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Continuous Quality Improvement – Knowledge Management by Any Other Name. Peter Hobby Director of Communications and KM Center for Pharmaceutical Management Management Sciences for Health. Systems for Improved Access to Pharmaceuticals and Services. Goal
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Continuous Quality Improvement – Knowledge Management by Any Other Name Peter Hobby Director of Communications and KM Center for Pharmaceutical Management Management Sciences for Health
Systems for Improved Access to Pharmaceuticals and Services • Goal • To assure the availability of quality pharmaceutical products and effective pharmaceutical services to achieve desired health outcomes • Objective • To promote and use a systems-strengthening approach consistent with the Global Health Initiative that will result in positive and sustainablehealth impact
The continuous quality improvement (CQI) concept… • Program management method known also as continual improvement process and plan-do-study-act. • Includes reflection on processes to trim inefficiencies • Adaptation through small-scale, incremental changes. • Creates and codifies learning in applied settings • Indicators or targets helps determine success. What is CQI?
Why Implement CQI ? • To improve quality through continual reviews and small-scale changes that do not overwhelm the staff or the system • To implement self-determined changes, NOT the ones thrust in from outside • To help reduce variations in practice (which are common and often have no clear reason or basis) • To identify opportunities for cost containment in the current environment of escalating health care costs
PDSA Cycle Adapted from: CIE & Datatel – CQI 101
PDSA for Jordan A multidisciplinary team conducts CQI through PDSA cycles • PLAN • Study the existing practice (collect data and current process) • Identify issues/problems • Develop action plan for change, including plan for measuring success • DO • Undertake the planned activities on a small scale
PDSA for Jordan • STUDY • Examine or check the result of the action before waiting too long • Look for signs of progress, constraints, or unexpected outcomes • Look for any lessons brought by this small scale action • ACT • Use the findings (and lessons learned) from the study to identify and make any necessary mid-course modifications or adjustment • Then continue the PDSA process with the next cycle, going from P to D to S to A (in an iterative manner)
CQI for Antibiotic Prophylaxis in C-section: Conclusion • The CQI framework has a strong potential to— • Standardize processes • Strengthen systems • Progressively improve antibiotic prophylaxis in c-section • The framework can easily be expanded later to improve prophylaxis for other surgeries Source: vzimbel.com
MSH has helped groups in: Afghanistan, China, Ethiopia, Jordan, Kenya, Liberia, Malawi, Mozambique, Rwanda, South Africa, South Sudan, Tanzania, and Uganda, to: Where Else has CQI Worked?
Increase in the percentage of 64 primary health care facilities that complied with national cold chain management standards from 26 to 48% • 70% improvement in medicine labeling practices and a 27% increase in the number of patients who knew how to take their medication properly • 17% increase in the number of prescriptions that complied with standard treatment guidelines • 17% reduction in the number of medication errors recorded at four hospitals. South Africa Example
Establish revolving drug funds in 340 NGO clinics. • Help hospitals to establish Drug and Therapeutics Committees to address service delivery bottlenecks • Use in HIV/AIDS training to improve inventory management and increase use of SOPs by 50% • Create action plans to improve antibiotic prophylaxis practices for C-sections, including practice profiles , baseline data, and self-monitoring indicators • Applied at 44 hospitals now scoring above 70% on indicators of inventory management, storage management, and supply chain management. How Else has CQI Been Applied?
