The Challenge: To help a mid-sized local health department in the eastern United States develop comprehensive performance management (PM) and quality improvement (QI) plans that would establish a sustainable culture of quality while meeting PHAB accreditation requirements.
The Background:
Like many public health departments serving populations between 150,000-250,000 residents, our client was struggling to prove that it could make meaningful change in how it delivered services to improve community health. As the department pursued accreditation with the Public Health Accreditation Board, leadership recognized that a more systematic approach was needed.
Ascendient was engaged to develop two interconnected plans: a quality improvement plan to guide continuous improvement efforts and a performance management system to track progress on strategic priorities. Both plans needed to align with PHAB requirements while remaining practical and implementable for a team of approximately 100 staff members.
Most importantly, the client wanted both plans to advance health equity throughout the organization.
Our Work:
Ascendient brought together an experienced team to guide the department through a comprehensive planning process. Rather than delivering cookie-cutter templates, we designed an engagement that combined recognized best practices with local customization.
The project began with the NACCHO Culture of Quality Self-Assessment, a foundational tool that helped the department understand its current standing across six key elements of quality culture. As our project lead explained during the engagement, "The self-assessment isn't just a checkbox exercise – it's a catalyst for meaningful conversations about how the department operates and where it wants to go."
Based on the initial assessment, we provided targeted trainings and materials to support plan development. Our team worked closely with department leadership to ensure that both the performance management system and quality improvement plan would integrate seamlessly with existing operations. The emphasis was on practical implementation – helping staff understand not just what needed to be in the plans, but how to bring them to life in daily practice.
A key example was aligning the quality improvement plan directly with the department's existing strategic plan. Instead of creating competing systems, the team ensured that every QI project charter was connected to strategic objectives. This allowed staff to see how their improvement efforts advanced organizational goals, making QI work feel like a strategic management tool rather than an isolated compliance activity.
Beyond developing the plans themselves, the Ascendient team also created practical implementation tools including project suggestion forms, PDSA tracking templates, and project charters. More than just research documents, these were working tools that staff could immediately use to identify, propose, and manage improvement projects.
A critical component was ensuring PHAB compliance without losing sight of the health department's mission. We carefully mapped each plan element to accreditation standards while maintaining focus on what would truly benefit community residents. Health equity considerations were woven throughout both plans, reflecting the department's commitment to addressing disparities in their community.
The Outcome:
By project completion, the health department had two robust, interconnected plans ready for implementation. The quality improvement plan provided clear guidance for identifying, prioritizing, and addressing improvement opportunities across all programs. The performance management plan established systematic approaches for tracking progress on strategic objectives, with dashboards and reporting mechanisms that made data accessible and actionable.
The planning process itself generated significant value beyond the written documents. Department staff gained confidence in applying quality improvement methodologies and performance management principles, with practical tools they could use immediately rather than theoretical concepts that sit on a shelf. Leadership discussions during the engagement strengthened alignment around priorities and approaches. Most importantly, the department now had the foundation for a true culture of quality – one that would sustain improvements long after the consultant engagement ended.
Our client has reported that the integrated PM/QI system has streamlined operations and improved the ability to demonstrate impact to stakeholders. Staff surveys showed increased understanding of how individual roles contribute to department-wide goals, and early results have already indicated improved performance on key health indicators.
The Takeaway:
Performance management and quality improvement aren't just accreditation requirements – they're essential tools for public health excellence. This project demonstrates that with the right support and approach, local health departments can develop plans that are both PHAB-compliant and genuinely transformative.
The key is balancing technical requirements with practical implementation, always keeping community health and equity at the center.
