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Animal control quality improvement process

Posted Tuesday, February 1, 2005

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The Animal Control Quality Improvement process follows the format outlined in the Chatham County Public Health Department’s (CCPHD) Quality Plan. The purpose of the Quality Improvement (QI) Plan is to provide a guide to design, measure, assess and pursue opportunities to continually improve service and program outcomes for the benefit of Chatham County residents. Effective implementation of an integrated quality improvement approach demonstrates accountability to the public, and the regulatory agencies that govern our service delivery.

The QI plan encompasses the entire organization and community, beginning with the Board of Health (BOH), the Health Director and Leadership Team, who together set expectations and provide resources to the staff and communities, and who must be committed to a cooperative effort to improve health. The opportunities for improvement will be identified by examining the systems and processes by which services are provided; these processes cross divisional, discipline, and community lines, necessitating exceptional communication and collaboration.

The objectives of the QI Plan are to:
o Establish a framework that demonstrates accountability for quality essential public health services and programs
o Establish a mechanism for the measurement of quality through the development and use of an agency-wide reporting system and evaluation process
o Provide the structure for agency-wide measurement and improvement of performance indicators including service utilization and program outcomes.

The indicators will:
o Respond to community-identified needs
o Relate to the mission, vision, and values of CCPHD
o Describe achievement of program and organizational goals
o Identify opportunities for improvement of outcomes
o Identify methods of reporting progress to stakeholders
o Identify resources needed to implement changes
o Improve the plan for ongoing internal/external communication of our quality initiatives, and process improvement activities

The Ten-Step Internal Assessment and Monitoring Process used by CCPHD follows. The specifics of the Animal Control process are outlined within the steps.

Step 1: Assign responsibility
After reviewing public feedback regarding concerns with animal welfare and AC operations, the BOH charged the Health Director to develop the team necessary to perform a comprehensive internal review of AC operations and make improvement recommendations to the BOH. The Health Director convened a team which includes the CCPHD Quality Officer, Assistant County Manager, the Veterinarian BOH Member, and a community member with many years of animal advocacy experience.

Step 2: Delineate the scope of service
The AC QI Team identified key governance, managerial, administration, support, and operational functions, which impact AC services. This was accomplished by inventorying the key services and activities performed by AC. Examples follow.
o Mandated and assumed AC functions and activities
o Types of clients/communities and animals served
o Range of conditions or services managed
o Range of activities involved in serving clients
o Types of staff providing services
o The sites and times where services are provided
o High volume activities and High cost activities
o Strongly perceived activities linked to quality

Step 3: Identify important aspects of service
Using the scope of service as a basis, the team selected aspects of service that are important for ongoing monitoring. The AC team selected Animal Welfare, Sheltering, Adoption, Field Operations, and Leadership/Organization/Finance.

Step 4: Identify the indicators
The team reviewed the AC Ordinance, HSUS and APS standards, and external reviews of several AC operations to develop the above aspects of service for industry standard for quality. An assessment format was developed which included these indicators or measures.

Step 5: Establish the thresholds for evaluation (benchmarks or internal)
The team made site visits to six AC operations across NC for best practices. The AC Operations included those under Health Department, County Manager, and other county management systems. The Assessment tool, based on established standards, was used to assess each operation.

Step 6: Collect and organize data
The team developed a plan to assess the local AC operations based on the trialed Assessment Tool and best practices gleaned from our site visits to other AC operations. The plan also included Focus Group input from the community, local Veterinarians, and the AC staff. Key Informant interviews were conducted to vet Focus Group feedback and recommendations with stakeholders. Additional public forums will be conducted in November and December to provide for the opportunity for broad community comment.

Step 7: Initiate the Evaluation
Using the Assessment Tool, the team reviewed all local AC operations, services, and the facility in early November 2004. A summary of findings and recommendations will be presented to the BOH in January 2005.

Step 8: Take actions to improve the service
Action will be taken based on identified opportunity for improvement. The team is charged with making improvement recommendations to the decision making group, the BOH. Pilot projects or trials in a limited area will be undertaken before a system wide change is ndertaken. Actions will be directed toward the root causes and overall improvement of quality of service. Examples of actions include:
o System issues: changes in communication channels, changes in organizational structure and processes, adjustments in staffing, and changes in equipment
o Knowledge issues: in-service education, continuing education, making accessible data
A detailed Implementation Plan, including accountability, resources, and timeline will be developed to assure all approved recommendations are enacted.

Step 9: Assess the effectiveness of actions to assure improvement is maintained
Monitoring and evaluation continues after actions are taken; it must be determined whether those actions actually improved service and that improvement is maintained. The findings from continued monitoring (or from special follow-up monitoring, for areas not subject to ongoing monitoring) will provide evidence to determine whether the actions were effective. Data from several monitoring periods may be required to make the determination. If service does not improve within the expected timeframe, those with delegated responsibility will initiate further evaluation and recommend action.

Step 10: Communicate results to affected individuals and groups and continue monitoring
To close the loop of monitoring and evaluation, the conclusions, recommendations, actions, and follow-up must be reported to appropriate individuals and groups. The BOH will receive formal and informal comments, reactions and information from involved persons and groups on the effectiveness of monitoring and evaluation. The information should also be communicated to affected persons and groups.

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A copy of the full Chatham County Public Health Department Quality Plan can be obtained by contacting, Jean Vukoson, Quality Officer, at 919-545-8366.

 
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