Improving primary health care (PHC) services in Jordan – using collaboratives to achieve large-scale accreditation of PHC centers

Purpose - The Government of Jordan has made great strides in improving the quality of PHC services and related health outcomes. Yet challenges remain to ensuring full access to high quality, integrated PHC. A USAID-funded project is preparing 120 PHC centers for accreditation and assisting the MOH to take full leadership of this process. Method - The Accreditation Collaborative approach combines traditional accreditation preparations with a participatory improvement model for rapid scale-up of best practices through a planned spread strategy. The Project led an 18-month 30-center collaborative in which multidisciplinary PHC teams participated in monthly learning sessions to share experiences, understand the requirements of the 129 standards and produce action plans. Between sessions, PHC teams implement standards, collect data, and run PDSA cycles. The MOH and the project together provided technical support to address barriers encountered. At the end of the accreditation preparedness phase, centers are formally surveyed by the Health Care Accreditation Council. Through continuous capacity building, full engagement of MOH staff at all levels, and support in establishing structures at the MOH, the project prepared the MOH to assume leadership. Results – From the 30 PHC centers, 28 centers were accredited. The remaining 90 PHC centers are now in their final accreditation preparation stage; they are expected to have similar results with increasing support from MOH. Conclusion – Systematic design and application of accreditation collaboratives is feasible and effective to achieve large-scale accreditation in a middle-income country. In Jordan, improvement capacity and leadership has been vital to success.