scholarly journals Continuous quality improvement as a tool to implement evidence-informed problem solving: experiences from the district and health facility level in Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hector Tibeihaho ◽  
Charles Nkolo ◽  
Robert Anguyo Onzima ◽  
Florence Ayebare ◽  
Dorcus Kiwanuka Henriksson
Keyword(s):  
Quality Improvement ◽  
Health Facility ◽  
Continuous Quality Improvement ◽  
Health Management ◽  
District Level ◽  
Successful Implementation ◽  
District Health ◽  
Continuous Quality ◽  
Health Facility Level ◽  
Facility Level

Abstract Background Continuous quality improvement processes in health care were developed for use at health facility level, and that is where they have been used the most, often addressing defined care processes. However, in different settings different factors have been important to support institutionalization. This study explores how continuous quality improvement processes were institutionalized at the district level and at the health facility level in Uganda. Methods This qualitative study was carried out in seven districts in Uganda. Semi-structured interviews with key informants from the district health management teams and document review were conducted. Thematic analysis was used to analyze the data. Results All districts that participated in the study formed Continuous Quality Improvement (CQI) teams both at the district level and at the health facilities. The district CQI teams comprised of members from different departments within the district health office. District level CQI teams were mandated to take the lead in addressing management gaps and follow up CQI activities at the health facility level. Acceptability of quality improvement processes by the district leadership was identified across districts as supporting the successful implementation of CQI. However, high turnover of staff at health facility level was also reported as a detrimental to the successful implementation of quality improvement processes. Also the district health management teams did not engage much in addressing their own roles using continuous quality improvement. Conclusion The leadership and management provided by the district health management team was an important factor for the use of Continuous Quality Improvement principles within the district. The key roles of the district health team revolved around the institutionalisation of CQI at different levels of the health system, monitoring results of continuous quality improvement implementation, mobilising resources and health care delivery hence promoting the culture of quality, direct implementation of CQI, and creating an enabling environment for the lower-level health facilities to engage in CQI. High turnover of staff at health facility level was also reported as one of the challenges to the successful implementation of continuous quality improvement. The DHT did not engage much in addressing gaps in their own roles using continuous quality improvement.

Organizational Learning and Continuous Quality Improvement: Examining the Impact on Nursing Home Performance

2002 ◽  
Vol 15 (2) ◽  
pp. 17-23 ◽  
Author(s):  
Kent V. Rondeau ◽  
Terry H. Wagar
Keyword(s):  
Quality Improvement ◽  
Organizational Learning ◽  
Organizational Performance ◽  
Corporate Culture ◽  
Continuous Quality Improvement ◽  
Successful Implementation ◽  
Total Quality ◽  
Term Care ◽  
Continuous Quality ◽  
The Impact

Interest is growing in learning more about the ability of total quality management and continuous quality improvement (TQM/CQI) initiatives to contribute to the performance of healthcare organizations. A major factor in the successful implementation of TQM/CQI is the seminal contribution of an organization's culture. Many implementation efforts have not succeeded because of a corporate culture that failed to stress broader organizational learning. This may help to explain why some TQM/CQI programs have been unsuccessful in improving healthcare organization performance. Organizational performance variables and organizational learning orientation were assessed in a sample of 181 Canadian long-term care organizations that had implemented a formal TQM/CQI program. Categorical regression analysis shows that, in the absence of a strong corporate culture that stresses organizational learning and employee development, few performance enhancements are reported. The results of the assessment suggest that a TQM/CQI program without the backing of a strong organizational learning culture may be insufficient to achieve augmented organizational performance.

scholarly journals TQM: The Quality Imperative

1991 ◽  
Author(s):  
William Smitley ◽  
Teri Yanovitch
Keyword(s):  
Quality Improvement ◽  
Quality Management ◽  
Total Quality Management ◽  
Continuous Quality Improvement ◽  
Successful Implementation ◽  
Senior Executive ◽  
Total Quality ◽  
Continuous Quality ◽  
Tools And Techniques

A wide variety of methods, tools, and techniques currently exist to assist companies enhance quality. However, many of them do not bring about substantiative improvement. The reasons are varied but usually begin with a lack of senior executive commitment and leadership. This paper explores the concepts and actions that are needed to change the culture of an organization to one of continuous quality improvement. It provides the outline for successful implementation of Total Quality Management (TQM) in any corporation. Paper published with permission.

