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. 

 

 

Review of health services accreditation programs in South Africa

Still emerging from the vestiges of apartheid, South Africa's healthcare system is, generally, not conducive to quality. As it strives to improve the quality of the healthcare delivery system, the government must particularly focus on...

Neighbor-to-neighbor education to improve malaria treatment in households in Bungoma district, Kenya

This study's main objective was to determine the impact of a low-cost outreach "neighbor-to-neighbor" (jirani kwa jirani or JKJ) education program on caretaker purchase and consumption of antimalarial drugs in Bungoma District, Kenya. The...

A team in Malawi uses quality assurance to address cholera issues.

Cholera is a serious, infectious disease with a high case fatality rate. In 1998 in Mangochi district, Malawi, 100 cases of cholera were treated by the Kapire Health Center (HC). As part of the Community Health Partnerships (CHAPS) project...

Licensure, accreditation, and certification: Approaches to health services quality

With the onset of quality movement in the health care sector, a growing interest in the quality evaluation of health services has been noted. Licensure, accreditation, and certification are systems available to meet the need for quality...

Setting up a national hospital accreditation program: the Zambian experience

In 1997, Zambia became one of the first countries in sub-Saharan Africa to launch a national hospital accreditation program. In mid-2000, a team of researchers was organized to assess the milestones and successes of the Zambian...

Redesigning hospital documentation systems to improve the quality of obstetric patient records in Ecuador.

This study tested whether a redesign methodology would improve the quality of medical records in the obstetric services of four Ecuadorian hospitals. Quality teams in each hospital implemented a redesign methodology, working in cooperation...

Developing and testing a generic job aid for malaria rapid diagnostic tests (RDTs). Field report.

The traditional approach to malaria diagnosis has been examination by microscope of a thick blood smear from the individual suspected of being infected. In an attempt to provide a more rapid alternative, companies worldwide have developed...

Health care quality glossary. Russian Federation-United States of America, 1999

This glossary represents both an important "process" and "outcome" of the cooperation between the United States Department of Health and Human Services and the Ministry of Health of the Russian Federation in the Priority Area of Access to...

Using client satisfaction data for quality improvement of health services in Peru

This case study illustrates how a clinic-based team in Peru used client satisfaction data in two quality improvement methods--rapid team problem solving and systematic team problem solving--to address low clinic utilization. It is noted...

Helping district teams measure and act on client satisfaction data in Niger

This paper presents a summary of the Quality Assurance Project's operations research project entitled "The client perspective: helping district teams measure and act on client satisfaction data in Niger." Implemented in two stages, the...

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