Research versus practice in quality improvement? Understanding how we can bridge the gap

The gap between implementers and researchers of quality improvement (QI) has hampered the degree and speed of change needed to reduce avoidable suffering and harm in health care. Underlying causes of this gap include differences in goals and incentives, preferred methodologies, level and types of evidence prioritized and targeted audiences. The Salzburg Global Seminar on 'Better Health Care: How do we learn about improvement?' brought together researchers, policy makers, funders, implementers, evaluators from low-, middle- and high-income countries to explore how to increase the impact of QI. In this paper, we describe some of the reasons for this gap and offer suggestions to better bridge the chasm between researchers and implementers. Effectively bridging this gap can increase the generalizability of QI interventions, accelerate the spread of effective approaches while also strengthening the local work of implementers. Increasing the effectiveness of research and work in the field will support the knowledge translation needed to achieve quality Universal Health Coverage and the Sustainable Development Goals.Fil: Hirschhorn, Lisa R.. Northwestern University; Estados UnidosFil: Ramaswamy, Rohit. University of North Carolina; Estados UnidosFil: Devnani, Mahesh. Post Graduate Institute of Medical Education & Research; IndiaFil: Wandersman, Abraham. University Of South Carolina; Estados UnidosFil: Simpson, Lisa A.. Academy Health; Estados UnidosFil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentin

Quality improvement and emerging global health priorities

Quality improvement approaches can strengthen action on a range of global health priorities. Quality improvement efforts are uniquely placed to reorient care delivery systems towards integrated people-centred health services and strengthen health systems to achieve Universal Health Coverage (UHC). This article makes the case for addressing shortfalls of previous agendas by articulating the critical role of quality improvement in the Sustainable Development Goal era. Quality improvement can stimulate convergence between health security and health systems; address global health security priorities through participatory quality improvement approaches; and improve health outcomes at all levels of the health system. Entry points for action include the linkage with antimicrobial resistance and the contentious issue of the health of migrants. The work required includes focussed attention on the continuum of national quality policy formulation, implementation and learning; alongside strengthening the measurement-improvement linkage. Quality improvement plays a key role in strengthening health systems to achieve UHC.Fil: Abrampah, Nana Mensah. Organizacion Mundial de la Salud; ArgentinaFil: Syed, Shamsuzzoha Babar. Organizacion Mundial de la Salud; ArgentinaFil: Hirschhorn, Lisa R.. Northwestern University; Estados UnidosFil: Nambiar, Bejoy. Malawi University of Science and Technology; Malaui. Colegio Universitario de Londres; Reino UnidoFil: Iqbal, Usman. Taipei Medical University.; República de ChinaFil: Garcia Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Chattu, Vijay Kumar. University of the West Indies; Trinidad y TobagoFil: Devnani, Mahesh. Post Graduate Institute of Medical Education and Research; IndiaFil: Kelley, Edward. Organizacion Mundial de la Salud; Argentin

Factors associated with Integrated Counselling and Testing Center (ICTC) service satisfaction: experience from Chandigarh, India

Background &amp; Objectives: People while availing services at Integrated Counselling and Testing Centers (ICTC) face a lot of administrative and procedural problems which affect their level of satisfaction. This study was conducted at ICTC, Post Graduate Institute of Medical Education and Research, Chandigarh; within the scope of a larger research evaluating the “Quality of Infrastructure and Services available to PLHA”; to analyze the user’s perception about quality of services and factors affecting satisfaction level. Materials &amp; Methods: Exit interviews of 50 randomly selected ICTC clients were conducted with structured questionnaire containing five groups of questions and questions on waiting time and satisfaction level. A scoring system was devised. The satisfaction level was cross matched with group questionsResults:  The mean group scores of five groups of questions were: Information, access &amp; guidance for services (42.5%), Behaviour of counsellors (94%), Quality of counselling (77.28%), Physical facilities (65.5%), Confidentiality, discrimination and grievance redressal (67%). All respondents said that counsellors were respectful and 91% found the behaviour of counsellor supportive &amp; helpful, 80% reported that they understood everything that counsellor said. Eighty percent rated satisfaction level as satisfactory or above (6% very satisfactory, 74% satisfactory), 18% indifferent and 2% very dissatisfied. Factors found to be associated with client satisfaction level were counsellor’s response to the concerns and worries of clients up to their satisfaction (p=0.009), illumination in ICTC (p=0.04), knowledge of grievance redressal system (p=0.04) and total time spent in ICTC (p=0.03).Conclusion: This study provided user’s perspective about ICTC service and revealed the factors associated with ICTC service satisfaction level. Better quality ICTC Services can be provided by addressing these factors.</p