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Quality Improvement and Patient Safety

Sustainable Improvement in Primary Health Care/Family Planning Services: Jordan's Accreditation Experience

Developed for the USAID Health Systems Strengthening II Project in Jordan, Initiatives Inc., 2014.

The Jordanian Ministry of Health and the Health System Strengthening (HSS) II project utilized an innovative accreditation collaborative model to prepare 120 primary health care centers for accreditation and assist 50 of them to achieve accreditation. The collaborative combined a traditional accreditation structure based on standards, a measurement system, and action planning for improvement within a collaborative learning structure that promotes shared learning and scale-up of best practices. In all, 90 primary health centers were accredited. This report describes the model and the results of its application in the Jordanian health system.

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See also: Jordan Health Systems Strengthening II Project

Implementing a Patient Referral and Appointment System in Jordan

Developed for the USAID Health Systems Strengthening II Project in Jordan, Initiatives Inc., 2014.

An effective referral and appointment system provides patients with continuity of care while maintaining cost effectiveness, reduces overcrowding at emergency rooms and outpatient departments, and contributes to overall patient satisfaction. This report describes the Health Systems Strengthening (HSS) II project’s approach to the referral and appointment systems, its support to the Jordanian Ministry of Health in strengthening the system, and the challenges and improvements in system functioning at the health directorate, hospital, and health center levels.

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See also: Jordan Health Systems Strengthening II Project

Injection Safety Tool Kit

Developed for the Guyana Safer Infection Project, Initiatives Inc., 2010

Organized in eight sections and developed in collaboration with Guyana’s Ministry of Health, this handbook offers information and training resources for injection safety and medical waste management. Contents include training guides, presentations, job aids, posters, and facilitation guidance to lead discussions that will help patients understand their rights, responsibilities, and alternatives. These materials are designed to assist health care workers, supervisors, regulatory bodies, municipalities, training institutes and programs, and procurement departments in ensuring safe, appropriate use of injections.

The print edition comes with all of the materials in their original formats on CD and two informational videos on DVD. The downloadble PDF includes the Injection Safety Took Kit Introduction only.

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See also: Guyana Safer Injection Project, 2010

NZP+ District Chapter Certification Handbook

Developed for the Support for AIDS Research in Zambia (SHARe) project, 2010

The Network of Zambian People Living with HIV/AIDS (NZP+) is a national network that advocates for people living with HIV/AIDS, facilitates access to information and services, and helps enhance quality of life. Developed with Initiatives’ guidance and support through the Support to the HIV/AIDS Response Project, this handbook is a user’s guide for the NZP+ Secretariat that describes how to complete the district chapter certification process. This handbook is a companion to the NZP+ Management Handbook. Its main sections describe the certification process and present NZP+ certification standards. Three annexes present a curriculum, a sample certification timeline, and a sample action plan for improving performance.

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See also: Support for the AIDS Response in Zambia, 2011

Zambia Performance-Based Incentives Final Study

Prepared for the Quality Assurance Project by Rebecca Furth, Initiatives Inc., 2005.

This report documents findings from a 15-month pilot study of the effects of financial and non-financial awards on staff motivation and health facility performance. The study was built around clearly documented and shared health facility performance standards that included HMIS indicators, client satisfaction, health center cleanliness, and rational prescription of antibiotics in addition to process standards such as the development of performance plans and definition of clear actions to address problems. It was conducted in two districts in Zambia, one testing out trophies as non-financial incentives and the other providing cash awards for both high performance and improvement. Study results indicate that non-financial awards are more motivating for staff and influential on facility performance than financial awards, in part because they are not nearly as controversial and financial awards.

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Quality Assurance in the Jordan Primary Health Care System: Best Practices

Developed for the Ministry of Health in Jordan under the Primary Health Care Initiatives (PHCI) Project. Initiatives Inc., 2004.

This booklet presents examples of successful implementation of quality improvement strategies by health center staff at 10 primary health care centers across the Kingdom of Jordan. The descriptions illustrate how systematic problem identification and problem solving can assist health centers to strengthen management, service delivery, performance, and client satisfaction.

This publication has been selected by the World Health Organization (WHO) as a resource for its website and CD for health service managers, MAKER (Managers taking Action based on Knowledge and Effective use of resources to achieve Results). For further information, see the WHO Management for Health Services Delivery website.

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Jordan: Building Quality in Primary Health Care

Developed for the Ministry of Health in Jordan under the Primary Health Care Initiatives (PHCI) Project by Donna Bjerregaard, Initiatives Inc., 2004.

This short report summarizes the process adopted by the Jordan Ministry of Health to improve the quality of and access to primary and reproductive health care in centers that serve as the initial contact for medical care. The importance of using data for documenting baseline performance and preparing action plans, monitoring processes, and creating an enabling structure for sustainability are all highlighted.

