USAIDs experience improving the quality of care in low and middle income countries Applying Science to Strengthen and Improve Systems ASSIST Project 2 Approaches to Improving Health Care Processes Quality ID: 572440
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Slide1
Performance Improvement
USAID’s experience improving the quality of care in low and middle income countriesSlide2
Applying Science to Strengthen and
Improve Systems (ASSIST) Project
2Slide3
Approaches to Improving Health Care Processes (Quality)
Training
Pre-service
In-serviceHuman resources/performance managementWell-defined interventionsAudit & feedbackDecision aidsEducational materialsAcademic detailingRegulatory approaches: Accreditation, certification, licensingPerformance-based incentivesProprietary approachesStandards-based Management & Recognition (SBM-R)Client-oriented, Provider Efficient (COPE)Continuous Quality Improvement (CQI)
Collaborative Improvement Slide4
IOM Workshop Report on Improving Quality in LMICs
4Slide5
Donabedian model of a system
Resources necessary to carry out a process
Inputs
A series or sequence through which inputs are transformed into outputs
Process
The sum of all elements (including processes) that interact together to produce a common goal
Traditional approaches have failed to address processes of care
The outputs (services/products) and outcomes (health outcomes) result
from the inputs & processes
OutcomesSlide6
How do we learn about improvement?
Purpose:
Bring together thought leaders to collaborate and identify appropriate evaluation methods for improvement
Product:Develop statement to provide guidance on how we learn about improving the quality of careSalzburg Global Seminar 2016Slide7
Purpose of case book:
Document how quality improvement interventions have been carried out in low-resource settings
Describe the rationale for what teams did to improve
Describe QI implementation activities in enough detail that the reader could carry out a similar activityGive decision makers and supervisors a clear understanding of quality improvement as it was actually carried outInclude a candid treatment of obstacles and problemsTarget audience:Health managersAcademiaPractitionersHost country government leaders
Case Book of
Improvement Stories
(Under Development)Slide8
What we have learned from improving processes?
Frontline providers can analyze and use data to make decisions, not just collect and report up
Leadership needs to be involved from the beginning and should lead scale up
Scaling up appears to increase cost-effectiveness compared to the pilot phase—but more studies are neededNeed to define roles of external assistance and jointly plan transfer of technical assistance to host country counterpartsSustainability depends on making improvements/best practices a permanent, integral part of health services