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. 



Improving Health Care: Training Participant Guide

This training participant guide was developed to accompany a two-day improvement training course designed by M. Rashad Massoud , translating the in-person course to a user-friendly guide for participants. The training course, “ Improving...

Improving Health Care: Training Facilitator Guide

This training facilitator guide was developed to support a quality improvement trainer to lead a traditional classroom training using the same content and slides as delivered in the online course Improving Health Care . It was first...

What do we mean by innovation in healthcare?

Just as in other modern industries, the term ‘innovation’ in healthcare has become associated with any developments in the field done in new, better, or more effective ways. Innovation—a buzzword lifted from the business, technology, and...

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).

Documentation and Knowledge Management Report FY16

The United States Agency for International Development (USAID) Applying Science to Strengthen and Improve Systems (ASSIST) Project supports the deliberate harvesting of what we are learning from the implementation and evaluation of...

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

Better Health Care: How Do We Learn About Improvement? (Salzburg Global Seminar, Session 565 Report)

The Salzburg Global Seminar (Session 565) was convened July 10th – 15th, 2016, bringing together over 60 leaders in improvement and research from 10 organizations from 28 countries to think through the best ways to learn about improvement...

Tools for the South Africa Integrated People-centered Health Services Baseline and Endline Assessments

These tools were used in South Africa for the ASSIST activity on integrated people-centered health services (IPCHS). The baseline report is in review by USAID and should be available soon. The data collections tools may be downloaded below...

Landscape Analysis of Global Learning Networks to Inform the Development of a Learning Laboratory for Quality Universal Health Coverage

The World Health Organization (WHO) Department of Service Delivery and Safety (SDS) has decided to create a global learning laboratory (GLL) to harness and consolidate the growing knowledge base on Universal Health Coverage (UHC) and...