Looking to the Future: Lessons from the USAID ASSIST Project in India
The USAID ASSIST Project started working in India in September 2013. Initially, we supported staff in over 400 public healthcare facilities in 27 districts in six states to use quality improvement (QI) approaches to deliver better care to pregnant and delivering women and newborns. This work went well; the staff in these facilities were able to reduce perinatal mortality by 15% over 18 months. During this time, we were fortunate to meet great partners from important organizations and institutions across India.
These institutions are now leading a growing movement to help more people apply QI methods to deliver care that prevents harm, improves outcomes, and meets the needs of the people receiving it. For ASSIST/India’s final meeting on November 8th, Looking to the Future: Lessons from the USAID ASSIST Project, we provided a forum for these institutions to share what they have accomplished over the past two years and brainstorm how they can continue to move this work forward. During this meeting, participants engaged with each other and shared ideas over social media using the hashtag #ASSISTandBeyond.
Below we’ve shared materials from the meeting and information about our partners’ work in India. We invite you to explore these presentations and posters and to visit the sites created by our partners (listed in the "marketplace" section) to learn more about their work.
Panels and Presentations
Panel discussion – The experience of QI interventions in state public health systems
- "Improving Quality of Newborn Care in Meghalaya" Dr. Hunsi Giri, Ganesh Das Government MCH Hospital, Shillong
- "Medical Colleges as Resources for a District/State Level Quality Improvement Program: West Bengal Experience" Prof. Dr. Asim Kumar Mallick, Medical College and Hospital, Kolkata
- "Overview of State Quality of Care (QoC) Initiative in Himachal Pradesh" Dr. Rajesh Guleri, State Nodal Officer & District Health Officer, Government of Himachal Pradesh
Panel discussion - Nursing leadership in improving the quality of care
- Introduction to the topic by moderator Dr. Sonali Vaid, ASSIST
- "Quality Improvement: Role of Nurses" Yangchen Dolma, Senior Nursing Officer, AIIMS, New Delhi
- "Quality Improvement Initiative: A New Beginning in AIIMS NICU" Meena Joshi, Nurse Educator, WHO Collaborating Centre for Training and Research in Newborn Care, AIIMS
- "Department of Nursing doing Quality Improvement at Kalawati Saran Children's Hospital and beyond…" Jeena Pradeep, CNE Facilitator, Kalawati Saran Children's Hospital
Panel discussion - QI in the private sector
- Panelists discussed their journey into QI and what about improvement attracted them to this methodology as a means to change the way operate their organizations (no presentations).
Marketplace of QI Resource Centers
In this marketplace, various domestic organizations that can continue to provide QI support to other hospitals and organizations in India shared the work they've done and their resources for support.
All India Institute of Medical Sciences (AIIMS)
AIIMS QI website: aiimsqi.org
This website shares QI resources and results from successful QI projects from the quality improvement (QI) team at All India Institute of Medical Sciences, New Delhi and other health care teams from South-east Asian Region (SEAR) member countries that they've engaged in improving knowledge and skills of QI methods. .
