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. 

 

 

How a Gender-sensitive Quality Improvement Approach Supports Integrated People-centered Health Services

The World Health Organization framework on integrated people-centered health services (IPCHS) supports increasing timely access to essential health services and making health care more people-centered through five strategic shifts in...

Why Economic Analysis of Health System Improvement Interventions Matters

There is little evidence to direct health systems toward providing efficient interventions to address medical errors, defined as an unintended act of omission or commission or one not executed as intended that may or may not cause harm to...

Gender integration in quality improvement: Increasing access to health services for women in rural Mali

Anemia is one of the leading contributors to infant and maternal mortality and morbidity in Mali. The causes of anemia are many and complex, but are influenced by social norms and cultural beliefs as well as lack of access to health and...

Intégration du Genre dans l’Amélioration de la Qualité : Augmenter l’accès aux services de santé pour les femmes en milieu rural au Mali

Au Mali, l’anémie contribue très fortement à la mortalité et à la morbidité infanto-juvénile. Les causes d’anémie sont multiples et souvent complexes, mais ces deux causes immédiates de l’anémie sont influencées par certains facteurs comme...

Integrating Gender and Gender-based Violence in Medical and Nursing Curricula in Nicaraguan Universities

In Nicaragua, the USAID ASSIST Project supports the application of continuous quality improvement to integrate HIV prevention and treatment topics in the medical and nursing training programs in nine universities. Baseline data clearly...

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:

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