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Adapting the Collaborative Improvement Model to Resource-constrained Settings

One of URC’s most significant advances is adapting the collaborative improvement model (see figure below), developed by the Institute for Healthcare Improvement for application in industrialized countries, to the realities of resource-constrained settings. The model involves improvement teams from different clinics and hospitals and from different levels of the health system, supporting them in working together on common aims to improve particular aspects of the system. They share their experiences as they test changes for improvement. High-level health authorities can then spread the successful changes on a wider scale.

Collaborative Improvement Methodology

Since 1998, URC has implemented over 100 improvement collaboratives with USAID support to solve a wide variety of health care challenges. In 2009, URC undertook a study reviewing data from over 1300 teams that participated in 27 applications of collaborative improvement addressing services for maternal, newborn, and child health, HIV/AIDS, family planning, malaria, and tuberculosis. The collaboratives studied achieved performance levels of 80% or higher, regardless of baseline levels for 88% of the measures studied and performance levels of 90% or higher for 76% of those measures.

Emphasizing on peer-to-peer learning and local adaptation of interventions, the model has demonstrated its power to achieve rapid results and enable the  large-scale spread of models of evidence-based care. URC has found that intentionally spreading a tested package of effective interventions and mobilizing teams who have successfully implemented them to show new teams how to do it leads to fast achievement of results in spread phases.

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