Project 1.  Linking Assessment and Measurement to PHEP Systems Improvement
Systems improvement approaches have been used to improve performance in a variety of endeavors in health care and other industries, but are relatively new to public health.  Systems improvement (also known as quality improvement) emphasizes processes and systems, focuses on measurable outcomes, seeks to reduce unwarranted variability, and enables continuous improvement using iterative feedback in a Plan-Do-Study-Act (PDSA) cycle. System improvement approaches also employ specific tools such as failure mode analysis and learning collaboratives.

 As part of the CDC-funded Linking Assessment and Measurement to PHEP Systems Improvement (LAMPS) center (http://www.hsph.harvard.edu/hcphp/lamps/) based at Harvard School of Public Health, the LAMPS Systems Improvement project will seek to adopt these practices to improving public health emergency preparedness (PHEP).  Specifically, the project will capitalize upon the groundbreaking work of the Institute for Health Care Improvement (IHI) to address three specific aims: 

1.   How can the systems improvement approach be adapted for PHEP and implemented in actual public health systems, especially given the multi-disciplinary, multi-jurisdictional nature of these systems?

2.  What kinds of metrics and measurement systems are appropriate and necessary for PHEP systems improvement?

3.  Does this systems improvement approach actually improve PHEP in the long run?

The LAMPS-Systems Improvement project, based at Georgetown University, will initially collaborate with the Partnership for Effective Emergency Response (PEER), based at Boston University School of Public Health, which coordinates over 300 hospitals, health departments, and other health agencies regarding notification and information sharing around public health emergencies.  As the project matures, other partners will be identified.

Principal Investigator for Project 1:
Michael A. Stoto, PhD serves as Lead Investigator for Project 1. Dr. Stoto serves also as the Co-Principal Investigator for LAMPS.  One of the leading PHEP performance measurement experts in the country, Dr. Stoto is currently an Adjunct Professor of Biostatistics at HSPH, Director of the Evaluation Core of the HSPH CPHP, and Professor of Health Systems Administration and Population Health at Georgetown University.  He currently leads the evaluation team for the DC Healthcare Coalition Emergency Management Partnership, funded by the DHHS Office of the Assistant Secretary for Preparedness and Response (ASPR), and recently completed a multi-site project investigating regional approaches to PHEP funded by the Robert Wood Johnson Foundations Public Health Systems Research initiative.  Previously, he led an evaluation of NACCHO's Project Public Health Ready to recognize local health departments prepared for PHEP, as well as a case study of the public health response to outbreaks of West Nile Virus, SARS, monkeypox, and hepatitis A in the U.S.  He has also worked as an evaluator of syndromic surveillance systems.  With extensive experience in the application of quantitative and qualitative research methods to guide public health policy and practice, including the development of Healthy People 2000, Dr. Stoto has conducted research on PHEP measurement and improvement, as well as on public health interventions, and ethical issues in research and practice.  He has published extensively, is a co-editor of an IOM report that provided public health data for the Washington, DC area, and authored the chapter on evaluation in Public Health Administration, now in its second edition.

Co-Investigators:
Don Goldmann, MD currently serves as both a senior vice president for IHI and is a Professor of Pediatrics at HMS and Professor of Immunology and Infectious Diseases at HSPH.  With thirty years of experience in epidemiology and health systems improvement research, he has developed methodologies to advance the patient safety field to monitor and improve critical control/risk points efficiently in industrial systems.  For PHEP, Dr. Goldmann has helped develop novel methods of detection for clusters of infections using syndromic surveillance.

Harold Cox, MSSW is the Associate Dean for Public Health Practice and Associate Professor of Social and Behavioral Sciences at BUSPH.  In his former role as Chief Public Health Officer for Cambridge, MA, he established the Cambridge Advanced Practice Center for Emergency Preparedness, which develops policies and program implementation for 27 Massachusetts communities.  Dean Cox is also the PI and director of PEER (Partnership for Effective Emergency Response), which coordinates over 300 hospitals, health departments, and other health agencies regarding information systems for PHEP.

Contact Information:
Michael A. Stoto, PhD, Project Director
Professor of Health Services Administration and Population Health Georgetown University
School of Nursing & Health Studies
3700 Reservoir Road, NW  Room 235
Washington, DC  20057-1107
Email: stotom@georgetown.edu
Telephone:  (202) 687-3292

Melissa Higdon
Research Assistant
Email: mah49@georgetown.edu
Telephone:  (202) 687-6427