Contact us | Home
URC/CHS Projects
Past Projects in Quality Management
Quality Assurance Project III
Client: United States Agency for International Development (USAID)
The Quality Assurance Project III (QAP) III completed activities September 26, 2008, bringing to a close over six years of work to adapt and apply modern quality improvement (QI) methods to the most serious health care problems challenging USAID-assisted countries. Since 1990, the three consecutive Quality Assurance Projects (QAP I, II, and III) provided technical leadership for USAID’s global efforts to improve health care quality in developing countries. This work has helped to raise awareness in the global health community that quality improvement is an essential component of health systems strengthening and that quality standards and QI capacity development are vital to the development of health care systems in even the most resource-constrained countries.
The five-year USAID Health Care Improvement Project (HCI), awarded to University Research Co., LLC (URC) in 2007, is building on QAP’s global efforts to improve health care quality in developing countries worldwide and continues to expand and refine applications of the QI methods championed by QAP. The most significant element of QAP’s legacy is adaptation of the Institute for Healthcare Improvement’s collaborative model to the realities of developing countries. QAP pioneered the use of the collaborative methodology in resource-constrained environments through implementation of 39 collaboratives in 15 developing and middle-income countries. Through 50 research studies, QAP III documented quality obstacles and developed approaches to their solution. Findings were applied by QAP field programs to improve care in specific countries and were disseminated to the wider public health community. URC and its QAP III partners—EnCompass LLC, Initiatives Inc., and Joint Commission Resources—were privileged to carry out this work for USAID.
NGO Service Delivery Program/Bangladesh
Client: United States Agency for International Development (USAID)
(Prime Contractor: Pathfinder International)
The NGO (Non-Government Organization) Service Delivery Program (NSDP) contract, which was implemented from 2002 through 2007, provided high impact and high quality primary health care services and increased the public's demand for these basic services in both rural and urban areas of Bangladesh. Health services covered in this program included family planning (including emergency contraception); maternal health care, including safe delivery and emergency obstetric care as well as post-abortion care; management of childhood illnesses; and prevention and treatment of infectious diseases, including tuberculosis, sexually transmitted diseases, and HIV/AIDS. The project improved NGOs' role in meeting primary health care needs of the population, with special emphasis on the poor and under-served. As one of seven subcontractors to Pathfinder International, URC is provided technical assistance in the development and institutionalization of quality improvement concepts, techniques, and activities and also in conducting operations research in various programmatic areas to enhance efficiency and output.
Partners for Health Reformplus (PHRplus)
Client: United States Agency for International Development
As USAID's flagship project in health policy and systems strengthening, PHRplus brought together the expertise of leaders in international health care development in a joint global health reform initiative. PHRplus provided technical assistance and helped maintain USAID's worldwide leadership role in health care reform, health policy, management, health financing, and systems strengthening. Awarded in 2000 as a five-year project, PHRplus was built on the foundation established by the preceding Partnerships for Health Reform Project (PHR), which ran from 1995 through 2000. PHRplus continued a focus on implementation of improvements in health policy, management, financing, and health services delivery, and placed new emphasis on developing and strengthening health information and infectious disease surveillance systems, HIV/AIDS, and expanding community participation.
As the principal sub to Abt Associates, URC provided overall leadership through its participation on the Senior Management Team and specific leadership in critical project technical areas including National Health Accounts, decentralization, infectious disease surveillance, quality assurance, hospital management and accreditation. URC staff made important contributions to health systems strengthening, costing, resource allocation, health information systems, communications, and research. URC-led research focused on health worker motivation, sector-wide effects of the Global Fund, community-based health insurance, and quality improvement. In addition, URC had primary responsibility for PHRplus projects in Malawi, Eritrea, and Jordan and URC staff provided regional leadership for both West and Central Africa and East and Southern Africa, and the Latin America region. Finally, URC was responsible for the management of the PHRplus Resource Center.
Information Technology Support to the District of Columbia Department of Health
Client: District of Columbia Department of Health
In 1999, the District of Columbia Department of Health (DC DOH) began an information technology (IT) enhancement project to implement a state-of-the-art, department-wide IT system. URC was contracted by DC DOH to develop a three-year information technology strategic plan to guide the efforts of the Department in enhancing its use of information technology. URC developed a plan articulating the IT mission, vision, goals, and objectives, drawing on focus group research, document review, and interviews conducted by URC. URC’s team also designed communications materials related to the project, including an IT newsletter, fact sheet, and other materials necessary to ensure that the DC DOH workforce and other stakeholders were informed of IT activities. We developed a revenue-generation and charge-back system that assisted DOH in allocating costs and sustaining IT enhancements and established a project tracking system to monitor and integrate IT activities involving various contractors.