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Performance Improvement Review (PIR): Resources and Tools for NGOs & CBOs (Interactive CD)

Developed for the Zambia Integrated Health Programme (ZIHP) by Initiatives Inc., 2004.

The Performance Improvement Review is a self-directed process for improving the effectiveness, sustainability and quality of NGO programs. Guidance and tools for conducting PIRs have been packaged as a CD-ROM to make the materials more accessible to users. The tools address six different program areas: family planning; growth monitoring and promotion; HIV/AIDS (home-based care, VCT, and peer education); malaria; safe motherhood; and water and sanitation, and are designed for use by Program Managers, Donors, District Health Management Teams, and Trainers.

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Standards of Care for Health Centers in Jordan

Developed for the Ministry of Health in Jordan under the Primary Health Care Initiatives (PHCI) Project. Initiatives Inc., 2002.

This six-volume set of standards of care for health centers provides essential and detailed guidance for effective service delivery. Each of the first five volumes addresses a distinct aspect of health center services: health center management, clinical case management, reproductive health, preventive care, and nursing care. The sixth volume offers a comprehensive set of performance checklists, which can be used to facilitate self-assessment and performance review. As a set, the Standards serve as a convenient reference, a guide for service delivery, and a tool to support performance improvement.

This series of documents has been selected by the World Health Organization (WHO) as a resource for its website and CD for health service managers, MAKER (Managers taking Action based on Knowledge and Effective use of resources to achieve Results). For further information, see the WHO Management for Health Services Delivery website.

Volume 1: Health Center Management

Volume 4: Preventive Services

Volume 2: Clinical Case Management

Volume 5: Nursing Care Services

Volume 3: Reproductive Health

Volume 6: Performance Checklists

Quality Improvement In HIV/AIDS Programs: A Case Study for NGOs/CBOs and their Partners

Developed for the Zambia Integrated Health Programme (ZIHP) by Rebecca Furth, Joyce V. Lyons, and Jenny Huddart, Initiatives Inc., 2002.

Written in an engaging narrative style, this case study outlines the use of the Performance Improvement Review tool in NGO-managed programs. Combining examples from field experience with quality ideals, the case details a fictional NGO's progress through the processes of setting measurable goals, planning program monitoring, building monitoring teams, collecting program data, identifying problems, creating concrete performance improvement plans, and conducting follow-up monitoring reviews.

Integrated Technical Guidelines for Frontline Healthworkers (2nd ed.)

Produced for the Central Board of Health in Zambia, with support from the USAID-funded Zambia Integrated Health Programme, Component 3 (ZIHP-Systems). Initiatives Inc. and ZIHP, July 2002.

The Integrated Technical Guidelines (ITGs) outline key interventions for each of the technical areas of the Basic Health Care Package (BHCP), as well as the minimum standards of performance expected at community, health post, and health centre levels. These guidelines are intended to enhance frontline healthworkers' knowledge about the most important health problems in Zambia, and cost-effective interventions to tackle these problems. Use of these guidelines should improve the ability of frontline health workers to promote health and prevent illness, including proper case management and referrals, and thereby contribute to the attainment of the ultimate goal of "Better Health for all Zambians."

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Universal Precautions Guidelines for Primary Health Care Centers in Indonesia

Developed for the Universal Precautions and Training Project, Surabaya, Indonesia, by Initiatives Inc., 2000.

This document, designed for all levels of clinic staff, contains universal precaution guidelines for proper infection prevention procedures. The guidelines and curriculum stress behavior change and the importance of supervision in ensuring compliance with the guidelines.

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A Performance Improvement Review of the Nialama Classified Forest Co-Management Program

Julie Fischer and Rebecca Furth. Winrock International: Projet Elargi de Gestion des Ressources Naturelles. Report No. 77, 2000.

This report documents the first Performance Improvement Review (PIR) process conducted in the Nialama Forest Co-Management Program in October 2001. The report outlines the background of the forest co-mangement program in Guinea; the rationale for and development of the PIR process for co-management; problems identified and agreed actions determined during the first review; and lessons learned.

The Performance Improvement Review Package (PIR): A Quality Assurance Tool for Community Based Programs

Developed for the SEATS Project by Joyce V. Lyons, Rebecca Furth, Donna S. Bjerregaard, and Catherine C. Mukwakwa, Initiatives Inc., 1999.

A set of quality assurance tools to support PVOs/NGOs as they integrate family planning and reproductive health activities into their existing portfolios. Assists community-based programs to conduct self-directed program reviews, identify key problems and develop corrective action plans. Provides an effective monitoring and evaluation system with data for tracking progress.

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