Quality Improvement

CHS - About1

Class instructor and Student. Photo by Brian Donnelly

CHS and its affiliate University Research Co., LLC (URC) help national and lower level government entities apply quality improvement (QI) methods to improve 1) the effectiveness, efficiency, and safety of service delivery and 2) the performance of human resources in delivering products and services.

The fundamental concept underlying QI is that a system left unchanged can only continue to produce the same results. To achieve better performance, the system must change in ways that enable it to produce a better result. In health care, QI seeks to change health care systems in ways that will enable high-impact, evidence-based interventions to achieve better results. QI also identifies unnecessary, redundant, or incorrect parts of systems and enables people to change them to streamline the delivery of care.

CHS and URC have over 30 years of experience applying QI to health care and have demonstrated that significant improvements in health care quality are attainable in even the most resource-constrained settings. Our approach applies the main principles of QI:

  • Focusing on the client,
  • Involving teams of health workers in testing changes to make health care better, and
  • Making changes to both the content of care and the process of care to yield improvement (see figure).

Quality Improvement

Building on traditional approaches to making the content of health care more effective through evidence-based standards and guidelines, we focus QI methods on strengthening health care delivery processes, thereby achieving appreciable impact. Changes proven successful on a limited scale in improving a system of care are then scaled up throughout the health system.

CHS applies a range of approaches and methodologies (listed below) to improve the quality of care in low- and middle-income countries. Our assistance has included national quality policy and program design; system and process redesign; regulatory strategies such as accreditation, integrating continuous QI within district health management; and collaborative improvement approaches. Working with partners at the national, sub-national, and facility levels, we have designed, introduced, and ensured implementation of clinical guidelines and standards, monitoring and assessment methods, improved training approaches, and effective job aids that have contributed to sustainable improvements in the quality of care, interpersonal communications, and patient satisfaction.

Adapting the Collaborative Improvement Model to Settings in Low- and Middle-income Countries: One of our most significant advances is adapting the collaborative improvement model to resource-constrained settings. Learn more here.