Quality assurance of health care in developing countries. 2nd ed.
This document is the first report of the research component of the Quality Assurance Project (QAP), which helps developing countries design and implement effective strategies for improving the quality of health care. This report describes how the QAP introduces quality assurance methods into health care delivery systems in developing countries. The first part explains how the quality of health care has been assessed and improved in developing countries. Part 2 discusses the feasibility and rationale for using quality assurance methods to define clinical guidelines and standard operating procedures, assess performance against performance standards, and improve program performance and effectiveness. The third part offers definitions of quality and analyzes the following dimensions of quality: technical competence, access to services, effectiveness, interpersonal relations, efficiency, continuity, safety, and amenities. Part 4 reviews the definition and basic tenets of quality assurance. The fifth part outlines the following steps in the quality assurance process: planning, setting standards and specifications, communicating guidelines and standards, monitoring, identifying problems and selecting opportunities for improvement, defining the problem, choosing a team, analyzing the problem to identify its root cause, developing solutions and actions for quality improvement, and implementing and evaluating efforts. The report ends with a consideration of the challenges of creating a quality assurance program.