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Development of a framework of intervention strategies for point of care quality improvement at different levels of healthcare delivery system in India: initial lessons.
Datta, Vikram; Srivastava, Sushil; Garde, Rahul; Mehta, Rajesh; Livesley, Nigel; Sawleshwarkar, Kedar; Pemde, Harish; Patnaik, Suprabha K; Sooden, Ankur; Singh, Mahtab; John, Susy Sarah; Pradeep, Jeena; Vig, Anupa; Kumar, Achala; Singh, Vivek; Bhatia, Vandana; Garg, Bishan Singh; Baswal, Dinesh.
  • Datta V; Neonatology, Kalawati Saran Children's Hospital, New Delhi, Delhi, India drvikramdatta@gmail.com.
  • Srivastava S; Neonatology, Lady Hardinge Medical College, New Delhi, Delhi, India.
  • Garde R; Pediatrics, University College of Medical Sciences, Delhi, Delhi, India.
  • Mehta R; Quality Improvement, Nationwide Quality of Care Network, New Delhi, Delhi, India.
  • Livesley N; Newborn, Child and Adolescent Health, World Health Organization Regional Office for South-East Asia, New Delhi, Delhi, India.
  • Sawleshwarkar K; Independent Health Consultant, Fremont, California, USA.
  • Pemde H; Neonatology, Deogiri Children's Hospital, Aurangabad, Maharashtra, India.
  • Patnaik SK; Pediatrics, Lady Hardinge Medical College, New Delhi, Delhi, India.
  • Sooden A; Neonatology, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharastra, India.
  • Singh M; QI, University Research Co LLC, Bethesda, Maryland, USA.
  • John SS; Technical Advisor Health Systems, Nationwide Quality of Care Network, Indora, Himachal Pradesh, India.
  • Pradeep J; QI, Nationwide Quality Of Care Network India, New Delhi, Delhi, India.
  • Vig A; College of Nursing, Lady Hardinge Medical College, New Delhi, Delhi, India.
  • Kumar A; Department of Nursing, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, Delhi, India.
  • Singh V; Telemedicine, Piramal Swasthya, Noida, NCR, India.
  • Bhatia V; Obstetrics and Gynaecology, Piramal Swasthya, New Delhi, Delhi, India.
  • Garg BS; Department of Nursing, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, Delhi, India.
  • Baswal D; UNICEF India Country Office, Delhi, India.
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.
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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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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