Management Reform Project for the District of Columbia Department of Health
Client: District of Columbia Department of Health
In 1997, the District of Columbia (DC) Financial Responsibility and Management Assistance Authority engaged URC to assist in developing a management reform plan for the DC Department of Health (DOH). URC conducted an organizational and program assessment to gain an overview of the status of DOH activities by program area. We then addressed department-wide topics, such as the department’s mission, strategic plan, critical administrative systems, performance measures, and quality assurance. The assessment served as the foundation for the development of management reform projects to enhance the operations of DOH and improve the quality and delivery of services in DC DOH-operated facilities. Nearly 100 management reform projects were identified, mostly directed at improving key business processes and instituting performance measurement.
In phase two of the project, which was completed in 1998, URC staff provided leadership, management training, and facilitation services to enable the DC DOH to implement the management reform projects. These projects developed a preliminary strategic management framework for managing change and process improvement in the DOH overall and in selected divisions. URC assisted DOH staff in conducting the various activities required to effect the improvements, including team building, benchmarking, reviewing and flowcharting processes, developing strategic plans, and identifying performance standards and indicators.
The Maram Project: Healthier Palestinian Families
Client: USAID
On the Maram Project, awarded in 2001 and managed by IBM Global Services, URC was one of a consortium of US-based technical assistance organizations which worked to build Palestinian health service delivery capacity and provide support for the service delivery sector during emergencies. In cooperation with the consortium partners, the USAID Mission, the Ministry of Health of Palestine, local non-governmental organizations, and village health worker networks, URC spearheaded a number of research activities including an assessment of health services in the West Bank and Gaza which established uniform definitions that allowed for comparisons between public, private, and the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) services.
URC led a comprehensive immunization coverage assessment which was the first conducted in the region in approximately 10 years and contributed to establishment of a research web site. Following a 2002 UN declaration of a nutrition humanitarian emergency in the West Bank and Gaza, the URC team contributed to nutrition related activities including facilitation of the development of a national nutrition strategy, design and conduct of a regional conference on state of the art approaches to data-based decision-making for nutrition programs and policies, and research of a number of maternal and child nutrition issues in the West Bank and Gaza Strip.
Peru Consultancy in Quality Assurance and Improvement
Client: World Bank
The Health and Basic Nutrition Project (PSNB), financed by the World Bank, spearheaded health sector reform in Peru by helping the Ministry of Health (MOH) to improve the quality of primary health care services and establish decentralized health service networks. Through the PSNB, URC was hired by the Ministry of Health in a two-year consultancy to support the introduction of quality management approaches and quality improvement projects in MOH facilities in Lima and the departments of Cusco and Piura. URC’s consultancy focused on strengthening leadership in four health service networks, developing a broad range of quality management tools to support supervision and monitoring, supporting quality improvement projects, and training health professionals in health services management. URC also assisted the MOH in improving its health information system and introducing key quality indicators and standards to monitor the quality of care. The consultancy was completed in 2000.
Primary Health Care Management Advancement Programme
The Primary Health Care Management Advancement Programme (PHC MAP) was a collaborative effort of the Aga Khan Health Network and URC from 1991 to 1993 to develop practical tools to help program managers collect, process, and analyze information to strengthen the management of primary health care services. URC played the lead technical role in the development of PHC MAP’s nine self-instructional modules and participated in the field-testing of the modules in thirteen countries. The PHC MAP modules covered: assessing information needs; assessing community health needs and coverage; planning and assessing health worker activities; surveillance of morbidity and mortality; monitoring and evaluating programs; assessing service quality; assessing the quality of management; cost analysis; and sustainability analysis. Each module also included an accompanying Facilitator's Guide to assist trainers, teachers, consultants, and others to adapt and use the materials in their own programs. PHC MAP also included four management guides: 100 tips for better management, problem-solving, computers, and the computerized version of the Primary Health Care Thesaurus of indicators of service delivery and support activities, created by URC’s Primary Health Care Operations Research Project.