- Reducing General Anaesthesia Waiting Area Time in Eye OT by 87%: R.P. Centre QI Initiative
- Reducing Waiting Time of Patients for Minor Procedures in Eye Casualty in Tertiary Eye Care Centre - A QI Initiative
- Improving Scrub Time of Surgical Team in Eye Operation Theatre
- Reducing Waiting Time of Preterm Babies in ROP Clinic at AIIMS, New Delhi
National Quality of Care Network (NQoCN)
- Nationwide Quality of Care Network (NQOCN): Our Story
- A Quality Improvement Project to Reduce the Incidence of Neonatal Hypothermia at Admission in NICU (Chinmaya Mission Hospital, Bangalore)
- Improving the Duration of Kangaroo Mother Care of Low Birth Weight Newborns Admitted in Sick Newborn Care Unit (Ganesh Das Hospital, Meghalaya)
- Reduction of Neonatal Hypothermia at Admission: A Quality Improvement Initiative (Kalawati Saran Children's Hospital/Lady Hardinge Medical College, New Delhi)
- Providing Immediate Skin-to-Skin Contact to All the Newborns as a Standard of Care in Labor Ward (MCH Tura Hospital, Meghalaya)
- Providing Sucrose Analgesia - A Quality Improvement Project (Deogiri Children's Hospital, Aurangabad)
- Initiating Point of Care Quality Improvement Methodology in a Challenging Scenario (University College of Medical Sciences, Gurutegh Bahadur Hospital, Delhi)
- Nurses Role in Facilitating Quality Improvement Process across NQOCN-India (Kalawati Saran Children's Hospital, Delhi)
- Reduction of the financial cost for patient by reducing the number of ultrasound scans performed by radiologists and cardiologists in Neonatal Intensive Care Unit (NICU) Karnataka, India (Manipal Hospitals, Bangalore)
- Reducing the Radiological Exposure in the Neonatal Intensive Care Unit at Ovum Hospital, Bangalore, India (Ovum Hospital, Bangalore)
Dr. Ram Manohar Lohia Hospital, Delhi
- Quality Improvement Initiative on Early Skin-to-Skin Contact (SCC) and Early Initiation of Breastfeeding among Babies Born after Caesarean Section at Dr. R.M.L. Hospital, New Delhi
- Quality Improvement Project on Improvingn the Compliance towards Hand Washing among Parent/Attendant of Sick Newborns Admitted in NICU Under Family-Centered Care at Dr. R.M.L. Hospital
- Improving Hand Washing among Parent Attendants Entering the Newborn Intensive Care Unit (NICU), Dr. R.M.L. Hospital, New Delhi, India
- Quality Improvement Project On Increasing Average Amount of Breast Milk Intake Among Sick Newborns in Out-born Nursery at Dr. R.M.L. Hospital and PGIMER, New Delhi, India
State of Himachal Pradesh
Video: Quality Improvement Initiatives in the Government of India’s RMNCH+A Strategy: Lessons from Chamba, Himachal Pradesh
- Quality of Care Initiative in Himachal Pradesh
- Reduction in Overcrowding in Labor Room Complex: A Qualitative Initiative
- To Establish Exclusive Breastfeeding in Neonates During Hospital Stay - A Quality Initiative
State of West Bengal
- A Quality Improvement Initiative to Increase Compliance with Clean Delivery Techniques in Labour Room, First Three Processes – Clean Hands, Clean Perineum And Clean Surface
- Early Initiation of Breastfeeding in Labour Room in Uncomplicated Vaginal Delivery
- A Quality Improvement Initiative to Increase the Use of Corticosteroid to Mother (27-34 weeks of gestation) in Antenatal Period, Nilratan Sircar Medical College & Hospital, Kolkata
- A Quality Improvement Initiative for Early Initiation of Emergency Management of Sick Neonate, Nilratan Sircar Medical College & Hospital, Kolkata
- A Quality Improvement Initiative to Decrease the Incidence of Hypothermia of Well Small Baby (weighing 1500-1800 gm) at the Time of Admission in SNCU, Nilratan Sircar Medical College & Hospital, Kolkata
- A Quality Improvement Initiative to Reduce the Mean Duration of Stay of Healthy Babies in SNCU, Nilratan Sircar Medical College & Hospital, Kolkata
Point of Care Continuous Quality Improvement website: pocqi.org
This website is a collaborative learning platform for progressively building the capacity of health care teams and other stakeholders to use improvement methods to work towards ending preventable mortality among mothers, newborns and children; and as a repository of knowledge in quality improvement methods & experiences throughout Southeast Asia.
- Better Identification of Obstetric Complications by Increasing Partograph Use at Shaheed Suhrawardy Medical College (Bangladesh)
- Reducing the Number of Readmission of Babies Due to Dehydration Fever After Delivery to Neonatal Units at Teaching Hospital Anuradhapura (Sri Lanka)
Photos from the event can be viewed or downloaded here.