The Institute of Medicine's Community Health Improvement Process (CHIP) supports a planned approach for improving health. CHIPs operate through two primary interacting cycles as illustrated in the figure below. The top half of the figure represents the overarching problem identification and prioritization cycle. It focuses on bringing stakeholders together in a coalition, monitoring community level indicators, and specifying health issues as community priorities.
The analysis and implementation cycle analyzes a health issue, assessing resources, determining how to respond and who should respond, and selecting and using stakeholder-level performance measures together with community-level indicators to assess whether desired outcomes are being achieved. More than one analysis and implementation cycle can be operating at one time.
Adapted from: Institute of Medicine. (1997). Committee on Using Performance Monitoring to Improve Community Health: Durch, J.S., Bailey, L.A., & Stoto, M.A. (Eds). Improving health in the community: A role for performance monitoring. Washington, D.C.: National Academy Press.