, all four LHDs have agreed to use consistent sources for secondary data and use uniform questions for primary data across 28 indicators and 78 measures. The partnership also made recommendations for future CHAs that would provide measureable improvements, such as a consistent cycle, a shared data-collection contract, and a shared dashboard software to display regional as well as county-level data.