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. 

 

 

The Zambia Quality Assurance Program Final Evaluation

This document reports on an evaluation of the Quality Assurance Program (QAP) in Zambia. The evaluation took place in the fall of 1998, during the QAP's fifth year. The QAP's strategy was to build quality assurance (QA) capacity at the...

Maximizing quality of care in health sector reform: the role of quality assurance strategies

This paper explores the important role of quality assurance as an integral part of health sector reform. Chapter One presents a model for health sector reform, introduces the basic principles of quality assurance, and briefly reviews the...

Cost and impact of quality improvement interventions in developing country health systems. APHA, 1999.

This document explores the cost issues associated with implementing quality improvement initiatives in developing country health settings and determines the economic benefits of management systems for improving quality. It consists of a...

Health care sector reform and quality assurance in Costa Rica. Results of process improvement teams working in health facilities

An organizational reformation took place in Costa Rica to improve the access, quality, and delivery of health care services based on the needs of the target population. Under the health sector reform program, the Caja Costarricense del...

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...

Using quality assessment to improve maternal care in Nicaragua

Quality assessment is the measurement of the quality of healthcare services: it measures the difference between expected and actual performance. Information gained from an assessment can be used to identify opportunities for improvement...

Designing the integration of district and refugee health services in West Nile, northern Uganda

This case study outlines the application of quality design in the integration of refugee health care activities and the local health system of a rural district in northern Uganda. It illustrates how stakeholders with diverse interests and...

Vendor-to-vendor education to improve malaria treatment by the private sector: a "how-to" manual for district managers

This manual was developed to assist district health management teams in countries where malaria is endemic to improve the quality of malaria treatment given by private clinics, pharmacies, shops, and kiosks. It gives step-by-step...

The Guatemala QAP evaluation: Application and institutionalization of quality assurance

This report documents the experiences of the Quality Assurance Project (QAP) in implementing quality assurance activities in five regions of Guatemala: Quetzaltenango, Chimaltenango, Totonicapán, Sololá, and San Marcos. QAP initiated...

The Chile quality assurance program: Final evaluation

This evaluation report provides an overview of the Quality Assurance (QA) Program in the Chilean health care system. It is noted that the program began in the early 1990s, and, working through a QA Unit in the Ministry of Health, developed...

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