Rural LHD Achieves Operational Excellence through Employee Recognition, Productivity Tracking, and Prevention Initiatives

By Lindsay Tiffany, Communications Specialist, NACCHO

Janet McAlister, Director, Giles County Health Department

Janet McAlister, Director, Giles County Health Department

Giles County Health Department (GCHD) is a rural local health department (LHD) in southern Tennessee. The county has a population of approximately 29,000. The department directly serves around 3,500 clinical patients per year, providing daily care for residents of Giles County and surrounding counties as needed. GCHD offers services such as Women, Infants, and Children (WIC), family planning, sexually transmitted disease screening and treatment, immunizations, and well-child check-ups.

GCHD won NACCHO’s 2015 Local Health Department of the Year Award in the small LHD category for its excellence in employee recognition, productivity tracking, and primary prevention initiatives. The Local Health Department of the Year Award recognizes and honors outstanding accomplishment of LHDs across the country for their innovation, creativity, and impact on communities. At NACCHO Annual 2015, NACCHO Voice spoke with Janet McAlister, Director of the Giles County Health Department, to learn more about her department’s successful strategies.

Employee Recognition
Recognizing that job satisfaction related directly to an employee’s sense of worth in his or her work environment, GCHD developed award recognition programs and conducted staff satisfaction surveys as one way to improve operational performance. “Trying to develop ways to recognize staff is important and doesn’t have to cost money,” McAlister noted. “We have learned that recognition is a motivating factor for staff—whether it be within the health department, within the region, or at the state level. Award recognition creates a sense of value and worth for employees, which improves overall productivity.”

Employees are recognized for their contributions to state, regional, and local teams through programs such as the Good Catch Award, the Commissioner’s Achievement Awards, the South Central Regional Excellence Awards, and the Giles County Early and Periodic Screening, Diagnostic, and Treatment Award. Additionally, GCHD assesses employee feedback regarding job satisfaction, supervisor/employee communication, and other areas each year as part of its Workforce Engagement Survey.

Productivity Tracking
Another component of GCHD’s operational excellence is its focus on tracking productivity. A regional team works with managers at GCHD to analyze and evaluate data in its Patient Tracking Billing Management Information System to show productivity within various program areas and the generation of patient encounters and Relative Value Units. The team also works to eliminate concerns about possible negative impacts on quality as productivity improves by assisting with reporting and supporting managers.

McAlister also added that a well-aligned strategic planning process that involves staff is an important way to engage employees in increasing productivity. GCHD uses the Tennessee Department of Health’s strategic plan to inform its own goals; the department also uses the Baldrige Performance Excellence Criteria as framework for organizational improvement.

Primary Prevention Initiatives
The third component in GCHD’s operational success is its focus on promoting primary prevention initiatives. Over the past three years, GCHD has expanded its partnerships that focus on primary prevention initiatives and aim to improve population health through lifestyle and behavior changes. As part of the initiative, each employee at GCHD should spend five percent of their work time engaged in community-based primary prevention activities in areas such as immunizations, chronic disease, obesity, oral health, tobacco, and worksite wellness.

Partnership development is an ongoing goal for the department and is the primary way it sustains community-level programs. “Getting staff out, having them involved, and knowing those community agencies is important for our primary prevention initiatives,” McAlister explained. “Having the school system, patients, and other members of the community see staff out at events, at the library, at the ballpark working on these initiatives really helps us.”

In addition to improving the prevention initiatives, having staff work outside the health department in the community increases public awareness about the role GCHD fills in the county. “We wanted to get involved in the community and get staff outside the walls of the health department. Creating a healthy community perception of the local health department is key to increasing the use of our services by community members,” said McAlister.

McAlister provided six key tips to help other LHDs achieve similar success with operational improvement initiatives:

  • Any employee awards program should align with the needs and expectations of the workforce and should be relevant to employees’ daily functions.
  • Tying recognition to strategic objectives and values reinforces the sort of thinking and behaviors leaders would like to see more of in an organization.
  • Great recognition programs show employees how the work they do contributes to the bottom line.
  • Primary prevention programs help staff engage with community partners and find data to support new projects that reflect the needs of the community; exploring evidence-based practices is helpful place to start to avoid reinventing the wheel.
  • Involvement in some type of national awards program is an effective way to energize employees, increase the focus on business results, and examine organizational systems.
  • Participation in a national awards program helps align resources; identify strengths and opportunities for improvement; improve communication, productivity, and effectiveness; and achieve strategic goals.

For more information about NACCHO’s Local Health Department of the Year Award, visit

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