Improvement Collaborative Results Presented at 2008 International Forum on Quality and Safety in Health Care
HCI's pioneering work to scale up quality improvements in health care systems through collaboratives was presented at the 2008 International Forum on Quality and Safety in Health Care. Held this year in Paris, the conference drew more than 2,200 delegates from around the world.
HCI was recognized as a leader in the collaborative movement when Institute for Healthcare Improvement President and CEO Don Berwick made mention of its successes during his inaugural keynote address. The project's work to apply modern quality improvement approaches to ameliorate problems of quality, safety, and efficiency that constrain health care in USAID-assisted countries have, in many cases, produced dramatic results. The evidence of the impact presented by HCI from a number of countries, including Nicaragua, Ecuador, and Russia, shows that the Improvement Collaborative approach is effective and that it is possible to spread improvements to large areas of a country or health system.
Dr. M. Rashad Massoud, HCI Deputy Director, presented a course entitled “New generation of ideas on spread: from collaboratives to wave sequence spread and campaigns.” The workshop addressed how a new era of thinking is generating ideas on how to spread best practices in health care. Key frameworks underlying effective spread were described and examples of their application were examined.
“Using collaboratives to foster interdisciplinary and intersectoral collaboration in the Russian AIDS Program” was given by HCI’s Russia Country Director, Dr. Victor Boguslavsky. In Russia, a collaborative developed a municipal model for delivery of treatment, care and support services to persons living with HIV/AIDS (PLWHA) at demonstration sites in four cities. Following on this successful demonstration collaborative, spread collaboratives to scale up improved systems for detection, referral, and follow-up of HIV-positive persons are now being implemented in St. Petersburg City and Leningrad and Orenburg Oblasts.
As part of a session on obstetric care, HCI Latin America Director Dr. Jorge Hermida presented “Reducing maternal mortality in Ecuador through collaborative improvement of obstetric care”. Ecuador’s Ministry of Health (MOH) and the USAID-funded Quality Assurance Project (QAP, the predecessor to HCI) implemented a collaborative in six of Ecuador’s 22 provincial hospitals to improve care for pre-eclampsia/eclampsia, hemorrhage and sepsis, the primary causes of maternal mortality in the country. Improved care processes for complications management resulted in a decrease of in-hospital maternal deaths by 37 percent.
“Improving child health in Nicaragua” was presented by Dr. Oscar Nunez, HCI Nicaragua Country Director. Since its inception in 2003, the pediatric hospital improvement collaborative, implemented in partnership with Nicaragua’s Ministry of Health, has expanded from six initial SILAIS hospitals to 17 national and SILAIS hospitals and 28 health centers. Hospitals that have consistently collected and reported data have shown a sustained high level of compliance with key clinical standards and a clear trend towards reducing mortality from key pediatric conditions. In 12 hospitals from year 2005 to 2007, the number of child deaths from pneumonia declined by 55 percent and from respiratory distress syndrome, by 31 percent.
A new generation of ideas on spreading improvement, Dr. M. Rashad Massoud
Using collaboratives to foster interdisciplinary and intersectoral collaboration in the Russian AIDS Program, Dr. Victor Boguslavsky
Reducing maternal mortality in Ecuador through collaborative improvement of obstetric care, Dr. Jorge Hermida
Improving child health in Nicaragua, Dr. Oscar Nuñez
Russia HIV/AIDS treatment, Care and support collaborative: Improving access to HIV/AIDS care and patient retention in four Russian cities (poster presented by Dr. Victor Boguslavsky)