Quality Problems and Improving Processes
Quality deficiencies can be found in any health care setting, from the most sophisticated urban hospital to the village clinic. Poor quality reduces the benefit to clients, frustrates health care providers, and wastes scarce health resources. A systematic, ongoing process of ensuring and improving quality is therefore an essential component of an effective, efficient, and responsive health care system.
This monograph presents a step-by-step approach for improving processes and for solving problems related to health care quality. As such, the approach applies to any level of the health system. A quality-related problem has been described as the gap between what is and what is desired . Situations do exist in which the current service delivery process works well and there are no major gaps between performance and expectations, i.e., there are no “problems.” However, conscientious health professionals recognize that it is normally possible to improve the quality of services by making them more efficient, more responsive to clients’ needs, and less likely to run into problems. Opportunities for improvement can be found at every level of the health system.
Individuals or teams may find them in their own work, in the work of supervisees, or in the district, region, or country as a whole. Solving problems and improving processes require more than intuition and judgment. The methods presented in this monograph follow logical steps developed from practical problem-solving experiences in health care and other settings. While personnel solve problems every day without mapping out a stated plan, the steps presented here provide concrete measures for improving quality efficiently
and effectively. They are designed to help to avoid common pitfalls.
Problem solving and process improvement work best when conducted as part of a quality assurance (QA) program in which standards are developed and quality indicators are monitored. Nevertheless, the problem-solving steps presented herein can be applied whenever and however an opportunity for improving quality arises.