Transcript Title of Presentation - The ACQUIRE Project : EngenderHealth

Introducing QI Tools and
Approaches
Taking QI & PI Approaches
and Tools to Scale
APPENDIX F
Session G
Facilitative Supervision for
Quality Improvement Curriculum
2008
The QI Process
Information gathering
and analysis
Follow-up/
evaluation
Action plan development
and prioritization
Implementation
Information Gathering
CFA
Client
interview
Observation
of services
Data
review
Record/
case review
Staff
interview
Facility
audit
INFO
COPE®
Quality
Measuring
Tool
Community
assessment
PNA
INFO
Cost analysis
Identify gap between
actual practice and best
practice
Action Plans (examples)
INFO
COPE® Action Plan
District
Supervisor’s
Site Training Plan
Plan
INFO
Community Action Plan
Replication?
Diffusion?
Taking QI/PI Approaches to Scale
Expansion?
Institutionalization?
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
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
From Pilot to Institutionalization

Site selection

Orientation for managers and staff

Training

Range of facilitators, supervisors, staff involved
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Funding/other support for activities and solutions

Systems and management
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Partnerships

Communities

Supporters and Leadership
Site Selection

Starting with “best potential for change”
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Moving beyond to “real”

Need to go everywhere - eventually
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Choosing sites - by interest, by supportive
supervisors
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
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
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
Partnerships

MOH, other NGOs, private sector to support the
process

Other sectors - Education, Development, Social
Services

Local businesses

Other funding organizations
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 problemsolving
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
Environmental Context

Health Sector Reform

National policies

Other organizations

Other sectors

Other actors (donors, insurers, etc.)

New or well-known ideas (BTC)
Example: Taking COPE to Scale





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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
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.
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