Development of a framework of intervention strategies for point of care quality improvement at different levels of healthcare delivery system in India: initial lessons.
BMJ Open Qual
; 10(Suppl 1)2021 07.
Article
in English
| MEDLINE | ID: covidwho-1341330
ABSTRACT
BACKGROUND:
Inadequate quality of care has been identified as one of the most significant challenges to achieving universal health coverage in low-income and middle-income countries. To address this WHO-SEARO, the point of care quality improvement (POCQI) method has been developed. This paper describes developing a dynamic framework for the implementation of POCQI across India from 2015 to 2020.METHODS:
A total of 10 intervention strategies were designed as per the needs of the local health settings. These strategies were implemented across 10 states of India, using a modification of the 'translating research in practice' framework. Healthcare professionals and administrators were trained in POCQI using a combination of onsite and online training methods followed by coaching and mentoring support. The implementation strategy changed to a fully digital community of practice platform during the active phase of the COVID-19 pandemic. Dashboard process, outcome indicators and crude cost of implementation were collected and analysed across the implementation sites.RESULTS:
Three implementation frameworks were evolved over the study period. The combined population benefitting from these interventions was 103 million. A pool of QI teams from 131 facilities successfully undertook 165 QI projects supported by a pool of 240 mentors over the study period. A total of 21 QI resources and 6 publications in peer-reviewed journals were also developed. The average cost of implementing POCQI initiatives for a target population of one million was US$ 3219. A total of 100 online activities were conducted over 6 months by the digital community of practice. The framework has recently extended digitally across the South-East Asian region.CONCLUSION:
The development of an implementation framework for POCQI is an essential requirement for the initiative's successful country-wide scale. The implementation plan should be flexible to the healthcare system's needs, target population and the implementing agency's capacity and amenable to multiple iterative changes.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Quality of Health Care
/
Point-of-Care Systems
/
Delivery of Health Care
/
Quality Improvement
/
Patient Care
Type of study:
Experimental Studies
/
Prognostic study
/
Qualitative research
Limits:
Humans
Country/Region as subject:
Asia
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
Bmjoq-2021-001449
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