This course was designed to help mid-level health managers develop skills in monitoring quality of care in an ambulatory healthcare setting. Building on standards already in use, the course guided participants through the steps of developing and using indicators in a systematic method to routinely monitor health worker performance. Participants defined and developed indicators, design data collection tools, collect data in a facility, and analyze and interpret that data. This course was part of a larger technical plan in which participants already had general knowledge of QA, and were planning to use quality improvement techniques to address the gaps between standards (desired performance) and actual performance detected through this monitoring.