Modality of Using 3 tools

Modality of Using the Three Parts of the QI Framework by the Facility Manager

The Facility Manager plays a crucial role in implementing, monitoring, and improving healthcare quality. The three parts of the QI framework serve as guiding tools to ensure systematic quality enhancement. Below is the modality for when and under what conditions each part should be used:

🔹 Part 1: Donabedian-Based QI Framework for Bangladesh

📌 When to Use?

✅ During policy development for hospital/clinic-wide quality improvement plans.
✅ When orienting new staff on the facility’s quality improvement approach.
✅ Before conducting facility-wide quality assessments to understand how quality should be structured.
✅ When reporting to higher authorities (MoHFW, QIS, regulatory bodies, accreditation agencies, etc.) about the facility’s QI strategy.

📌 Conditions for Use

➡️ If the facility lacks a structured QI framework, this part serves as the foundational guideline.
➡️ If the facility is preparing for accreditation, external audits, or quality certification, this framework provides the global alignment needed.
➡️ If the facility wants to align its quality policies with national and international standards, this section serves as a benchmark reference.

🔹 Part 2: Donabedian-Based QI Indicators & Assessment Criteria

📌 When to Use?

✅ During routine facility assessments and quality audits.
✅ When identifying gaps in structure, service delivery (process), and health outcomes.
✅ While preparing improvement action plans based on performance data.
✅ When implementing continuous monitoring systems (digital dashboards, checklists, and performance scorecards).

📌 Conditions for Use

➡️ If the facility wants to track progress and set clear quality targets, this part provides specific indicators and measurable criteria.
➡️ If there is a need for performance-based funding or incentives, this section helps in justifying resource allocation.
➡️ If the facility is struggling with compliance issues, these indicators serve as benchmarks for corrective actions.
➡️ If comparisons with other facilities (peer benchmarking) are required, these criteria help in standardizing evaluations.

🔹 Part 3: Process Indicators Considering the 7 Domains of Healthcare Quality

📌 When to Use?

✅ When monitoring day-to-day service delivery performance (e.g., patient waiting time, referral efficiency, emergency response).
✅ During root cause analysis (RCA) of patient complaints, adverse events, or inefficiencies.
✅ When setting short-term quality improvement goals (e.g., reducing hospital-acquired infections, improving referral rates).
✅ While conducting staff training & capacity building to improve clinical and non-clinical processes.
✅ When engaging with patient satisfaction surveys, feedback mechanisms, and grievance redressal.

📌 Conditions for Use

➡️ If the facility wants to improve specific quality domains (e.g., safety, efficiency, timeliness, patient-centeredness), this section helps prioritize key process improvements.
➡️ If health outcomes are not improving despite investments in infrastructure, this section helps identify bottlenecks in service delivery.
➡️ If there is high patient dissatisfaction or complaints, this part provides structured indicators to measure and improve the experience of care.
➡️ If the facility is preparing for external performance evaluations (e.g., hospital accreditation, WHO compliance), this part provides global alignment and benchmarking.

🔹 Summary: When Should Each Part Be Used?