Table 1.

Analytical framework for assessing health care quality and patient safety

Component	Elements
Macro-level
Health systems context	• Governance, financial and delivery arrangement of the health system in each country
Policies and legislation	• Presence of an explicit and comprehensive national policy for quality and patient safety • Incentives and disincentives for participation in quality improvement and patient safety initiatives
Organizations & institutions	• Coordination of quality improvement and patient safety initiatives • Accountability and mechanisms to implement and follow up on quality improvement and patient safety initiatives • Support structures for quality:  - National council on clinical governance  - National society for quality in healthcare
Methods, techniques & tools	• Licensing of health professionals and healthcare institutions • Systems for adverse drug event reporting • National health care accreditation programs • National performance indicators
Meso-level
Health care infrastructure and resources	• Infrastructure for quality improvement and patient safety • Human resources for health • Health information system • Financial resources