Guidance for Developing and Implementing a Quality Improvement Council

July 07, 2026 | Colton Anderson

This resource provides guidance and recommendations to support the development, implementation, and sustainability of a Quality Improvement (QI) council within a public health agency.

QI in public health refers to the use of a deliberate and defined improvement process, such as Plan-Do-Study-Act, to improve efficiency, effectiveness, service quality, and population health outcomes. A QI council helps establish a coordinated approach to QI, supports a culture of continuous improvement, and strengthens organizational performance and accountability. A well-functioning QI council can help agencies:

• Prioritize and oversee QI activities.
• Align improvement efforts with agency strategic priorities.
• Support performance management and accreditation readiness.
• Foster staff engagement and a culture of learning and innovation.
• Promote data-informed decision-making and operational excellence.

Purpose of a QI Council

A QI council serves as the central body responsible for guiding, coordinating, and supporting QI efforts across the agency. The council typically provides leadership and oversight for:

• Agency-wide QI priorities and goals.
• QI project selection and monitoring.
• QI training and staff engagement.
• Performance management alignment.
• Communication of QI activities and successes.
• Accreditation and reaccreditation-related QI activities.
• Building and sustaining a culture of quality throughout the organization.

Developing a QI Council Charter

A charter is a foundational document that formally establishes a QI council and defines how it will operate. The charter should clearly outline the council’s structure, expectations, and responsibilities. A clear charter helps establish accountability, ensures consistency, and provides direction for the council’s work. Recommended components of a QI council charter include:

• Purpose and mission statement.
• Scope of authority.
• Membership composition.
• Roles and responsibilities.
• Leadership structure.
• Meeting frequency and expectations.
• Decision-making process.
• Measures of success.
• Definitions and common terminology.
• Reporting and communication expectations.

Establishing QI Council Membership

QI councils are most effective when they include representation from multiple areas and levels of the organization. Diverse perspectives strengthen collaboration and support agency-wide engagement in improvement efforts.

Considerations for Membership

• Include representatives from leadership, programs, operations, and administrative areas.
• Identify individuals who are interested in or experienced with QI and performance management.
• Include staff who can champion QI efforts within their divisions or teams.
• Consider including frontline staff to ensure operational perspectives are represented.
• Maintain a manageable group size, often between 5-10 members.

Recruitment Strategies

• Request nominations from leadership.
• Invite volunteers through an agency-wide call for participation.
• Include participation as a professional development opportunity.
• Consider rotating membership terms to encourage broader staff engagement over time.

Designing an Effective QI Council Structure

QI councils should be structured in a way that reflects the agency’s size, capacity, and organizational structure. Some agencies may choose to establish a standalone QI council, while others may designate an existing leadership team, management team, or cross-functional committee to serve in this role. For example, an agency may utilize regularly scheduled management team meetings to oversee QI activities, review performance data, monitor improvement initiatives, and support implementation of the QI Plan. Leveraging an existing group can help streamline communication, reduce meeting burden, and strengthen integration of QI into organizational decision-making processes.

Common Structural Components

• Council chair or co-chairs.
• QI or performance management coordinator.
• Administrative support for meeting coordination and documentation.
• Standing or ad hoc workgroups for specific initiatives or projects.

Best Practices

• Establish clear goals and expectations for the council.
• Ensure leadership support and visibility.
• Align council activities with the agency's strategic plan and performance management system.
• Develop shared understanding of QI terminology, tools, and processes.
• Define how the council will communicate decisions and updates across the organization.

Implementing QI Council Processes

Successful implementation requires consistent processes, clear communication, and ongoing engagement.

Meeting Practices

• Establish a regular meeting schedule.
• Use agendas with defined objectives and action items.
• Document meeting notes, decisions, and follow-up activities.
• Review progress on ongoing QI projects and council priorities.
• Include time for discussion, learning, and sharing successes.

QI Project Oversight

The council may:

• Review and approve proposed QI projects.
• Monitor project timelines and outcomes.
• Provide guidance and technical support to project teams.
• Ensure projects align with organizational priorities and available data.

Communication Practices

Consistent communication helps build awareness and sustain momentum for QI efforts.

Consider:

• Sharing council updates through newsletters, intranet pages, or staff meetings.
• Highlighting successful QI projects and staff contributions.
• Encouraging staff presentations or QI spotlights during leadership or all-staff meetings.
• Using visual tools such as storyboards or dashboards to communicate progress.

Measuring Success

The QI Council should establish measurable goals and regularly assess progress. Measures should align with agency strategic priorities and performance management efforts whenever possible.

Examples of Measures

• Number of completed QI projects.
• Staff participation in QI activities or training.
• Progress toward QI Plan objectives.
• Improvements in performance indicators.
• Increased staff awareness or engagement in QI efforts.
• Advancement in organizational QI culture assessments.

Assessing and Strengthening QI Culture

QI councils play a key role in fostering a culture of continuous improvement throughout the organization. Agencies may also consider using organizational self-assessment tools to evaluate their current culture of quality and identify areas for growth.

Strategies to Support a Culture of Quality

• Encourage staff involvement in QI initiatives.
• Promote transparency and shared learning.
• Recognize and celebrate improvement efforts.
• Provide ongoing training and professional development opportunities.
• Integrate QI into routine operations and decision-making.

Alignment with Accreditation

QI councils can support accreditation and reaccreditation through the Public Health Accreditation Board by helping coordinate and document quality improvement efforts. Integrating accreditation-related activities into regular council operations can help ensure continuous readiness.

Areas Commonly Supported by the QI Council

• Development and implementation of the QI Plan.
• Documentation of QI projects and outcomes.
• Performance management activities.
• Continuous improvement efforts related to agency processes and services.
• Ongoing review of accreditation standards related to QI and performance management.

Training and Capacity Building

Building staff capacity is essential for sustaining quality improvement efforts. Training should support both technical QI skills and broader organizational culture change.

Considerations for Training

• Provide introductory QI training for all staff.
• Offer additional training for council members and project teams.
• Include education on performance management and data use.
• Reinforce practical application of QI tools and methods.
• Incorporate QI into onboarding and workforce development activities.

Strategies for Sustainability

Sustaining a QI council requires ongoing leadership support, staff engagement, and integration into agency operations. A sustainable QI council helps create a continuous learning environment and strengthens the agency’s ability to improve programs, services, and health outcomes over time.

Strategies for Sustainability

• Embed QI responsibilities into organizational structures and workflows.
• Align council priorities with strategic and operational plans.
• Maintain visible leadership support for QI efforts.
• Regularly evaluate council effectiveness and adapt processes as needed.
• Continue investing in staff development and engagement.
• Celebrate successes and communicate the impact of QI activities.

For questions or follow-up, please contact ASTHO’s Performance Improvement team at performanceimprovement@astho.org.

This resource was created in partnership with ASTHO's Quality Advisory Group.

Reviewed by Lindsey Myers, MPH, Vice President, Public Health Workforce & Infrastructure.