Performance and Quality Improvement
The wide range of initiatives aimed at improving quality in health care build on models and tools first used in industry. One of the most widely used approaches promoted by the Institute for Health Care Improvement is based on Langley’s Model for Improvement, which asks three questions:
- What are we trying to accomplish?
- How will we know that a change is an improvement?
- What changes can we make that will result in improvement?
A good quality improvement intervention:
- Meets expectations and needs of community, clients, and providers, and internationally accepted technical standards
- Focuses on systems and processes
- Uses data to analyze the service delivery process, such as through a health facilities assessment, or other tools
- Encourages a team approach to ongoing problem solving and quality improvement
Elements of Quality for Family Planning
Initially, six elements of quality were identified that needed to be in place if FP services are to address client rights. These are:
- A choice of methods continuously available from FP service providers
- Interpersonal skills of FP service providers
- Accuracy and completeness of information given to clients
- Technical competence of providers
- Appropriate constellation of services
- Continuity of care and follow up
Based on further development of client rights and work in quality improvement, the following elements have been added for consideration:
- Adequate infrastructure and equipment
- Efficiency and effectiveness of services
Key Quality Improvement Resources:
- Partnership Defined Quality: A Tool Book for Community and Health Provider Collaboration for Quality Improvement (Save the Children, 2003)
- Screening Checklists for Family Planning Services: Tools for Service Providers (FHI, 2008)
- Applying Quality Improvement to Integrate Family Planning in Maternal Health and HIV Services (USAID, 2012)
 Langley, G.L., K.M. Nolan, T.W. Nolan, C.L. Norman, and L.P. Provost. 2009. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd Edition). San Francisco: Jossey-Bass Publishers.
Bruce, J. 1990. Fundemental Elements of the Quality of Care: A Simple Framework. Studies in Family Planning. Vol. 21, No. 2 (Mar – Apr 1990) pages 61-91.