Multidisciplinary Prerounding Meeting as a Continuous Quality Improvement Tool: Leveraging to Reduce Continuous Benzodiazepine Use at an Academic Medical Center

2018 ◽  
Vol 34 (9) ◽  
pp. 707-713 ◽  
Author(s):  
Alexander H. Flannery ◽  
Melissa L. Thompson Bastin ◽  
Ashley Montgomery-Yates ◽  
Corrine Hook ◽  
Evan Cassity ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Medical Center ◽  
Academic Medical Center ◽  
Successful Implementation ◽  
Multidisciplinary Meeting ◽  
Continuous Quality ◽  
Academic Medical ◽  
Number Of Patients ◽  
Benzodiazepine Use

Background: Evidence-based medicine often has many barriers to overcome prior to implementation in practice, hence the importance of continuous quality improvement. We report on a brief (≤10 minutes) multidisciplinary meeting prior to rounds to establish a dashboard for continuous quality improvement and studied the success of this meeting on a particular area of focus: continuous infusion benzodiazepine minimization. Methods: This was a prospective observational study of patients admitted to the medical intensive care unit (MICU) of a large academic medical center over a 4-month period. A morning multidisciplinary prerounding meeting was implemented to report on metrics required to establish a dashboard for MICU care for the previous 24 hours. Fellows and nurse practitioners on respective teams reported on key quality metrics and other important data related to patient census. Continuous benzodiazepines were tracked daily as the number of patients per team who had orders for a continuous benzodiazepine infusion. The aim of this report is to describe the development of the morning multidisciplinary prerounding meeting and its impact on continuous benzodiazepine use, along with associated clinical outcomes. Results: The median number of patients prescribed a continuous benzodiazepine daily decreased over this time period and demonstrated a sustained reduction at 1 year. Furthermore, sedation scores improved, corresponding to a reduction in median duration of mechanical ventilation. The effectiveness of this intervention was mapped post hoc to conceptual models used in implementation science. Conclusions: A brief multidisciplinary meeting to review select data points prior to morning rounds establishes mechanisms for continuous quality improvement and may serve as a mediating factor for successful implementation when initiating and monitoring practice change in the ICU.

scholarly journals Factors Affecting the Implementation of Continuous Quality Improvement in Health Facilities of Southern Nation and Nationalities People Region (SNNPR)

2019 ◽  
Author(s):  
Addisu Gize Yeshanew ◽  
Nebiyou Wendwessen ◽  
Dereje Teklemariam
Keyword(s):  
Quality Improvement ◽  
Service Delivery ◽  
Health Facility ◽  
Continuous Quality Improvement ◽  
Health Facilities ◽  
Quality Improvement Project ◽  
P Value ◽  
Improvement Project ◽  
Continuous Quality ◽  
New Ideas

Abstract Continuous Quality improvement has become an important aspect of healthcare organizations. The objective of this study was to identify contributing factors for implementing continuous quality improvement projects in health facilities for the better delivery of health care service in the case of south nation and nationalities people, Ethiopia. Cross-sectional study was conducted from April to May 2018 in SNNPR of two district woredas health facilities. Descriptive, bivariate and multivariate analysis used, during the analysis, 0.05 p-value and 95% confidence interval (CI) was used to judge the significance of the associations. So that p-value less than 0.05 were taken as significant association. The finding of this study showed that, a total of 144 health professionals were participated, giving a response rate of 100%. Majority of the respondents (75%) were male and 35% said that their respective health facility implemented continuous quality improvement project. More than halve of (51.4%) the leaders were not receptive for new ideas; moreover, majority of leader were not encouraging learning (62.5%) and not engaged in quality improvement project implementation process (66%). Variables like leaders receptive to new ideas, leaders share information/ data about health facility service delivery status, health facility has a quality improvement project plan, staff know using indicators to tell progress about service delivery, health facility assess client satisfaction level, were the independent predictors of continuous quality improvement(CQI) project implementation.

