Upon completion of this course, students should be able to:
1. Describe quality and improvement within public health and 
healthcare delivery from multiple stakeholders’ perspectives.
2. Identify the key factors that support/hinder continuous
learning in public health and healthcare delivery.
3. Appraise current systems, structures, and processes to assess 
risks and identify opportunities for improvement.
4. Analyze and evaluate quality and performance improvement
initiatives at the system, organization, and individual 
(provider/patient) levels.
5. Design and propose implementation strategies for quality and 
performance improvement programs that employ “systems thinking.”

1. The goals of public health and healthcare delivery systems 
and the concepts of quality, safety, risk management, 
improvement, and continuous learning
2. Crossing the Quality Chasm (Institute of Medicine, 2001) and 
other opportunities and challenges
3. The Donabedian model and control of processes versus control 
of outcomes
4. Attribution and causality 
5. Approaches to support continuous learning for 
individuals/patients 
   a. Influence of context, values, perceptions, and prior 
experience
   b. Introduction to N=1 trials, statistical process control
   c. Issues associated with adoption and adherence
6. Approaches to support continuous learning for public 
health/healthcare providers
   a. Influence of context, values, perceptions, and prior 
experience
   b. Introduction to professional exams and licensing, 
continuing education programs, and incentive systems
   c. Issues associated with locus of control
7. Approaches to support continuous learning for public 
health/healthcare organizations
   a. Influence of context, balancing performance goals, risk
management, and quality improvement
   b. Introduction to learning organizations and capacity for 
change models
   c. Introduction to Plan-Do-Check-Act (PDCA) cycles, quality
circles, process mapping and redesign (clinical pathways, lean
enterprise), and Failure Mode and Effect Analysis (FMEA)
8. Approaches to support continuous learning for public 
health/healthcare systems
   a. Issues in system assessment, measurement requirements, and 
risk adjustment
   b. Introduction to accreditation/certification models (e.g., 
Joint Commission on Accreditation of Healthcare Organizations 
(JCAHO), International Organization for Standardization (ISO))
   c. Introduction to quality award models (e.g., Malcolm 
Baldridge National Quality Award, European Foundation for 
Quality Management (EFQM))
   d. Introduction to professional supervision models (e.g.,
“visitation” in The Netherlands)
   e. Introduction to provider incentive models (e.g., Pay-for-
Performance)
9. Improving the evidence base in quality improvement in 
public health and healthcare delivery
10. Quality and safety as goals in health policy and health
system reform

All students are responsible for maintaining the highest standards 
of honesty and integrity in every phase of their academic 
careers.  The penalties for academic dishonesty are severe, and 
ignorance is not an acceptable defense. Academic honesty means 
performing all academic work without plagiarizing, cheating, 
lying, tampering, stealing, receiving assistance from any other 
person, or using any source of information that is not common 
knowledge.