USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project

The USAID ASSIST Project is a five-year cooperative agreement of the Office of Health Systems of the USAID Global Health Bureau designed to achieve measurable improvements in health care and social services in USAID-assisted countries. The project supports the application of modern improvement methods by health care and social service providers at facility and community levels, by managers in both government and non-governmental organizations, and by U.S. Government-supported implementing partners. USAID ASSIST achieves sustainable results by building the capacity of host country systems to improve the effectiveness, efficiency, client-centeredness, safety, accessibility, and equity of the services they provide.

Within the project’s technical assistance, ASSIST has prioritized five principles of people-centered care that reflect the linkages between people-centered care, health systems strengthening, and universal health coverage: Respect and compassion; choice and empowerment; Access and support; Continuity and coordination of care; and Information. The project is committed to designing, testing ...

How a Gender-sensitive Quality Improvement Approach Supports Integrated People-centered Health Services

Clients, family and friends, communities, and health providers are all influenced by the culture they live in and by that culture’s perspectives on gender. To ignore gender is to ignore a vital part of the people and their local context that the WHO framework aims to center. Gender must be considered in order to have truly people-centered health services. A gender-sensitive approach takes the different needs, constraints, and opportunities of women, men, girls, and boys into account and responds to them strategically in program design, implementation, and evaluation. By considering and responding to these differences, health services are more people-centered. The USAID ASSIST Project’s gender-sensitive approach facilitates analyzing the social and cultural influences that determine who has access to care, who remains in care, and who receives quality care, to be able to respond appropriately.

GLL Webinar 3: Quality improvement nuggets - wisdom from the field

Improvement efforts across the world yield important lessons and learning that can stimulate changes elsewhere. Documenting and sharing the accumulated wisdom from these improvement efforts is critical in fostering the generation of new knowledge to increase the impact of quality improvement interventions. Opportunities for shared learning and exploration are limited. This webinar of the WHO Global Learning Laboratory for Quality UHC provides an opportunity to hear directly from colleagues implementing quality improvement interventions using a variety of approaches in distinct health systems across the world. The focus will be on “change nuggets” that emerge from applying quality improvement approaches to a wide range of subject areas. Linkages between quality improvement and leadership & management processes will also be considered. The 60 minute interactive webinar will draw on the lessons learned and results from a number of countries supported by the USAID Applying Science to Strengthen and Improve Systems (ASSIST) project.

This ...

Challenges and achievements in integrated care: different health and social care providers working together. Successful projects that show that this is the way

The Catalan health system is a public healthcare system, funded by taxes, with universal coverage and public healthcare services portfolio. There´s a mixed healthcare providers network. Delivery of integrated health and social care witha a shift to a patient-centered model is one of the main challenges of our public system. this artcile share three experiences of different models developed to improve integration of social and healthcare services, to guarantee the continuum of care and to achieve quality health and social care outcomes. 

Digital Technologies Supporting Person-Centered Integrated Care – A Perspective

Shared electronic health and social care records in some service systems are already showing some of the benefits of digital technology and digital data for integrating health and social care. These records are one example of the beginning "digitalisation" of services that gives a glimpse of the potential of digital technology and systems for building coordinate and individualized care. 

Governing Collaborative Healthcare Improvement: Lessons From an Atlantic Canadian Case

The Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease (AHC) Quality Improvement Collaborative (QIC) in Eastern Canada provided an approach to spur system-level reform across multiple health systems for patients and families living with chronic disease. Developed and led by senior executives with a unique governance approach and involving clinical front-line teams, the AHC serves as a practical example of leadership creating and driving momentum for achieving success in collaborative health system improvements 

Strengthening decentralized primary healthcare planning in Nigeria using a quality improvement model: how contexts and actors affect implementation

Quality improvement models have been applied across various levels of health systems with varying success leading to scepticisms about effectiveness. Health systems are complex, influenced by contexts and characterized by numerous interests. Thus, a shift in focus from examining whether improvement models work, to understanding why, when and where they work most effectively is essential

Integrated Care Regulation, Assessment, and Inspection – A Collaborative Learning Journey

Over the past ten years, the design and implementation of integrated health and social care organisations and systems has occurred across several continents. These models of care have implied the adoption of new approaches to their organization and governance. As a result, many countries have begun to focus specifically on the regulation, assessment and inspection of integrated care. This editorial argues that there is both an opportunity and a need to share the successes and challenges from these experiences and to promote methods for collaborative learning.

