Background: Quality Improvement (QI) approaches are used extensively in healthcare settings and increasingly in public health. However, the proliferation of QI in Canadian public health settings is unknown.

Purpose: The purpose of this study was to (a) assess the QI maturity in Ontario local public health units in Canada, and (b) to determine the relevance of the QI Maturity Tool in a Canadian setting

Methods: The QI Maturity Tool (Version 5) was used to conduct a cross-sectional assessment of the QI maturity of 36 local public health units in Ontario, Canada. After tool items were reviewed for relevance, individuals most responsible for QI at each health unit were surveyed. Descriptive statistics were used to analyze the data.

Results: Thirty-one individuals responded (response rate: 86%). Respondents reported strong leadership support for QI, but limited training and resources available to advance this area. Approximately half of public health units were found to be at the ‘beginner’ stage of QI maturity; 19% and 26% were in the ‘emerging’ and ‘progressive’ stages, respectively. Only 3% were in the ‘achieving’ stage and none are in the ‘excelling’ stage.

Implications: The QI Maturity Tool is valuable for determining the maturity of QI in Ontario public health settings. There appears to be strong support for advancing QI across local public health in Ontario, but limited infrastructure to enable associated QI activities.