ORIGINAL ARTICLESLessons Learned From Building a Culture and Infrastructure for Continuous Quality Improvement at Cabarrus Health AllianceRandolph, Greg D. MD, MPH; Stanley, Cappie RN, MPH; Rowe, Bobbie AMOA; Massie, Sara E. MPH; Cornett, Amanda MPH; Harrison, Lisa Macon MPH; Lea, C. Suzanne PhDAuthor Information North Carolina Center for Public Health Quality, Raleigh (Dr Randolph and Mss Cornett and Harrison); Department of Pediatrics and Adjunct Associate Professor, Public Health Leadership Program (Dr Randolph) and Quality Improvement Research Partnership, School of Medicine (Ms Massie), the University of North Carolina at Chapel Hill; Cabarrus Health Alliance, Kannapolis, North Carolina (Ms Stanley and Rowe); and Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina (Dr Lea). Correspondence: Greg D. Randolph, MD, MPH, NC Center for Public Health Quality, PO Box 18763, Raleigh, NC 27619 ([email protected]). The NC Center for Public Health Quality is funded through grants from the Duke Endowment, the NC Blue Cross and Blue Shield Foundation, the Kate B. Reynolds Charitable Trust, and the Centers for Disease Control and Prevention. The authors thank the following staff at Cabarrus Health Alliance: William F. Pilkington, DPA, chief executive officer and public health director; Linny M. Baker, MD, FAAP, pediatrician; Kimberly R. Dehler, MS, DDS, dental director; Suzanne Knight, RN, BSN, Women's and Children's Clinic director; Mary M. Medlin, RN, BSN, pediatrics/public health nurse; Linda J. Moose, RN, women's health/public health nurse; and Cindy Walker, RD, MPH, Project coordinator. They also thank Tilneil Gary for her assistance with manuscript preparation. Disclosure: The authors report no conflicts of interest. Journal of Public Health Management and Practice: January/February 2012 - Volume 18 - Issue 1 - p 55-62 doi: 10.1097/PHH.0b013e31822d2e23 Buy Metrics AbstractIn Brief This case study describes a local public health agency's multiyear effort to establish an infrastructure and organizational culture for continuous quality improvement, using data from interviews with the agency's senior leaders, managers, and frontline staff. Lessons learned include the importance of setting stretch goals, engaging leaders at all levels of the organization, empowering frontline staff to make changes, providing quality improvement training for staff and leaders, starting with small projects first, spreading quality improvement efforts to involve all parts of the agency, and sustaining momentum by creating a supporting infrastructure for continuous quality improvement and continually initiating new projects. This case study describes a local public health agency's multiyear effort to establish an infrastructure and organizational culture for continuous quality improvement, using data from interviews with the agency's senior leaders, managers, and frontline staff. © 2012 Lippincott Williams & Wilkins, Inc.