introducing qi tools and approaches taking qi & pi approaches and tools to scale appendix f...
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Introducing QI Tools and Approaches
Taking QI & PI Approaches
and Tools to ScaleAPPENDIX F
Session G
Facilitative Supervision for Quality Improvement Curriculum
2008
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The QI Process
Information gathering and analysis
Action plan developmentand prioritization
Implementation
Follow-up/evaluation
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INFO
Communityassessment
Client interview
CFA Observationof services
Datareview
Facility audit
Record/case review
INFO
Staff interview
COPE®
Information Gathering
Identify gap between actual practice and best practice
Quality Measuring
ToolCost analysis
PNA
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Action Plans (examples)
INFO
INFO
District Supervisor’s
Plan
Community Action Plan
COPE® Action Plan
Site Training Plan
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Taking QI/PI Approaches to Scale
Replication?Diffusion?
Expansion?Institutionalization?
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Taking QI & PI Approaches to Scale
Process:
– of planning, implementation and evaluation of strategies and activities
– designed to increase and expand the use of the QI approaches
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Taking QI & PI Approaches to Scale
Endpoint is institutionalization -- sustained use leading to sustained improvement
Other systems are created or adapted to support its use
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From Pilot to Institutionalization
Site selection Orientation for managers and staff Training Range of facilitators, supervisors, staff involved Funding/other support for activities and
solutions Systems and management Partnerships Communities Supporters and Leadership
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Site Selection
Starting with “best potential for change”
Moving beyond to “real”
Need to go everywhere - eventually
Choosing sites - by interest, by supportive supervisors
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Orientation and Training
Orientation for managers
Orientation for staff
Training for facilitators, participants
Involve a range of supervisors, facilitators, staff to address staff turnover problem
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Resources
For conducting activities
For implementing interventions
Needs will be raised during assessment (COPE exercise)
Focus on local solutions, local resources
Identify external sources of support
Link action plans with cost-sharing
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Systems and Management
Inclusion of QI approaches and tools (COPE & other) in quality assurance policies and guidelines
Monitoring and supervision systems in place
Emphasize role of supervisor as liaison to sources for support
Incorporate review of QI action plans in regular meetings
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Partnerships
MOH, other NGOs, private sector to support the process
Other sectors - Education, Development, Social Services
Local businesses
Other funding organizations
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Communities
Use COPE for Community Involvement
Educating communities about their rights
Empowering community members to articulate their needs
Local decision-making for health funds through Health Sector Reform
Combine resources and efforts for problem-solving
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Supporters and Leadership
Site level
Institutional level
Charismatic leaders
How to build support and enthusiasm at a national level?
Share “success stories” and lessons learned
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Environmental Context
Health Sector Reform
National policies
Other organizations
Other sectors
Other actors (donors, insurers, etc.)
New or well-known ideas (BTC)
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Example: Taking COPE to Scale
Strategies for taking COPE to scale Planning and conducting activities to
introduce COPE Planning and conducting activities to
expand use of COPE within an institution Evaluation of strategies and activities to
expand use of COPE Evaluation of impact of COPE Update strategies, share lessons learned
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What Systems Support the Use of COPE?
Supervision --- Facilitative Supervision
Training --- Whole Site Training, Inreach
Monitoring --- Medical Monitoring, MIS
Evaluation --- QMT, Annual Reporting, etc.
Community level --- Community COPE, PLA, advocacy for Informed Choice, MAP, PAC, etc.
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The Goal of Taking Approaches to Scale
COPE and other QI/PI approaches used throughout a program/institution
Quality Improvement process sustained over time -- ultimately sustained when our (others) assistance is withdrawn