Quality Assurance

This paper presents data on the views of midwives from one maternity unit in England following the introduction of an organisation wide quality improvement initiative to improve in-patient postnatal care and processes to transfer women home. As quality improvement initiatives are highly influenced by the context into which they are introduced and by the processes of implementation, our findings may support others to address how clinician engagement could be enhanced. [adapted from author]

The Peruvian Ministry of Health approved the Policy Guidelines on Human Resources in Health to address important aspects such as training tailored to the needs of the country, development of competencies, decentralized management of human resources, motivation, and commitment. This summary outlines the process of implementing this political and strategic framework for carrying out programs to develop human potential with a competency-based approach. [adapted from author]

This report documents how the use of performance and quality improvement (PQI), a technique for achieving desired performance at service delivery sites and within communities, has helped to improve skilled attendance, and shares some lessons learned about how best to use PQI in safe motherhood programs. [adapted from aouthor]

The primary purpose of the Data for Improvement and Clinical Excellence Long-Term Care (LTC) project is to assess the effects of a quality improvement audit with feedback intervention delivered monthly over 13 months to healthcare workers in four LTC facilities. [adapted from abstract]

This study evaluates the impact and sustainability of a competitive voucher program on the quality of reproductive health care for poor and underserved female adolescents and the usefulness of the simulated patient method for such evaluation. [from abstract]

This handbook contains the complete set of resources and tools required to introduce and maintain a performance and quality improvement process at primary health care centers in the Hashemite Kingdom of Jordan including: facilitator’s guide; performance improvement review process and tools; monitoring and support guide; and monitoring tools and forms handbook. [adapted from introduction]

This document details the results of a study to determine whether a quality improvement package designed to enable small-scale commercial reproductive health service providers to improve the quality of services provided through self-assessment, action-planning, and supervisors’ support is effective in improving service quality. [adapted from sbatract]

Few countries require that physicians demonstrate explicitly that they remain fit to practice. The term revalidation is defined as an evaluation of a medical practitioner’s fitness to practise. Although this definition focuses on assessment, it is recognized that the process leading up to it should be formative, encouraging professional development as well as identifying those unfit to practice. [adapted from author]

This presentation outlines a methodology to improve quality and accessibility of health care with greater involvement of the community in defining, implementing and monitoring the quality improvement process.

This presentation discusses the QIQ method of evaluating the quality of service delivery and provider performance.

A number of low- and middle-income countries have a severe shortage of health workers. This paper studies how health workers’ choices of labour supply and work effort impact on the quality of health services when health workers are in short supply. [from abstract]

This field guide is intended to provide some help with the task of improving the delivery of health services using standards of care as the basis for improvement. This guide is designed to answer questions such as: What types of standards are really useful to local providers and mangers? How can they be implemented in a practical way? How can the improvement process be supported?

This article discusses the agenda for monitoring and improving the quality of health care through the use of clinical governance in National Health Service organizations in the UK. [adapted from introduction]

Medical education in Saudi Arabia is facing multiple challenges, including the rapid increase in the number of medical schools over a short period of time, the influx of foreign medical graduates to work in Saudi Arabia, the award of scholarships to hundreds of students to study medicine in various countries, and the absence of published national guidelines for minimal acceptable competencies of a medical graduate. We are arguing for the need for a Saudi national medical licensing examination that tests the basic science and clinical knowledge and the clinical skills and attitudes.