scholarly journals Evaluation of Engineering Students’ Learning Outcomes: Creating a Culture of Continuous Quality Improvement

2021 ◽  
Vol 16 (15) ◽  
pp. 62
Author(s):  
Chia Pao Liew ◽  
Marlia Puteh ◽  
Li Li Lim ◽  
Lih Jiun Yu ◽  
Jully Tan ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Learning Outcomes ◽  
Continuous Quality Improvement ◽  
Analytical Tool ◽  
Higher Learning ◽  
Assessment Model ◽  
Successful Implementation ◽  
Analytical Instruments ◽  
Continuous Quality ◽  
Learning Institutions

Assessment and evaluation of outcomes and continuous quality improvement often lead to uneasiness among engineering educators, which is a barrier to implementing an effective system of results-assessment. The sophisticated evaluation models and analytical instruments adopted by higher learning institutions are believed to worsen this uneasiness, impeding the successful implementation of programme quality improvement. In this paper, the challenges in assessing and evaluating learning outcomes, types of programme outcome assessment model and an analytical tool known as Engineering Outcome Analytics developed by Tunku Abdul Rahman University College for the assessment were presented. Documents related to quality improvement from two higher learning institutions in Malaysia were reviewed and discussed based on the key elements of continuous quality improvement. The results can be used to avoid the shortcomings and adopt the best practices in continuous quality improvement. With proper understanding on the key elements of continuous quality improvement, and adoption of culminating assessment model and a highly integrated analytical tool, engineering educators and programme owners are expected to benefit from this re-search in three ways. First, it cultivates a culture of continuous improvement of quality by increasing the educators' willingness to evaluate results. Second, it enhances their existing analytical tools to reflect students' actual developments, resulting in significant continuous actions to improve quality. Third, it satisfies the accreditation requirements on outcomes-based assessment.

Pelaksanaan Continuous Quality Improvement(CQI) dalam Kalangan Pensyarah di Kolej Kemahiran Tinggi Mar

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Lyssa Daud ◽  
◽  
Faizal Amin Nur Yunus ◽  
Mohd Bekri Rahim ◽  
Mohd. Zulfadli Rozali ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Continuous Quality

scholarly journals Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

2021 ◽  
Vol 6 (6) ◽  
pp. e005833
Author(s):  
Leena N Patel ◽  
Samantha Kozikott ◽  
Rodrigue Ilboudo ◽  
Moreen Kamateeka ◽  
Mohammed Lamorde ◽  
...  
Keyword(s):  
Health Facility ◽  
Healthcare Workers ◽  
National Level ◽  
Lessons Learned ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Health Facility Level ◽  
Ensure Patient Safety ◽  
Increased Risk ◽  
Facility Level

Healthcare workers (HCWs) are at increased risk of infection from SARS-CoV-2 and other disease pathogens, which take a disproportionate toll on HCWs, with substantial cost to health systems. Improved infection prevention and control (IPC) programmes can protect HCWs, especially in resource-limited settings where the health workforce is scarcest, and ensure patient safety and continuity of essential health services. In response to the COVID-19 pandemic, we collaborated with ministries of health and development partners to implement an emergency initiative for HCWs at the primary health facility level in 22 African countries. Between April 2020 and January 2021, the initiative trained 42 058 front-line HCWs from 8444 health facilities, supported longitudinal supervision and monitoring visits guided by a standardised monitoring tool, and provided resources including personal protective equipment (PPE). We documented significant short-term improvements in IPC performance, but gaps remain. Suspected HCW infections peaked at 41.5% among HCWs screened at monitored facilities in July 2020 during the first wave of the pandemic in Africa. Disease-specific emergency responses are not the optimal approach. Comprehensive, sustainable IPC programmes are needed. IPC needs to be incorporated into all HCW training programmes and combined with supportive supervision and mentorship. Strengthened data systems on IPC are needed to guide improvements at the health facility level and to inform policy development at the national level, along with investments in infrastructure and sustainable supplies of PPE. Multimodal strategies to improve IPC are critical to make health facilities safer and to protect HCWs and the communities they serve.

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