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Project Title:

Improving Quality of Health Care Globally
PIN: IOM-BGH-16-02        

Major Unit:

Institute of Medicine

Sub Unit: Board on Global Health
Board on Health Care Services

RSO: Snair, Megan Reeve

Subject/Focus Area: Health and Medicine

Project Scope
In light of the call in the Sustainable Development Goals (SDGs) for achieving Universal Health Coverage (UHC), the National Academies of Sciences, Engineering, and Medicine will convene an ad hoc committee to study particular prospects for improving health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas.

This study will put the emphasis on the organization and delivery of safe and effective care at the patient/provider interface. Dimensions of care to be considered by this committee should include access (to services and commodities), effectiveness, safety, efficiency, and equity. The focus will be on front line service delivery that can directly impact health outcomes for individuals and populations. Recommendations would be targeted to key stakeholders, governments, donors, health systems, professions, and others.

The report will specifically address the following tasks:

• Describe the context-- Illuminate the consequences of poor quality care in developing countries and the challenges regarding both acute and chronic care for noncommunicable diseases that relate to avoidable morbidity and mortality, as well as lost productivity. The degree of financial waste and increased cost from ineffective or poor quality care should also be covered.

The committee should also consider non-health features of low quality care, e.g., the question of financial protection, particularly as it relates to the implementation of universal health coverage elements.

• Define the opportunity-- The committee should review the evidence on the potential to systematically improve quality of effective and safe care and offer recommendations about when and where quality improvement methods (defined broadly to include policies, processes, behavior change, and system modifications) most reliably benefit health outcomes. Issues of financial protections, especially in the setting of out-of-pocket payment for services, are germane.

• Analyze gaps-- Giving attention to the constraints on health systems in many countries, the committee should suggest promising models (including short, intermediate, and long term time frames) that, if employed, might facilitate improvements in quality, give countries a descriptive pathway to consider, and build capacity for widespread progress.

• Define a research agenda for the application of implementation science to the improvement of quality - The committee should offer an agenda of high priority implementation science research topics that would enable translation and broad implementation of scalable quality interventions, including issues of enrollment and financing UHC expansion.

• Offer approaches to setting priorities for advancing quality improvement-- The committee will offer recommendations on systematic approaches to setting priorities for implementing interventions and more institutionalized processes.  Issues of process quality, continuity of care, and retention of patients in programs are germane.

The project will begin in August 2017, and a final report will be available at the completion of this project, by August 2018. This study is supported by the National Institutes of Health, U.S. Agency for International Development, U.S. President's Emergency Plan for AIDS Relief, Medtronic, Johnson & Johnson Global Public Health, Wellcome Trust, and Institute for Global Health Innovation at Imperial College.

Project Duration: 16 months    

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Committee Membership
Committee Membership

 Meeting 1 - 10/18/2017
 Meeting 2 - 12/18/2017
 Meeting 3 - 03/08/2018
 Meeting 4 - 03/14/2018
 Meeting 5 - 05/14/2018


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