Title: Quality Management in International Health
Keywords: Quality (incl. accessibility)
Country: Germany
Institution: Germany - Institute of Public Health, University of Heidelberg
Course coordinator: Sylvia Sax
Date start: 2018-06-11
Date end: 2018-06-22
About duration and dates: 2 weeks on-site 4 days preparation
Classification: advanced optional
Mode of delivery: Face to face
Course location:
Institute of Public Health, University of Heidelberg
ECTS credit points: 4.5 ECTS credits
135 hours
Lectures: 37 hours, Group work and presentations: 47 hours, Field visit: 8 hours, Independent study: 43 hours;
Language: English
By the end of the module the participants should be able to:
1. Identify challenges and current developments for improving healthcare quality in low and middle income countries.
2. Critically analyse international healthcare quality management mechanisms and their global transferability.
3. Describe the roles of different stakeholders in healthcare quality improvement initiatives and activities both locally and globally.
4. Design a framework for strengthening healthcare quality in their country or region using key quality improvement principles and mechanisms.
5. Develop personal and team skills to lead the use of quality improvement tools and mechanisms in their setting.
Assessment Procedures:
2 –hour closed book examination using multiple choice (40%), short definitions (20%), and one 2 page essay question (40%). Failure requires a 2000 word essay on a healthcare quality improvement topic using a minimum of three key references,
negotiated between the student and the coordinator.

- Resource poor setting quality improvement case study and assessment tool to critically evaluate quality in a resource poor setting
- Internet resources for healthcare quality management publications and grey literature
- Major steps and trends in the healthcare quality and patient safety movements
- Quality improvement principles, mechanisms and tools and their contextual relevance
- Leadership in healthcare quality improvement
- Leading teams to use quality improvement tools
- Implementing healthcare quality management mechanisms and tools in low and middle income countries
- Healthcare quality evaluation mechanisms in low and middle income contexts
- Skills development in healthcare quality evaluation
- Practical exercise in critically analyzing quality improvement mechanisms in a German healthcare facility
- Designing and sustaining a healthcare quality improvement framework in a low or middle income country or regional context.
- Use quality improvement literature critically to inform individual and team exercises
- 3 day self-study exercise including reading and analysis of Nanda Devi Case Study and completion of quality assessment tool
- Six hours critical readings and pre-course completion of healthcare quality improvement history exercise based on key readings
- Two x 60 minute interactive lectures to introduce key subjects of major steps and trends in history of healthcare quality movement with two group exercises on these subjects
- 60 minute interactive lecture to introduce key quality improvement principles and two x 2 hour guided team exercises on using principles in different contexts
- Three x 30 minute lecture on teams and five x 30 to 45 minute individual and group exercises on team building and using quality improvement tools and mechanisms
- Four x 30 – 45 minutes lectures with three 15 – 45 minute team and individual exercises on leadership in healthcare quality improvement
- 30 – 45 minute lectures and 30- 45 minute group exercises to analyze three country case studies on introducing and/or implementing healthcare quality management mechanisms
- 2 hour guided and self-study exercise in searching the internet and internet resources for quality management
- Two day (16 hours) healthcare surveyor leadership training using critical reading, interactive lectures, individual and group exercises and Nanda Devi case study
- 1.5 day (14 hour) interactive field visit to a healthcare facility including design and use of a quality assessment tool, analysis of findings and role play presentations to key stakeholders
- Two hour exploration of patient rights and responsibilities in healthcare using short lectures, role plays and debates
- Six hours to design and present a country or regional healthcare quality framework using quality improvement principles
Policy managers, public health professionals and healthcare managers in key decision making positions with at least two years’ experience in a public health field, preference given to those with proven leadership experience in quality policy or management in a low or middle income country (identified in their CV). English Toefl: Computer based >237; Paper based >580; Internet based >90; IELTS > 6.5. (Or as requested at respective English taught home institute = tropEd enrolment sufficient)
The number of participants including tropEd students is limited to 22
first come, first serve
Fees: 1000 EUR (for tropEd students, others have to pay EUR 1.500)
Scholarships: None
Major changes since initial accreditation:
Revision of case study and assessment tool with an Increase in time allotted for case study to three days, based on recommendations of students and trainers. Critical readings recommended before the course will now be required with a pre-course exercise to complete and hand in (both were recommended by participants). We are now recommending 4.5 ECTS for this module. Minor adjustments to the objectives and overall contents based on recent changes in the quality improvement and safety scientific literature and recommendations of participants. The contents include more of a focus on leadership within quality management at policy and practice level, including an increased emphasis on patient focused care.
Student evaluation:
The course has received excellent reviews for the last five years, with comments such as: “ Well organized course. I learnt a lot and I have already changed my perception of the importance of using quality management in my work” and “The course spent much time on group discussions- using practical approach. Made teaching in very simple way to help trainees easily understand”. The students have also consistently commented on the the value of having GIZ sponsored participants with the tropEd student and the learning this fosters.
Key areas for improvement identified were the need for more time to complete the case study before the course, benefit of preparation using key readings before the course, more comfortable room arrangements, enhancing learning in QM through additional courses in other countries, increasing the
focus on leadership and less (and more) work in teams and groups during the course. These suggestions have been addressed through improvements in changes to the course preparation requirements, furnishings in the rooms and changes to the curriculum.
Lessons learned:
The use of the detailed case study as an exercise before the course and continued use within the course is an excellent learning tool. Participants learn a lot through practical exercises but these require detailed design with close mentoring throughout.
tropEd accreditation:
Accredited in Bordeaux, January 2002 with 4 ECTS credit points, previous accreditation in London 2000 with 3 ECTS credit points. Re-accredited in May 2008 and September 2012 . This accreditation is valid until September 2017.
This course is jointly coordinated with GIZ (Deutsche Gesellschaft für Internationale Zusammenarbeit), students benefit as the course participants include low and middle income health sector policy and project managers from within the GIZ programmes. Quality Management and Improving Quality of Health Care Services are similar courses, but with different target audiences and tropEd students are not allowed to take both.
Email Address: grys@uni-heidelberg.de
Date Of Record Creation: 2012-01-09 20:44:56 (W3C-DTF)
Date Of Record Release: 2012-01-10 03:49:58 (W3C-DTF)
Date Record Checked: 2017-05-22 (W3C-DTF)
Date Last Modified: 2017-10-10 04:47:01 (W3C-DTF)

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