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Institut für Public Health

Quality Improvement: a Key for Health Systems Strengthening

May 01 - October 31, 2018 (distance-based e-learning course)



Content Overview

The course includes the following topics:  

  • Module 1. Why quality matters within a health system/country context, key historical figures and trends in the quality improvement movement, definitions of and defining quality, Deming cycle and Donabedian model, Quality improvement (QI) concepts such as QI, Quality management (QM), Quality assurance (QA) and Quality control (QC), understanding perspectives and roles in quality improvement, key characteristics of QI methods and frameworks, linkages between management, leadership and quality improvement.
  • Module 2. Key health system factors influencing quality of health care services, international frameworks to strengthen quality improvement strategies, levels and mechanisms regulation and standardization, the role of frameworks and methods such as International Organisation for Standardization (ISO), European Foundation for Quality Management (EFQM), Accreditation and certifications, mechanisms and tools to implement quality management frameworks and methods, country examples.
  • Module 3. Basic principles of health systems thinking, analysing a quality improvement approach with a system thinking lens, QI Methods and tools commonly used in QI based on the system thinking approach, designing and planning a quality improvement or patient safety initiative using systems thinking principles.
  • Module 4. Basic concepts of Monitoring & Evaluation (M&E) in QI including their key features, M&E methods and instruments, linkages between M&E and key quality mechanisms such as the Donabedian model, the Plan-Do-Check-Act (PDCA) Cycle, standards and indicators, setting up a M&E system for critical incidents in a health facility.
  • Module 5. Patient safety and its importance as a core element of quality health care, historical development of patient safety, types of medical errors, theory and practice of patient-centeredness, strategies, mechanisms and tools to improve patient safety and ensure quality health care and better outcomes, roles of legislation and regulations in patient safety.
  • Module 6. Health human resource (HHR) management and its importance in ensuring quality health care, function and tasks of strategic human resources management for quality improvement, meaning and significance of performance management in quality health care, change management as an instrument to improve HHR functions and practices, HR mechanisms to strategically influence successful change management processes and develop competent health human resources.
  • Module 7. Quality and related financial concepts such as efficiency and cost-effectiveness, financing strategies and mechanisms including collection of funds, pooling of funds, purchasing, insurance, purchaser provider split, private / governmental / mixed health service provision, linking funding to QI mechanisms such as Licensing/ Certification/ Accreditation, country examples linking health financing strategies and mechanisms with QI mechanisms and outcomes.
  • Module 8: Transfer project


Learning Objectives

By the end of the Course participants should be able to:  

  • Critically analyse the importance of improving quality in health systems
  • Analyse strengths and weaknesses of different types of regulatory and other mechanisms that influence quality improvement in the health system.
  • Use system thinking in quality improvement activities at all levels of a health care system
  • Propose appropriate methods for monitoring and evaluating quality within a specific context
  • Formulate patient safety, patient centred care and family/community engagement in QI initiatives within health systems
  • Demonstrate how appropriate human resource mechanisms and change interventions contribute towards improving quality
  • Interpret how financial mechanisms impact the quality of health systems and services and decision-making of patients and providers
  • Develop a QI initiative in current health setting (transfer project)


    Learning Methods

    The course is divided into 8 modules, each module follows a set of standardised elements based on the overall didactic setup and course structure: Content of the modules are framed through the elements of an introduction, overview of content and objectives, 3-4 lessons based on learning objectives, summary of the module, self-assessment questions and modular assignments.


    Assessment Procedures

    Assessment of participants’ achievement of the learning objectives will be determined as follows:

    • 4 % individual transfer project based on project template and project assessment criteria
    • 25% multiple-choice final exam based on all learning objectives
    • 21% seven modular assessments

    Participants will be informed of all assessment processes during orientation to the course. Marking guidelines for evaluation of participant transfer projects will be made available to participants. These guidelines are in line with the expected course outcomes. If students fail the assessment, an opportunity will be offered to them to re-take the test and/or to redo their transfer project. Participant progress in working through the modules will be monitored, participants will not be able to progress to module 4 if they have not completed the first three modules and to module 7 if they have not competed modules 4-6, including assignments.


    Duration/ Accreditation

    • 6 Months
    • 225 SIT (Modules 1, 4, 5, 6 & 7 are 21 hours each, Module 2 & 3 are 14 hours each, Module 8 is 60 hours)
    • around 9 hours per week
    • 7.5 ECTS (tropEd Master in International Health)

    Course Fee

    • € 2000.-

    Please register as soon as possible as the number of participants (including tropEd students) is limited to 30. The selection is on first come, first serve basis.

    Unfortunately, no Scholarships are available.


    In Cooperation between

    • Heidelberg University, Institute of Public Health
    • Institute on Applied Quality Improvement and Research in Healthcare ( aQua Institute) - www.aqua-institut.de
    • evaplan at the University Hospital Heidelberg - www.evaplan.org
    • International Society for Quality in Health care (ISQua) -  isqua.org
    • common sense eLearning & training consultants GmbH - www.common-sense.at


    Contact Registration

    PD Dr. Stevla Loukanova

    Heidelberg University / evaplan at the University Hospital Heidelberg 

    Fon: + 49 - (0) 62 21 - 56 47 44 



    Short Course Programme Coordinator

    Nandita Rothermund-Bucher, M.A.

    Institute of Public Health, University of Heidelberg

    Im Neuenheimer Feld 365, D-69120 Heidelberg

    Fon: + 49 - (0) 62 21 - 56 46 48 

    Fax: + 49 - (0) 62 21 - 56 49 18



    Course Coordinators 

    PD Dr. Stevla Loukanova

    Institute of Public Health, University of Heidelberg


    Teaching Coordinator/
    tropEd Coordinator

    Dr. Pauline Grys

    Institute of Public Health, University of Heidelberg

    Fon: + 49 - (0) 62 21 - 56 50 48


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    Course Coordinator

    PD Dr. Svetla Loukanova,

    Institut of Public Health,

    Heidelberg University