Sexual and Reproductive Health Quality Improvement System (SRQIS)

Background: Within the health care reform environment, quality improvement is considered a means of reducing health care costs by improving efficiencies, as well as health outcomes.  Increasingly, sexual and reproductive health programs are making quality of care a top priority. Programs and providers are finding more and better ways to satisfy clients' needs and raise the quality of services while using resources more efficiently.

Objectives: To describe the implementation of an evidence-based quality improvement system in family planning clinics in PHS Region VIII, and how the system can be adapted to any sexual and reproductive health clinical setting.

Project Description: With an emphasis on client-oriented services, the core focus of SRQIS is building capacity to assess and improve quality of care. Performance measurement and quality improvement data are collected via three audit instruments designed to measure specific quality indicators related to service delivery.  Its innovation lies in the system’s ability to address both Quality Improvement (process indicators and outcomes) and Quality Assurance (documentation of non-outcome chart information).

Findings: The quality of care indicators of the framework are interrelated. Their quality is often determined by common environmental factors such as program policies, operations management, and resource limitations. They represent points of intervention:  services can be expanded and updated, and staffs’ counseling skills can be improved. However, when all the elements of the system are working well, impacts, such as clients making informed decisions and engaging in safer sexual behaviors, can be achieved.

Conclusions: The SRQIS reflects the principles of Continuous Quality Improvement in which the tools, sampling, and data collection methods are adapted and improved to better assist clinics in assessing their performance.

Implications for Programs, Policy, and Research: SRQIS allows clinics to: measure quality improvement; monitor and document achievements; evaluate program effectiveness and impact; track progress toward an established goal; and use objective data to support program implementation and policy development.