Performance Improvement is one component of a Performance Management System that uses data for decisions to improve policies, programs, and outcomes. It enables an organization to forecast and manage change, and it creates a system of learning and building organizational excellence.

• Performance improvement is the effort to assess and improve the level of performance of key processes (and outcomes) within an organization.
• Performance improvement is a continuous process that identifies problems, examines solutions to those problems, and regularly monitors the solutions for improvement.
• Performance improvement involves strategic changes to address organizational weaknesses and the use of evidence to inform decision-making.

The third North Carolina Public Health Task Force has built on the accomplishments of the 2004 and 2006 Public Health Task Forces to further strengthen public health infrastructure, improve health outcomes, and eliminate health disparities. Its final report, the N.C. Public Health Improvement Plan (PDF, 1.85 MB), was published in January 2008.

• Public Health Taskforce 2008 page

The DPH Office of Performance Improvement and Accountability (OPIA) was established as a result of recommendations from the Public Health Task Force 2004 to:

• Develop and implement a state accreditation process as a platform to initiate performance improvement.
• Implement a performance improvement process for DPH and local health departments.
• Develop and implement a formal reporting and accountability process for DPH and local health departments.

OPIA Contact Information

• Phone: 919-707-5134
• Fax: 919-870-4833
• Email
• Mailing Address
  • Division of Public Health
  • 1916 Mail Service Center
  • Raleigh, North Carolina 27699-1916

Plan-Do-Check-Act:

• Plan: What are we trying to accomplish? How will we know that a change is an improvement? What changes can we make that can lead to an improvement?
• Do: Try out the changes on a small scale.
• Check (or Study): Observe the results, look at the data.
• Act: Refine as necessary. What worked, what didn’t work, how can it be better the next time?

In the Division of Public Health, Performance Improvement Teams are called DOT Teams: DPH On Target. DOT teams are multi-disciplinary and may include the following: Team sponsor (a member of the Division Management Team) Team leader Technical expert Front-line employee Data-oriented person “Customer” of the process (i.e., an end user of the process) Employee involved in the process but who is not necessarily a subject matter expert

Currently, DPH has identified the following areas for Performance Improvement activities. The first four are recommendations from the State Pilot Accreditation Site Visit Team. The Accreditation was based on the Ten Essential Services (ES) of Public Health.

1. Inform, educate, and empower people about health issues. (ES #3)
   • Dennis Harrington (sponsor), Donna Gregory (team lead)
   • Issue: What are the opportunities for improvement for the state to develop division-wide coordination with IT activities to more effectively develop and disseminate health information messages.
2. Develop policies and plans that support individual and community health efforts. (ES #5)
   • Marcus Plescia (sponsor), Mary Bobbit-Cooke (team lead)
   • Issue: What are the opportunities for improvement for the state to develop a clear relationship between the State Health Improvement Plan (Healthy Carolinians 2010) and policy changes needed to achieve objectives?
3. Assure a competent public health and personal health care workforce. (ES #8)
   • Rick Mumford (sponsor), Linda Carter (team lead)
   • Issue: What are the opportunities for improvement for the state to determine whether there are adequate numbers of skilled personal health care workers to fill the state’s current and future needs?
4. Research for new insights and innovative solutions to health problems. (ES #10)
   • Steve Cline (sponsor), (team lead TBD)
   • Issue: What are the opportunities for improvement related to the state developing new research resources for the future?
5. Agreement Addendum
   • Dennis Harrington (sponsor), Denise Pavletic (team lead)
   • Issue: What are the opportunities for improvement in the Agreement Addendum (AA) process to ensure that the AA are clear, consistent and measurable so that local health departments know what the division expects of them and what the consequences will be if expectations are not met?
6. Budget Office and Program Alignment
   • Dennis Harrington (sponsor), Allen Hawks (team lead)
   • Issue: Where are there opportunities for improvement related to the division ensuring that grants and the budget planning process address comprehensive needs (i.e., better integration of Programs and Budget Office).

• State Pilot Accreditation Evaluation (PDF, 156 KB)
• The State Pilot Accreditation Site Visit Conclusions and Recommendations (PDF, 62 KB)
• NC Honored for State Pilot Accreditation Site Visit (PDF, 369 KB)
• April 2007 DHHS Newsletter (PDF, 1.4 MB): NC Public Health pilot accreditation a success!!
• Workforce Assessment Reports
  • Public Health Workforce Assessment Report (424 KB)
  • DPH State Assessment Supplement (271 KB)
  • DEH State Assessment Supplement (254 KB)
• External Sites
  • Exploring Accreditation (NACHO and ASTHO)
  • Institute for Healthcare Improvement
  • Multi-State Learning Collaborative (National Network of Public Health Institutes)
  • Public Health Foundation
  • Public Health Accreditation Board

• North Carolina Local Public Health Performance Measurement Report (PDF, 47 KB)
• Performance Measures
  • County (PDF, 522 KB)
  • State (PDF, 118 KB)