Improvement Science

The power of existing interventions is not matched by the power of health systems to deliver them to those in greatest need, in a comprehensive way, and on an adequate scale.

                                                                                                                                                             -- Margaret Chan, Director General, WHO

Despite an abundance of evidence-based guidelines and consensus on what should be done, many simple, high-impact interventions capable of saving lives and alleviating suffering are not reaching the people who most need them.
Model for Improvement

Adapted from Associates in Process Improvement, 1996

Much of this implementation gap is related to weak health systems and processes of care delivery. The USAID ASSIST Project is designed to address this challenge, achieving better health outcomes and strengthening health systems in USAID-assisted countries, through improvement science

Improvement science is the application of scientific methods to make processes and systems work better.  The fundamental concept of improvement science is that improvement requires change. If a system is not changed, it can only be expected to continue to achieve the same results. In order to achieve a different level of performance, changes must be made to that system in ways that permit it to produce better results.

An equally important concept is that while improvement requires change, not every change is an improvement. Because not every change makes care better, changes must be tested and studied to determine whether the change improves care quality.

This section of the ASSIST Knowledge Portal provides information on improvement methods and tools and resources for building capacity for improvement to help you make changes to improve your own system of care.

We also invite you to browse our database of improvement stories or submit your own story of how you have improved care. 

 

 

A clear guide to improving care of mothers and babies in low-resource settings

By: Tamar Chitashvili, Silvia Holschneider, Jorge Hermida, and Nigel Livesley 

There is growing recognition that clinical training and health infrastructure — while essential—are insufficient for improving and sustaining life-saving maternal and newborn health care services in low-resource settings. Instead, broader systems strengthening and continuous quality improvement efforts at the service delivery level are needed to continuously assess gaps in processes and content of care and to plan, test, implement, regularly monitor, refine and institute changes to deliver services correctly and consistently. To respond to this need and help frontline care providers in their continuous quality improvement journey, “Improving Care for Mothers and Babies: A Guide for Improvement Teams” was recently developed through collaborative efforts of the Survive & Thrive Global Development Alliance (S&T GDA).

Top 3 Resources from USAID ASSIST

Vicky Ramirez

Consultant, USAID ASSIST Project/URC

These were the most viewed resources from the USAID ASSIST website in 2016. Check them out:

1. Kenya Quality Model for Health: A Training Course for the Health Sector

The ASSIST Experience: Reducing rejection rate in viral load testing across 15 districts of northern Uganda

Mirwais Rahimzai

Regional Director for East Africa, USAID ASSIST/URC

The overall goal of the USAID/ASSIST program in Northern Uganda is to increase access and quality of health care using high-impact interventions with special focus on areas of laboratory infrastructure, HIV/AIDS, TB, malaria, maternal, neonatal and child health (MNCH), family planning and nutrition.  USAID ASSIST rolled out viral load (VL) monitoring in the region in July 2015 and the gaps identified included high rejection rates arising from low sample quality, non-adherence to the eligibility criteria, and incomplete documentation on the request form as well as incomplete utilization of r

Understanding what ‘integrated people-centered health services’ means

Julia Holtemeyer

Improvement Specialist for Gender and Knowledge Management, USAID ASSIST Project/WI-HER, LLC

Earlier this year, at the Sixty-ninth World Health Assembly, WHO Member States officially adopted the Framework on integrated people-centred health services (IPCHS). Designed to support increasing timely access to essential health services, the Framework proposes the following five critical shifts in health care systems to make them more people-centered:

Quality improvement— a game changer for Kenya

Bill Okaka

Knowledge Management & Communications Officer, ASSIST Kenya

After the promulgation of the Kenyan constitution in 2010, the Right to Health by all Kenyans cannot be refuted. Fatuma Abdullahi, a practicing nurse, is the institutional memory of the unfolding of events in the northern frontier semi-arid regions of Kenya. Her three decades of facility and community work has been characterized by:

  • low utilization of health services (even in situations where access wasn’t a problem due to short distances)
  • high neonatal and maternal mortality (the region scores a Maternal Mortality Ratio of 790/ 100,000 live birth), and
  • low financial resource ploughing by national and county governments (compared to resource envelop received vis-à-vis the vastness of the region).

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