Integrating services for impact and sustainability: a proof-of-concept project in KwaZulu-Natal, South Africa

Integration of services in primary health care settings can provide mother/baby pairs with all required services at one visit. This study aimed to evaluate a proof of concept, quality improvement (QI) intervention to strengthen well-child service provision and integration with maternal health services in five rural clinics in KwaZulu-Natal, South Africa.

Are Clients Satisfied with Integrated Care? Enhancing Client Feedback on Discharge from a Domiciliary Based Multidisciplinary Integrated Care Service

The Integrated Care Programme for Older People has supported the development of integrated care services at pioneer sites in Ireland, each developed to meet local needs. Patient Reported Experience Measures (PREMs) have been used to evaluate user experience in intermediate care in the United Kingdom. This project aimed to evaluate client experience of a domiciliary based, multidisciplinary, integrated care service.

Patient feedback to improve quality of patient-centred care in public hospitals: a systematic review of the evidence

Public health services have been moving towards putting patients at the centre of their care. This paper aimed to review systematically the published literature relating to interventions informed by patient feedback for improvement to quality of care in hospital settings. Multi-component interventions which targeted both individual and organisational levels were more effective than single interventions. Care is truly patient-centred when it is guided by the perspective of the one that matters - the patient.

Applying Elinor Ostrom’s Design Principles to Guide Co-Design in Health(care) Improvement: A Case Study with Citizens Returning to the Community from Jail in Los Angeles County

Increased interest in collaborative and inclusive approaches to healthcare improvement makes revisiting Elinor Ostrom’s ‘design principles’ for enabling collective management of common pool resources (CPR) in polycentric systems a timely endeavour.

Ostrom proposed a generalisable set of eight core design principles for the efficacy of groups. To consider the utility of Ostrom’s principles for the planning, delivery, and evaluation of future health(care) improvement, the autors retrospectively applied them to a recent co-design project.

Three distinct aspects of co-design were identified through consideration of the principles. These related to: (1) understanding and mapping the system (2) upholding democratic values and (3) regulating participation. Within these aspects, four of Ostrom’s eight principles were inherently observed. Consideration of the remaining four principles could have enhanced the systemic impact of the co-design process.

Reconceptualising co-design through the lens of CPR offers new insights into the successful system-wide application of such ...

Addressing Common Challenges in the Implementation of Collaborative Care for Mental Health: The Penn Integrated Care Program

The purpose of this article was to develop and implement a new model of collaborative care that includes a triage and referral management system. The authors present initial implementation metrics using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.  

An Integrated Care Strategy for Pre-schoolers with Suspected Developmental Disorders: The Optimus Co-design Project that has Made it to Regular Care

Person-centred care to prevent hospitalisations – a focus group study addressing the views of healthcare providers

The primary healthcare sector comprises various health services, including disease prevention at local level. Research shows that targeted primary healthcare services can prevent the development of acute complications and ultimately reduce the risk of hospitalisations. While interdisciplinary collaboration has been suggested as a means to improve the quality and responsiveness of personal care needs in preventive services, effective implementation remains a challenge.

Development and Implementation of an Integrated Care Fellowship

Integrated care is a common approach to leverage scarce psychiatric resources to deliver mental health care in primary care settings. The Integrated Care clinical fellowship serves as a model for training programs seeking to provide training in clinical and systems-based skills needed for practicing integrated care. Whether such training is undertaken as a standalone fellowship or incorporated into existing consultation-liaison psychiatry programs, such skills are increasingly valuable as integrated care becomes commonplace in practice.