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Institute for Global Health

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Quality Improvement

UCL Global Quality Improvement brings together a team of expert researchers, evaluators and practitioners from across UCL who are interested in improving global healthcare and health, particularly in low-income countries and resource-poor settings throughout the world. Our unique approach to quality improvement is founded on five core principles:

1. Whole systems thinking. The inter-relationships between the patient, clinical and non-clinical workers in the health system, different levels of the health system ranging from the community to tertiary referral systems, and required human and material resources and training, supervision and management structures are all considered as part of one dynamic complex adaptive system.

2. Accountability. The people involved in making health systems work must be accountable to the individuals and local communities the health system is there to benefit. Data for decision-making is key as it not only can be used to encourage quality improvement and track it, but can also be a mechanism by which service providers can be held to account. Community-linked death reviews involving the community of the deceased as well as healthcare workers can also increase accountability.

3. Participatory approach. We believe a participatory, grounded and bottom-up approaches involving healthcare professionals, patients and wider communities as well as researchers-in-residence are crucial to understand whole systems, increase buy-in to quality improvement efforts, and consequently design and implement interventions that are effective in specific contexts; and build accountability.

4. Evidence-based. Evidence on what works to improve quality of care in low-income settings is scarce. Our approach is based on the highest standards of scientific and academic rigor, using innovative mixed methods approaches to research and evaluation.

5. Innovation. With expertise in a variety of research and evaluation methodologies related to quality improvement we aim to effectively use both plausibility and probability designs as part of a single research strategy to rigorously determine not only whether the interventions we test work but also how, why and in what circumstances they work. We use methods ranging from tailored formative research to cluster randomised controlled trials with accompanying detailed multidisciplinary theory-based evaluations, and encourage the use of researchers-in-residence.