The Cochrane Effective Practice and Organisation of Care (EPOC) review group has identified four categories of quality improvement strategies. Figure 3.2 below outlines these and gives examples. To learn more about each one for examples visit the Cochrane Effective Practice and Organisation of Care Group (EPOC) website.
In the following sections we will use this framework to discuss some of these quality improvement strategies in more detail, focusing on those where there is experience of use for MNH in low and middle income settings.
Other noteable frameworks
Though the focus on this package is around improvement of the quality of MNH Services other frameworks that exist may be more applicable or useful in other circumstances. Below we highlight three different examples.
Effects of strategic interventions on quality
In addition to quality improvement strategies a number of recent systematic reviews have investigated the effects of various strategic interventions. Some examples are listed in Figure 3.3 below.
For example, in the study by Opiyo et al, which looked at different forms of in-service neonatal emergency care courses, the authors found that the evidence for improvement of health workers’ practices when caring for a seriously ill newborn after in-service training was limited, although there is some evidence of benefit in terms of provider practices
- Renfrew, MJ. McFadden, A. Bastos, MH. Campbell, J. Channon, AA. Cheung, NF and others, (2014) Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care
- The Health Foundation, (Website) Quest for Quality and Improved Performance (QQUIP)
- Effective Practice and Organisation of Care (EPOC) Group, (2002) EPOC Taxonomy
- Forsetlund, L., Bjorndal, A., Rashidian, A., Jamtverdt, G., O’Brien, M., Wolf, F., Davis, D., Odgaard-Jensen, J., Oxman, A. , (2009) Continuing education meetings and workshops: effect on professional practice and health care outcomes (Review)
- Giguere, A., Legare, F., Grimshaw, J., Turcotte, S., Fiander, M., Grudniewicz, A., Makosso-Kallyth, S., Wold, F., Gagnon, M., (2012) Printed educational materials: effect on professional practice and health care outcomes (Review)
- O’Brien, M., Rogers, S., Jamtvedt, G., Oxman, A., Odgaard-Jensen, J., Kristoffersen, D., Forsetlund, L., Bainbridge, D., Freemantle, N., Davis, D., Haynes, R., Harvey, E., (2007) Educational outreach visits: effects on professional practice and health outcomes (Review)
- Akl, E., Kairouz, V., Sackett, K., Erdly, W., Mustafa, R., Fiander, M., Gabriel, C., Schunemann, H., (2013) Educational games for health professionals
- Ivers, N., Jamtvedt, G., Flottorp, S., Young, J., Odgaard-Jensen, J., French, S., O’Brien, M., Johansen, M., Grimshaw, J., Oxman, A. , (2012) Audit and feedback: effect on professional practice and health outcomes (Review)
- Flodgren, G., Parmelli, E., Doumit, G., Gattellari, M., O’Brien, M., Grimshaw, J., Eccles, M., (2011) Local opinion leaders: effects on professional practice and health care outcomes (Review)
- Arditi, C., Rege-Walther, M., Wyatt, J., Duriex, P., Burnand, B. , (2012) Computer-generated reminders delivered on paper to healthcare professionals: effects on professional practice and health outcomes (Review)
- Kredo T , Adeniyi FB , Bateganya M Pienaar ED , (2014) Task shifting from doctors to non-doctors for initiation and maintenance of antiretroviral therapy
- Reeves, S., Perrier, L., Goldman, J., Freeth, D., Zwarenstein, M. , (2011) Interprofessional education: effect on professional practice and healthcare outcome (update) (Review)
- Scott, A., Sivey, P., Ait Ouakrim, D., Willenberg, L., Naccarella, L., Furler, J., Young, D., (2011) The effect of financial incentives on the quality of healthcare provided by primary care physicians (Review)
- Witter, S, Fretheim A, Kessey FL, Lindahl AK , (2014) Paying for performance to improve the delivery of health interventions in low- and middle-income countries