Programmatic and Fiscal Audit of the Fulton County Department of Health and Wellness
Client: Fulton County Dept. of Health and Wellness, Atlanta, GA
In 1998, URC conducted an organizational assessment of the Fulton County Department of Health and Wellness (DOHW) in Atlanta, Georgia. The objectives of this on-site audit were to review and analyze the department’s centralized administrative functions and operating programs. A team of URC specialists in the fields of public health, environmental health, quality management, data systems, health care finance, administration, personnel systems, and maternal and child health reviewed documents, performed structured interviews, and facilitated focus groups to gather qualitative information on DOHW successes, issues, and problems. The audit identified the need for fundamental changes in the way DOHW was organized and operated. The URC team worked with DOHW staff members at all levels to identify opportunities for effecting these changes and for developing improvement strategies. Recommended improvement projects included enhancing the cost accounting system, revamping the budget process, and exploring options for revenue generation, as well as program specific enhancements, such as providing more visible signage for a health center and organizing outreach workers.
PROGRESS Morocco
Client: USAID
From 1994-2003, URC provided technical assistance to the Ministry of Public Health of Morocco to advance the quality of reproductive health and maternal and child healthcare as part of the Progress Project (Project de Gestion Régionale des Services de Santé). Progress was funded by the U.S. Agency for International Development through a TASC contract with John Snow, Inc. (JSI). URC's work under a subcontract from JSI focused on prevention and treatment of sexually transmitted diseases, emergency obstetrical care, and building capacity in quality assurance skills. Under Progress, URC provided technical assistance at the regional level in Souss-Massa-Drâa and Tanger-Tétouan Regions to institutionalize quality assurance (QA) activities in accordance within the framework of the National Quality Assurance Program (PNAQ). URC staff facilitated innovative efforts of the MOPH Direction de la Population to develop a quality charter for population programs and worked with the Direction des Hôpitaux et Soins Ambulatoires to design their strategy for development of clinical care guidelines and build their capacity to implement the PNAQ. URC also helped to integrate a QA training module in nursing schools' pre-service training curricula.
Quality Assurance Evaluation of the Peace Corps Medical Support System
Client: U.S. Peace Corps Office of Medical Services
The United States Peace Corps Office of Medical Services called upon URC to conduct a three-phase quality assurance evaluation that took place from 1991 to 1995. URC assisted the Office of Medical Services to assess their existing quality assurance systems in Washington, DC and in the field; provided training to implement Continuous Quality Improvement (CQI); and developed a written quality assurance plan to integrate CQI and more traditional approaches to quality assurance into the system. Under the third phase of the project, URC reviewed and updated the Peace Corps Technical Guidelines (clinical and non-clinical), trained Office of Medical Services' staff in quality assurance methodologies, and conducted studies to provide data for policy and program decisions. URC also developed evaluation instruments for monitoring health care in the Volunteer Health Services and assessed the available health resources in host countries.
Quality Assurance Project I
Client: USAID
The Quality Assurance Project I (QAP I) was a five-year project of USAID to provide international leadership in the area of quality assurance (QA) and continuous quality improvement in health care and institutionalize quality assurance systems in USAID-supported health programs. QAP I carried out activities in 20 countries, providing technical assistance and training in standards development, quality assessment and monitoring, problem solving, and quality improvement. The project supported the development of national or regional QA programs in Chile, Costa Rica, Ecuador, Egypt, Jordan, Niger, and Nigeria and implemented smaller scale technical assistance efforts in Guatemala, Honduras, Indonesia, Malawi, Paraguay, the Philippines, Uganda, and other developing countries. The project also sponsored several central level activities to support the development of country programs, including operations research to develop and refine QA methods for use in developing countries and the design of standardized training courses that could be easily adapted to country-specific needs. QAP I also actively disseminated project results and methods to the international health community through newsletters, brief reports, and technical monographs. Implemented from 1990 to 1995, QAP I was followed by Quality Assurance Project II.
Strategic and Policy Assistance to the Agency for Accreditation and Quality Assurance/Republic of Srpska
Client: World Bank
Under a subcontract from Epsilon Research, Development & Consulting, Ltd., URC provided technical assistance in quality improvement and regulatory strategies to the Agency for Accreditation and Quality of the Ministry of Health in the Republic of Srpska, Bosnia Herzegovina. The objective of the consultancy was to develop a structure for implementation of health care regulations for accreditation and to construct a policy framework for implementation of government legislation, licensure of health care professionals and facilities, accreditation strategies, and certification for specialized skills. The project was implemented in partnership with Ministry of Health of Srpska, with financing from the World Bank. URC assisted in the development of a Strategic Plan for the Agency for Accreditation and Quality and a detailed implementation plan for the project and provided training to the project team in quality assurance and regulation.
Back to top |
