Performance Management in Local Public Health Departments: A Tool to Address Sexually Transmitted Infections

Introduction: STI rates have been increasing across the United States for the past decade. Incidence of STIs in the United States have increased by nearly 40% since 2000, congenital syphilis in Pennsylvania reached a historical high in 2018, and strains of antibiotic resistant gonorrhea continue to emerge. Allegheny County Health Department (ACHD) addresses this issue through clinical services, surveillance, partner services, and education. Performance management and quality improvement have gained attention by public health organizations as a way to elevate health departments’ performance and improve outcomes. Methods: This project identified best practices for performance management in local health departments, reviewed ACHD’s STD/HIV Prevention Program current practices and data, and developed recommendations based on that analysis and the identification of gaps that reduce program efficiencies and results. Results: The STD/HIV Prevention Program sets performance standards based on the previous year’s data, and is reflective of community needs, program goals and grant requirements. Performance measures indicate the program is having difficulty meeting screening goals, likely due to a change in location. Quality improvement can be used to address these problems, but currently no formal projects have been proposed. Conclusion: ACHD’s STD/HIV Prevention Program can benefit from broadening performance measures, strengthening the link between performance management and quality improvement, and assessing the workplace culture to determine the staff’s awareness and willingness to engage in quality improvement. Using performance management to its full extent reduces gaps in care, increases efficiency and cost-effectiveness, and increases the program’s ability serve the community. This is key to meet and maintain the high standards in health departments, and improving public health locally, and nationwide.