A conceptual framework that explicates the relationships among the various components of the public health system is an essential step toward providing a science base for the study of public health system performance.

Complexity science was used to explain the results. The findings open the door to rethinking nursing home management practice. Practices that increase communication and interaction among people are needed for better resident outcomes.

Having a public health workforce with a high level of competency is a prerequisite for having an effective public health system. The purpose of these two studies was to assess the competency level of practicing public health nurses (PHNs; n=168) from 50 local health agencies and public health nursing faculty (n=46) from 31 nursing programs in Illinois. The questionnaire consisted of nine reliable scales using self-reported levels of competence in each PHN competency domain. Overall, PHNs reported only feeling competent in one domain: "linking people to services." Although PHN faculty felt competent across the nine domains, they did not report feeling competent to teach any of the domains. Thus, PHNs and public health nursing faculty need education and training to meet the professionally established level of competence.