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Tools & Resources
The Improvement Collaborative Approach
HCI supports the application of a range of modern QI methods to priority health problems worldwide, including the Improvement Collaborative model. The Improvement Collaborative approach, adapted from the Institute of Healthcare Improvement in the U.S., integrates many of the basic elements of traditional health programming (standards, training, job aids, inputs) with classic QI elements (team work, process examination, monitoring of results, client satisfaction), resulting in a dynamic modern QI approach in which multiple teams from different sites work together intensively to share and rapidly scale up strategies for improving quality and efficiency of health services in a targeted technical area.
In the Improvement Collaborative model, established QI methods (continuous QI, training, supervision) are linked with evidence-based standards at a systems level for rapid change and large-scale impact. The Improvement Collaborative as it is being implemented by HCI is a dynamic approach that has been continuously modified over time for greater efficiency and impact in resource-constrained settings. The approach emphasizes more efficient use of existent resources and routine local analysis of common indicators for continuous quality improvement. It empowers local participants to reflect, test, and measure realistic solutions to their local health care problems that can in turn be shared with fellow collaborative participants and Ministry of Health (MOH) officials for scale-up.
Day-to-day activities of collaboratives are conducted and managed by regional MOH officials with technical support from HCI staff. Local teams receive regular on-site training that integrates technical and QI skills so that participants learn to problem solve to reduce obstacles to application of new standards in their local settings. Periodic supervision visits by regional MOH "external coaches" with technical support from HCI staff provide ongoing reinforcement to individual site teams.
All collaborative activities emphasize developing capacity for basic quality improvement at the local level with a focus on team-building skills for continuous improvment through monitoring and analysis of shared indicators. Best practices and results are shared during periodic "Learning Sessions" and disseminated to all participants countrywide. Since local actors themselves develop local solutions, their ownership of innovative solutions is higher, increasing the likelihood of sustainablity and spread to other sites.
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