1
Figure 1: Factors affecting the quality of care
Impact(change in health status)
Quality of Care
Supply:health system
Demand:expectations
and needs
2
High Quality
Care
Staff motivation
Staff competency
Adequate resources
Appropriate content of care defined
Good flow and organization of care
Figure 2: Immediate Determinants of High Quality Care
Patient res pons iveness and
compliance w
ith standards
3
High Quality
Care
Staff motivation
Staff competency
Adequate resources
Appropriate content of care defined
Good flow and organization of care
Figure 3: QA interventions and their effects on determinants of high quality care
Pre-service trainingCertification
Licensing
On-going capacity building
Build culture of quality:(leadership, focus on client,
teamwork, incentives)
Accreditation
Standards/Norms:(health tech. assessment,
evidence-based guidelines)
Quality improvement:quality design, process
improvement
Quality monitoring
Define Scope of practice
4
Qualityof care
Staff motivation
Staff competency
Adequate resources
Adequate contentof care defined
Good flow and organization of care
Figure 4: Health sector reform and its effect on quality of care
Human resource mgmt
Provider payment systems:•incentives•level
Rationalization of health system:•decentralization•separation of functions
Basic benefit package
Improved managerial capacity
Regulation
Distribution of financial burden:• public/private resource generation
Resource allocation
5
Staff motivation
Figure 5: Interventions to improve staff motivation
Human resource mgmt
Provider payment systems:•incentives•level
Build culture of quality:(leadership, focus on client,
teamwork, incentives)
Rationalization of health system:•decentralization•separation of functions
Quality improvement:quality design, process
improvement
6
Staff competency
Figure 6: Interventions to improve staff competency
Human resource mgmt
Regulation
On-going capacity building
Pre-service trainingCertification
Licensing
Accreditation
7
Adequate resources
Figure 7: Interventions to improve adequacy of resources
Human resource mgmt
Provider payment systems:•incentives•level
Rationalization of health system:•decentralization•separation of functions
Regulation
Distribution of financial burden:• public/private resource generation
Resource allocation
Accreditation
8
Appropriate content of care defined
Figure 8: Interventions to improve definition of content of care
Basic benefit package
Regulation
Resource allocation
Define Scope of practice
Standards/Norms:(health tech. assessment,
evidence-based guidelines)
9
Good flow and organization of care
Figure 9: Interventions to improve flow and organization of care
Improved managerial capacity
Quality improvement:quality design, process
improvement
Quality monitoring