Breaking barriers: assessing the impact of clinical quality improvements on reducing health disparities in hypertension care among Mumbai's urban slums.

The clinical quality improvement initiatives, led by the organisation's Health Equity Working Group (HEWG), aim to support healthcare providers to provide equitable, quality hypertension care worldwide. After coordinating with the India team, we started monitoring the deidentified patient data collected through electronic health records between January and May 2021. After stratifying data by age, sex and residence location, the team found an average of 55.

Effectiveness of in-service training plus the collaborative improvement strategy on the quality of routine malaria surveillance data: results of a pilot study in Kayunga District, Uganda.

Background: Surveillance data are essential for malaria control, but quality is often poor. The aim of the study was to evaluate the effectiveness of the novel combination of training plus an innovative quality improvement method-collaborative improvement (CI)-on the quality of malaria surveillance data in Uganda.

Methods: The intervention (training plus CI, or TCI), including brief in-service training and CI, was delivered in 5 health facilities (HFs) in Kayunga District from November 2015 to August 2016.

Politics of disease control in Africa and the critical role of global health diplomacy: A systematic review.

Africa is facing the triple burden of communicable diseases, non-communicable diseases (NCDs), and nutritional disorders. Multilateral institutions, bilateral arrangements, and philanthropies have historically privileged economic development over health concerns. That focus has resulted in weak health systems and inadequate preparedness when there are outbreaks of diseases.

Evaluation of the rapid, multi-country, parallel process, multi-tasking approach to startup of short-term technical assistance to improve service delivery in newborn and child health in the context of USAID's Zika response in four Eastern and Southern Caribbean countries.

In 2018, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project started a new partnership with four Eastern and Southern Caribbean countries impacted by the Zika virus: Antigua and Barbuda, Dominica, St. Kitts and Nevis, and St. Vincent and the Grenadines.

Assessing the Feasibility and Effects of Introducing the USA National Surgical Quality Improvement Program on Clinical Outcomes and Cost in Saudi Arabia: An Observational Study.

Introduction: This study aimed at introducing a systematic clinical registry to assess the outcomes of surgical performances and the associated costs of surgical complications in hospitals of Saudi Arabia.

Materials And Methods: This was an observational retrospective cohort study. Three large Saudi public hospitals from different regions participated in the study.

Do Quality Improvement Initiatives Improve Outcomes for Patients in Antiretroviral Programs in Low- and Middle-Income Countries? A Systematic Review.

Background: There have been a range of quality improvement (QI) and quality assurance initiatives in low- and middle-income countries to improve antiretroviral therapy (ART) treatment outcomes for people living with HIV. To date, these initiatives have not been systematically assessed and little is known about how effective, cost-effective, or sustainable these strategies are in improving clinical outcomes.

Methods: We conducted a systematic review adhering to PRISMA guidelines (PROSPERO ID: CRD42017071848), searching PubMed, MEDLINE, Embase, Web of Science, and the Cochrane database of controlled trials for articles reporting on the effectiveness of QI and quality assurance initiatives in HIV programs in low- and middle-income countries in relation to ART uptake, retention in care, adherence, viral load suppression, mortality, and other outcomes including cost-effectiveness and long-term sustainability.

Managing hundreds of improvement teams.

Recognizing the notable scale of USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project activities and sizable number of improvement teams, which in some cases is close to 1,000 improvement teams managed in one country at a point in time, we sought to answer the questions: How do we manage hundreds of improvement teams in one country alone? How do we manage more than 4,000 improvement teams globally? The leaders of our improvement programs manage such efforts as though they are second-nature, without pointing to the specific skills and strategies needed to manage thousands of teams. This paper was developed to capture the lessons, considerations, and insights shared in discussions with leaders on the USAID ASSIST Project, including country Chiefs of Party and Regional Directors. More specifically, this paper seeks to describe what is involved in scaling up and managing large numbers of improvement teams.

What initiatives do healthcare leaders agree are needed for healthcare system improvement? Results of a modified-Delphi study.

Purpose: The purpose of this paper is to identify five quality improvement initiatives for healthcare system leaders, produced by such leaders themselves, and to provide some guidance on how these could be implemented.

Design/methodology/approach: A multi-stage modified-Delphi process was used, blending the Delphi approach of iterative information collection, analysis and feedback, with the option for participants to revise their judgments.

Findings: The process reached consensus on five initiatives: change information privacy laws; overhaul professional training and work in the workplace; use co-design methods; contract for value and outcomes across health and social care; and use data from across the public and private sectors to improve equity for vulnerable populations and the sickest people.

A framework for learning about improvement: embedded implementation and evaluation design to optimize learning.

