Leveraging healthcare standards-based improvement initiatives to support learning and continuous improvement: lessons from implementing the Ideal Clinic programme in Cape Town, South Africa (FIELD ACTION REPORT)
Dublin Core
Title
Leveraging healthcare standards-based improvement initiatives to support learning and continuous improvement: lessons from implementing the Ideal Clinic programme in Cape Town, South Africa (FIELD ACTION REPORT)
Subject
healthcare standards, quality improvement, learning health systems
Description
the implementation of the Ideal Clinic Realisation and Maintenance Framework (ICRMF) in Cape Town, South Africa. The ICRMF is a national
standards-based quality improvement initiative that seeks to improve the quality of care in public primary healthcare (PHC) facilities. We share
lessons learned on how efforts to improve healthcare standards can be leveraged for learning and meaningful system change.
Methods: A three-pronged approach to improving the implementation of the ICRMF was used in 15 PHC facilities across two sub-districts. The
approach included (i) nurturing trust, (ii) changing the ICRMF assessment strategy, and (iii) promoting a collaborative and collective sense-making
approach to understanding performance and addressing gaps. Routine ICRMF quantitative data and qualitative feedback from both the ICRMF
assessment process and routine management meetings were used to reflect on the experience of using this approach and to draw lessons.
The results and conclusions were further confirmed through member-checking.
Results: We found that using the three-pronged approach, the ICRMF assessments were able to facilitate deep and reflexive conversations about
everyday health system challenges facing healthcare delivery in the sub-districts, while encouraging collective sensemaking and collaboration.
The ICRMF was often perceived as a compliance-driven exercise with limited value on the actual quality of care. The three-pronged approach
helped shift some of these perceptions and improved the experiences of facility managers in implementing the programme.
Conclusion: When supported by trusting relationships, reflexive processes and multidisciplinary ownership and collaboration, healthcare standards programmes such as the ICRMF can provide powerful avenues for learning and meaningful change. Our limited dataset could not
demonstrate if our approach addresses the challenge of maintaining standards or not (which is linked to continuous improvement).
standards-based quality improvement initiative that seeks to improve the quality of care in public primary healthcare (PHC) facilities. We share
lessons learned on how efforts to improve healthcare standards can be leveraged for learning and meaningful system change.
Methods: A three-pronged approach to improving the implementation of the ICRMF was used in 15 PHC facilities across two sub-districts. The
approach included (i) nurturing trust, (ii) changing the ICRMF assessment strategy, and (iii) promoting a collaborative and collective sense-making
approach to understanding performance and addressing gaps. Routine ICRMF quantitative data and qualitative feedback from both the ICRMF
assessment process and routine management meetings were used to reflect on the experience of using this approach and to draw lessons.
The results and conclusions were further confirmed through member-checking.
Results: We found that using the three-pronged approach, the ICRMF assessments were able to facilitate deep and reflexive conversations about
everyday health system challenges facing healthcare delivery in the sub-districts, while encouraging collective sensemaking and collaboration.
The ICRMF was often perceived as a compliance-driven exercise with limited value on the actual quality of care. The three-pronged approach
helped shift some of these perceptions and improved the experiences of facility managers in implementing the programme.
Conclusion: When supported by trusting relationships, reflexive processes and multidisciplinary ownership and collaboration, healthcare standards programmes such as the ICRMF can provide powerful avenues for learning and meaningful change. Our limited dataset could not
demonstrate if our approach addresses the challenge of maintaining standards or not (which is linked to continuous improvement).
Creator
Oupa Motshweneng , Lucy Gilson, Beth Engelbrecht, and Alfonso Patientia
Source
DOI:https://doi.org/10.1093/ijcoms/lyae001
Publisher
Oxford University Press
Date
10 April 2024
Contributor
Sri Wahyuni
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Oupa Motshweneng , Lucy Gilson, Beth Engelbrecht, and Alfonso Patientia, “Leveraging healthcare standards-based improvement initiatives to support learning and continuous improvement: lessons from implementing the Ideal Clinic programme in Cape Town, South Africa (FIELD ACTION REPORT),” Repository Horizon University Indonesia, accessed February 21, 2026, https://repository.horizon.ac.id/items/show/11288.