Florida Public Health Review

Publication Date



Quality improvement (QI) is a tool in the public health inventory. It has value in that it provides a modality for accelerating science-based intervention into routine public health practice. In doing so, it holds promise to make transparent how care and service systems demonstrate efficiencies in the structure, operations, and outputs that should translate into improvements in population health outcomes. One HIV health services grant in Northeast Florida touches the lives of over 4,200 persons. How to render services so that it maximally benefits all clients is ongoing work. Service recipients engage nine HIV care funded providers, who differentiate on client census, service mix, staffing, expertise, and resources. Past 12-months QI activities indicated that seven of nine providers had implementation scores in the range of 62.32 to 88.90, (one standard deviation of the geometric mean of 74.51). Submitting implemented improvement activities for external evaluation allows for assessment of implementation fidelity and critique of methodology covering review of documents, including an improvement plan, an annual report, and a normative reference document, (NRD); completion of a scoring rubric, which modeled themes in the NRD, and rendering a qualitative, professional judgment of the extent to which agency annual reports operationalized the NRD underpinnings. Such transparency holds the promise to build public trust by demonstrating accountability to diverse stakeholders. Viewed this way, QI in public health is a necessity, not an option.