Continuing education is necessary for all health care providers to remain up-to-date with the rapid technological advances and accumulation of new knowledge resulting from constant research. This booklet is intended to provide guidelines for planning, accrediting and implementing continuing professional development in Uganda. [adapted from foreword]

We reviewed published literature that outlines the principles of quality assurance in higher education from various institutions worldwide. Using this information, we designed a handbook that outlines the quality assurance principles in a simple and practical way. This was intended to enable institutions, even in developing countries, to adapt these principles in accordance with their local resource capacity. We subsequently pilot-tested this handbook at one of the sites in Ghana. [from abstract]

India has traditionally had a bureaucratic approach to regulating its health service. Research suggests that this approach has failed to protect the interests of poor and vulnerable groups and has not gained the trust of providers or the public. So are there any other ways to make India’s health systems more accountable? [from author]

The WHO Regional Office for the Eastern Mediterranean held a regional consultation on the accreditation of health professions education. The objectives of the meeting were to enable countries of the Eastern Mediterranean Region to exchange experience in establishing national systems of accreditation, identifying strengths and constraints, and to formulate region- and country-specific plans of action for establishing accreditation of health professions education. [from author]

Knowing that quality is never an accident, always the result of high intention, sincere effort, intelligent direction and skillful execution, and that it represents the wise choice of many alternatives, this abbreviated version of the Policy attempts to provide the strategic direction health facilities and officials need to follow to assure quality in health care and continuous improvement in the care that is being provided. Health care personnel are encouraged to use this copy of the Policy to focus their intentions and guide their efforts. [from foreword].

This study reviews the healthcare literature that examines the effect of financial incentives on the behaviour of healthcare organisations and individuals with respect to the quality of care they deliver to consumers. Its purpose is to provide guidance to policy-makers in government and decision-makers in the private sector in their efforts to improve quality of care through payment reforms. [adapted from summary]

This fact sheet highlights approaches to improving quality of care that can be rapidly implemented, over months rather than years, without great cost. The author writes that better quality can improve health much quicker than other drivers of health, such as economic growth, educational advancement, or new technology. [adapted from introduction]

In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers’ competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. [abstract]

One of the most important steps in the Performance Improvement Approach is the performance needs assessment (PNA). The PNA focuses on understanding the environment in which service providers work, i.e. the different systems within an organization that affect their performance, as well as the client and community perspectives which influence their family planning access. The performance factors, or those elements that providers need to be able to perform well, are the framework that guides the PI approach and what the PNA is geared to capture. [author’s description]

This is a QI package for the private sector that includes a review of service statistics, accompanying a QI self-assessment tool for midwives to identify quality issues, and a linked action plan for midwives and supervisors to help solve issues the QI tool identifies. [publisher’s description]

Family Medicine training and assessment is becoming more formalized and developed in South Africa. Assessment of competency in relation to clinical skills can involve observation in the clinical setting, but is more usually assessed in an examination. Summative assessment of family physician’s clinical skills now usually includes an Objective Structured Clinical Examination (OSCE). Standardisation of the OSCE is required to define the pass mark above which a candidate performs at the level expected of a family physician. [from abstract]

This Self-Assessment Inventory outlines the major areas of competence an effective supervisor must have. The competency areas are sub-divided into categories which correspond to the major functions supervisors perform. Its primary use is as a self-assessment tool. Individuals are encouraged to use it to assess their competence and performance as supervisors and use the results to develop a plan for improvement. This Inventory can also be used as a guide to curriculum development for Supervisory Training, using the components as the basis for a needs assessment exercise. [purpose]

This toolkit explores the nurse/workplace interface, overlapping factors that shape nurses’ work environments, the cost of unhealthy workplaces, and the characteristics and benefits of positive practice environments. A list of recommended actions and tools to help nurses negotiate for improved environments is also included. [from introduction]

This presentation discusses quality issues in private practice in developing countries, how the government can make licensing and regulation more effective, shifting the quality distribution and the use of accreditation. [adapted from author]

In recent years there has been a considerable growth of interest in the activities of providers in the private health sector in low income countries, and in how policy-makers might best capitalize on the accessibility and popularity of this sector. However, the evidence is limited as to which approaches work best. The aim of the present paper is to consider how the activities of the private health sector in low-income countries can be influenced so that they help to meet national health objectives. [from introduction]

Credentialing is a means of assuring quality and protecting the public by confirming that individuals, programmes, institutions or products meet agreed standards. Credentialing is becoming increasingly important as health systems strive to address issues of public safety and quality services. [author’s description]