The basic concept of improvement that one must make a change to get a different result is implemented by most people in everyday life in big and small ways. However, getting groups of people to jointly think through their problems, determine possible solutions, test those solutions, monitor the results and act according to those results takes effort and skill.
The resources here focus on the fundamental skills that are needed to improve systems of care, whether at a community, facility, district or national level. Some of the core competencies for include:
- Understanding work as systems and processes
- Working in teams
- Testing possible changes to those processes using plan-do-study-act cycles
- Measuring improvement
- Focusing on the needs of the client
- Sharing experiences with other teams with similar improvement aims
Classroom training may be a place to begin developing competencies in improvement skills, but needs to be followed up with mentoring or other support, ongoing refresher training, on the job practice, or sharing experiences with other teams. Basic improvement training should be geared toward the audience. National level ministry participants may need only an overview on basic improvement, with more focus on the types of resources, policies, and support needed to run a program. Community level or other low literacy participants may require an entirely exercise based training. Dramas and cartoons portraying the improvement process have been used as creative ways to reach low literacy audiences. Teams need practical, hands on experience starting their own improvement activities in order to fully understand the process.
The Modern Paradigm for Improving Quality in Healthcare provides a good first overview of key concepts and tools for individual teams beginning improvement activities. Training modules developed under the Quality Assurance Project go into more depth on some of the key concepts and skills for improvement. These modules use short lectures, exercises and games to teach the concepts and build competencies:
- Dimensions of Quality
- Four Steps of Quality Improvement
- Introduction to Quality Improvement Concepts
- Quality Improvement Success Stories (case studies for discussion)
- Processes and systems
- Focus on Measurement: Part 1 and Focus on Measurement: Part 2
- Focus on Teamwork
- Focus on Client
Additional resources for improvement competency development include:
- Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) QI Training for Teams and Coaches was developed as a completely exercise, game and discussion based training for low literacy participants.
- WIHI Free Audio Program from the Institute for Healthcare Improvement (IHI) contains a variety of topics around improvement geared towards policy makers or facility managers.
- IHI Open School is a free online resource for courses and certificates in healthcare improvement and patient safety designed for health professionals around the world.
- National Quality Center Game Guide contains a number of resources to teach improvement, including an online tutorial on the Plan-Do-Study-Act cycle, available in both English and Spanish. While the focus of the resources is HIV, they are useful for any students of improvement.