Improving health care involves many actors, often working in complex adaptive systems. Interventions tend to be multi-factorial, implementation activities diverse, and contexts dynamic and complicated. This makes improvement initiatives challenging to describe and evaluate as matching evaluation and program designs can be difficult, requiring collaboration, trust and transparency.

Salzburg Global Seminar Session 565-'Better Health Care: how do we learn about improvement?'.

A fundamental question for the field of healthcare improvement is the extent to which the results achieved can be attributed to the changes that were implemented and whether or not these changes are generalizable. Answering these questions is particularly challenging because the healthcare context is complex, and the interventions themselves tend to be complex and multi-dimensional. The Salzburg Global Seminar Session 565-'Better Health Care: How do we learn about improvement?' was convened to address questions of attribution, generalizability and rigor, and to think through how to approach these concerns in the field of quality improvement.

Are the SDGs leaving safer surgical systems behind?

The World Health Organisation (WHO) has set out its new aims for the post-2015 global agenda in the form of the Sustainable Development Goals (SDGs). Discussions around the historically neglected role of emergency and essential surgical interventions in global health has attracted widespread attention with the help of well-timed, high-profile reports including the Lancet Commission for Global Surgery [1]. The case for promoting safe surgery is clear with evidence suggesting that at least two-thirds of the years of life lost globally will be attributed to surgical conditions by 2025 [1].

How do we learn about improving health care: a call for a new epistemological paradigm.

Purpose: The field of improving health care has been achieving more significant results in outcomes at scale in recent years. This has raised legitimate questions regarding the rigor, attribution, generalizability and replicability of the results. This paper describes the issue and outlines questions to be addressed in order to develop an epistemological paradigm that responds to these questions.

Improving care for patients on antiretroviral therapy through a gap analysis framework.

Objective: To improve quality of care through decreasing existing gaps in the areas of coverage, retention, and wellness of patients receiving HIV care and treatment.

Design: The antiretroviral therapy (ART) Framework utilizes improvement methods and the Chronic Care Model to address the coverage, retention, and wellness gaps in HIV care and treatment. This is a time-series study.

A promising approach to scale up health care improvements in low-and middle-income countries: the Wave-Sequence Spread Approach and the concept of the Slice of a System.

There are several examples of successes in improving health care. However, many of these remain limited to the sites at which they were originally developed. There are fewer examples of successful spread of the improvement more widely inside or outside the health systems within which they were developed.

The Global Trigger Tool shows that one out of seven patients suffers harm in Palestinian hospitals: challenges for launching a strategic safety plan.

Objective: The aim of this study was to evaluate patient safety levels in Palestinian hospitals and to provide guidance for policymakers involved in safety improvement efforts.

Design: Retrospective review of hospitalized patient records using the Global Trigger Tool.

Setting: Two large hospitals in Palestine: a referral teaching hospital and a nonprofit, non-governmental hospital.

Charting the way forward to better quality health care: how do we get there and what are the next steps? Recommendations from the Salzburg Global Seminar on making health care better in low- and middle-income economies.

Objective: In April 2012, the Salzburg Global Seminar (SGS) brought together 58 health leaders from 33 countries to review experiences in improving the quality and safety of health-care services in low- and middle-income countries, synthesize lessons learned from those experiences, discuss challenges and opportunities and recommend next steps to stimulate improvement in such countries. This work summarizes the seminar's key results, expressed as five shared challenges and five lessons learned.

Design: The seminar featured a series of interactive sessions with an all-teach, all-learn approach.

The Chilean legacies in health care quality.

Objective: The Chilean quality assurance (QA) program evaluation took place in July 1999, at the request of the Chilean Ministry of Health. The main objectives of the evaluation were to identify key aspects of the 8-year-old Chilean QA program that could be considered by other countries and to make strategic recommendations.

Setting: In 1991, the Ministry of Health of Chile launched a national QA program.

The evaluation of quality assurance: developing and testing practical methods for managers.

Objective Of The Study: To develop an approach for evaluating quality assurance (QA) activities and programs in health care settings and to test different evaluation methods.

Design: This was not a formal scientific study, but rather a research and development (R&D) study, which followed the following steps: (1) reviewing the literature; (2) clarifying critical issues for all key aspects of QA activities; (3) drafting a guide to provide a flexible vehicle for different approaches; (4) testing and adapting the guide as it evolved in three countries; and (5) testing two evaluation tools (self-assessment and appreciative evaluation) in Chile.

Setting And Study Participants: The evaluation guide was tested by evaluating QA structures, activities, and programs at the country, regional, and facility levels in Zambia, Niger, and Chile.