Minnesota Public Health Collaborative for Quality
Kick Off Meeting
April 19, 2007
William Riley, PhD
School of Public Health
University of Minnesota
Quality Improvement (QI)
in Police Departments: Lessons for Public Health
– Review and analyze Continuous Quality Improvement
techniques in police departments.
– Document the use of CQI techniques in police
agencies to better understand how public health
agencies can use CQI methods.
– Learn more about the potential barriers to effective QI
projects that are inherent in government agencies.
– Make recommendations for public health agencies.
1) What is the Nature of QI Diffusion into
• “My vision is for us to achieve excellence in policing…we
will be totally a quality-driven, community oriented police
department…we will systematically institute each of the
(12) principles of Quality Leadership within every work
unit and have data to show it…we will have developed
long term total customer satisfaction with our
communities and have the data to show it…we will be
able to answer the question (with data) ‘How do we know
we are a quality organization’ “.
David Couper, Chief of Police, Madison, Wisconsin, 1991.
QI in Large Police Departments
• Characterized by
– a) an integrated management approach;
– b) a comprehensive system for the entire
– c) a top management focus on results;
– d) a continual and renewable focus on results;
– e) a focus on community measures;
– f) intensely proactive.
2) What are Barriers and Enablers of QI Diffusion into
– Union and civil service.
– Seen as academic.
– Resistance to change: “I’m too busy” or “what do you want me to
– Top agency leadership that established a vision, provided clear
direction, constantly communicated the mission and expected
vigilance in accountability.
– Political leadership outside the police department.
– Institutionalized by incorporating into promotion system.
– Resources associated with department size.
What Incentives Are in Place
in the Absence of a Profit Motive?
• “Law enforcement has expectations from the community
to have data, systems and outcomes. It must work
better with fewer resources,”
• “Government dollars is a scarce resource too, and
everyone is competing for it”.
• “ We are under more of a mandate (than for profit firms)
to improve police response to citizens and that is even a
higher moral and ethical responsibility because we are
the government and we must provide service and ensure
the public trust,”
• “ The incentives are there. . . most people in police work
have a commitment to serve the public, just like public
health. . . there is a real desire to do a job in a way they
can be proud of . . .it is a powerful motivator”.
3) What Measures and Metrics are in Place in
• Problem Oriented Policing
– a systematic way to conduct in-depth examination of, develop
informed responses to, and evaluate crime and disorder
– The CompStat Unit generates electronic pin maps of crime
locations citywide; …and gauges the crime-fighting effectiveness
of field commands by monitoring arrest activity, responses to
pattern crimes, and the implementation of crime strategies. **
* Boba, Problem Analysis in Policing, 2003
** NYPD, 2007
Statistical Tools for Quality
• Process Maps
• Pareto Diagrams
• Cause and Effect Diagrams
• Control Charts
• Scatter Diagrams
• Check Sheets
• PDSA Cycles
Source: The Quality Leadership Workbook: Quality Improvement Methods for
Police Agencies, Couper and Lobitz, 1991
Common Features of Police QI
• Wholistic Management Approach.
• Intensely Data Driven
– 4 generations of data analysis.
• Process and Outcome Measures
• Accountability for performance.
• Outcomes and customer focused.
Example of QI in Public Health
• WIC Study
New York Police Department Crime Statistics
Table 1. Example of Metrics
Lessons for Public Health and
• Recommendation One: Consider implementing
QI as a comprehensive management philosophy
rather than a project- by- project approach.
• Recommendation Two: Top officials must set
vision for agency and exhibit constant
• Recommendation Three : The focus on QI
should not be a narrow and sole focus on
numbers. The focus should be on mission and
Lessons and Recommendations
• Recommendation Four : Use the lessons
from police departments to overcome
• Recommendation Five: Find creative ways
to secure the resources necessary to
implement QI in your agency.
• Recommendation Six: Selectively
integrate proven methods from police
departments and medical care.
Lessons and Recommendations
• Recommendation Seven: Build on the existing tools and
capabilities currently available and specifically
developed for public health.
– Healthy People 2010,
– Assessment Protocol for Excellence in Public Health (APEXPH)
– The Community Health Improvement process (IOM); HEDIS
– The 10 Essential Public Health Services, The Turning Point
– Mobilizing Action through Planning and Partnerships (MAPP),
– The National Public Health Performance Standard by CDC and
DHHS, and the Protocol for Assessing Community Excellence in
Environmental Health (PACE EH).
• Conduct a self assessment for QI
readiness in your agency.
– Where is your agency now? ( Not Interested,
Maybe interested, Very Interested).
– Where do you want it to be: 1 year? 2 years?
– What are 3 reasons to proceed?
– What are 3 barriers?
– What are 3 ways to overcome barriers?