Issues in health services delivery: Improving provider skills

Overview

This paper is intended for health care personnel and managers who are interested in improving the quality of the health care system by fostering change in the process of care and in the performance of practitioners. It should be of assistance in  conceptualizing how to promote change and how to overcome barriers to positive change.

The first section provides an overview of how quality health care may be developed. Although quality control and assurance techniques are not new to health care, only recently have these methods been widely adopted. Quality improvement methods, which involve workers in thinking about what needs to be improved and in experimenting with ways to improve it, seem to be most helpful in fostering behaviour change at the individual worker level. All of these methods are needed for the continuing development of quality in the health care field.

This paper describes strategies for improving the performance of health care workers. Many factors interact to affect the quality of health care. The structure of the health care system, educational opportunities for health practitioners, the administrative system, the pace of change, economic conditions and the technology available may influence the ability of the existing workforce to acquire new skills and implement them in practice. Thus, a comprehensive strategy is needed if the quality of the overall system is to improve, including the development of indicators to measure progress.