1. Skills building on scaling up: Improvement Collaboratives Youssef Tawfik, MBBCH, MPH Sr. Quality Improvement Advisor, MNCH University Research Co., Reconvening Bangkok: 2007 to 2010 March, 6-11, 2010.

2. Session Outline IC definition and principles 10 min IC team work 25 min Team presentations 15 min Discussion 10 min

3. Definition of an Improvement Collaborative An Improvement Collaborative is an organized network of a large number of sites (e.g. districts, facilities or communities) that work together for a limited period of time, usually 9 to 24 months, to rapidly achieve significant improvements in a focused area through shared learning and intentional spread methods. The system, processes, quality and efficiency of care are to be improved.

4. Principles of Improvement Collaboratives Network of participating organizations/sites involved in shared learning Quality Improvement (QI) team at each site Focused on one clinical/public health topic Work to find better ways to implement best practices and achieve better results Regular communication between sites Common key indicators reported and shared monthly

5. Group Exercise: IC Team Work Divide into teams (health facilities) QI Aim: Increase contraceptive use among post partum women delivered in your clinic. Decide on QI team members Assign roles among the team Suggest key interventions to reach the QI Aim. Be ready to share suggestions with other teams

6. PharmacistNurse(s) Physican Lab technician Manager Who would be a member of the quality improvement team? All the people who are involved in the particular process of care at each facility site make up the quality improvement collaborative team! Midwife

7. Discussion What did you learn/like about suggestions of the other teams. What is the value of teams working together? Comparing results, challenges, and experiences among teams. Motivation for IC teams.

8. Examples of Team Interventions to Improve Evidence-Based Care in Niger and Benin Maternal Newborn Collaboratives Locally made AMTSL stamp For Partogram Pre-filled Oxytocin Syringes in Cooler in Delivery Area Thermal Control in First HourCare Re-organization for Private Separate Birth area

9. Program Impact: Niger Reduction in Post-partum Hemorrhage 9