Stroke nurse-led intravenous thrombolytic therapy strategy for ischemic stroke based on timeline process:A quality improvement program from China

Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy strategies for stroke could reduce treatment delays.Methods:To reduce delays in IVT therapy for ischemic stroke,a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou,Zhejiang Province,from June 2021 to August 2023,which included developing a timeline process management system,forming a nurse-led stroke process management team,providing homogeneous training,standardizing the IVT therapy process for ischemic stroke,and introducing an incentive policy.During the pre-(from June 2021 to February 2022,group A)and post-(from March to November 2022,group B1;from December 2022 to August 2023,group B2[implementation of an additional incentive policy])of the implementation the strategy,the door-tocomputed tomographic angiography(CTA)time(DCT),CTA time,neurology consultation to consent for IVT,CTA-to-needle time(CNT),and door-to-needle time(DNT),the percentage of people who underwent CTA within 20 min,15 min,and 10 min and DNT within 60 min,45 min,and 30 min were collected and compared.Results:Following the implementation of the standardized IVT process management strategy for stroke,the DNT for group B1 and group B2 were 30(24,44)min and 31(24,41)min,respectively,both significantly lower than the 46(38,58)min in group A(P<0.001);the median DCT were both 13 min in group B1 and B2 lower than 17min in group A(P<0.001);the median CTA were 12 min in Group B1 and 9 min in Group B2 lower than 14 min in group A(P<0.001);similar results were observed during the neurology consultation to obtain consent for IVT and CNT.Compared with group A,the proportion of DCT20 min,15 min,and 10 min was higher in groups B1 and B2(P<0.05),and the same result was observed at DNT60 min,45 min,and 30 min(P<0.05).However,the additional incentive policy did not significantly differ between Group B2 and Group B1.Conclusions:Optimizing IVT therapy for ischemic stroke is a feasible approach to limit the DNT to 30 min in ischemic stroke,significantly reducing delays within the therapeutic window and increasing the number of patients meeting target time segments.Additionally,generating a timeline for the IVT therapy process by scanning positioning quick response codes was a significant breakthrough in achieving the informatization of IVT quality management for stroke.

Identifying a competency improvement strategy for infection prevention and control professionals:A rapid systematic review and cluster analysis

Remarkable progress has been made in infection prevention and control(IPC)in many countries,but some gaps emerged in the context of the coronavirus disease 2019(COVID-19)pandemic.Core capabilities such as standard clinical precautions and tracing the source of infection were the focus of IPC in medical institutions during the pandemic.Therefore,the core competences of IPC professionals during the pandemic,and how these contributed to successful prevention and control of the epidemic,should be studied.To investigate,using a systematic review and cluster analysis,fundamental improvements in the competences of infection control and prevention professionals that may be emphasized in light of the COVID-19 pandemic.We searched the PubMed,Embase,Cochrane Library,Web of Science,CNKI,WanFang Data,and CBM databases for original articles exploring core competencies of IPC professionals during the COVID-19 pandemic(from January 1,2020 to February 7,2023).Weiciyun software was used for data extraction and the Donohue formula was followed to distinguish high-frequency technical terms.Cluster analysis was performed using the within-group linkage method and squared Euclidean distance as the metric to determine the priority competencies for development.We identified 46 studies with 29 high-frequency technical terms.The most common term was“infection prevention and control training”(184 times,17.3%),followed by“hand hygiene”(172 times,16.2%).“Infection prevention and control in clinical practice”was the most-reported core competency(367 times,34.5%),followed by“microbiology and surveillance”(292 times,27.5%).Cluster analysis showed two key areas of competence:Category 1(program management and leadership,patient safety and occupational health,education and microbiology and surveillance)and Category 2(IPC in clinical practice).During the COVID-19 pandemic,IPC program management and leadership,microbiology and surveillance,education,patient safety,and occupational health were the most important focus of development and should be given due consideration by IPC professionals.

Fundamental principles of an effective reinforcing roof bolting strategy in horizontally layered roof strata and areas of potential improvement

It is arguable that the development of reinforcing roof bolting systems has largely stagnated in recent times, primarily due to the prevailing industry view that few, if any, further improvements can be made to what currently exists.However, this paper contends that reinforcing roof bolting systems can be further refined by considering both the specific manner by which horizontally bedded roof strata loses its natural self-supporting ability and the specific means by which reinforcing roof bolts act to promote or retain this natural self-supporting ability.The Australian coal industry has insisted on minimising bolt-hole diameter to maximise load transfer and on targeting full-encapsulation by any means necessary for many years.This has led to a significant, albeit unintended, consequence in terms of overall roof bolting effectiveness, namely increased resin pressures during bolt installation and the associated potential for opening bedding planes that may have, otherwise, remained closed during the bolt installation process.Given that the natural self-supporting ability of roof strata is strongly linked to whether bedding planes are open or closed, logically, minimising resin pressures should be a significant benefit.This paper focuses primarily on three key issues that relate directly to the function of the roof bolting system itself:(1) the importance of proper resin mixing in the context of maximising load transfer strength and stiffness,(2) the importance of minimising resin pressures developed during bolt installation, and(3) the importance of maximising the effectiveness of the available bolt pre-tension.All mine operators should be invested in improving the individual effectiveness of each installed roof bolt, even by relatively small incremental amounts, so this is an important topic for discussion within the mining community.

Discussion on strategy of grain quality improvement for super high yielding japonica rice in Northeast China

japonica rice is mainly distributed in Northeast China and accounts for 44.6% of the total cultivated area of japonica rice in China. The comprehensive using of inter-subspecies heterosis is the main breeding mode of super japonica rice varieties in this region. Improving rice quality at relative high yielding level is the current research focus. Performing crosses between indica and japonica lines allows for the recombination of regulatory genes and genetic backgrounds, leading to complicated genetic rice quality characteristics, which can be used to explore patterns of quality improvement. In the present study, we utilize recombinant inbred lines （RILs） derived from indica-japonica hybridization to analyze the effect factors of rice quality derived from genetic factors, which contain both regulatory genes concerning rice quality and genetic backgrounds＇ random introduction frequency coming from indica （Di value）, and the improvement strategy was further discussed. The regulatory genes involved in amylase content （Wx） and nitrogen utilization efficiency （NRT1.1B） were the major factors affecting the amylose content （AC） and protein content （PC） in RILs, respectively. Both the Di value and the major grain width gene （GS5） had regulatory effects on milled rice width （MRW） in RILs, and their interaction explained the major variance of MRW in the RILs. With the mediation of MRW and chalkiness degree （C）, Di value had a further impact on head rice rate （HR）, which was relatively poor when the Di value was over 40%. In Northeast China, the Di value should be lowered by backcrossing or multiple crosses during the breeding of indica-japonica hybridization to maintain the whole better HR and further to emphasize the use of favorable genes in individual selection.

Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning

BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.

Influencing Factors and Improvement Strategy to the Quality of Nursing Work Life: A Review

This review introduces the definition, influencing factors and improvement strategy to the quality of nursing work life, which can provide references for nursing managers to understand the factors affecting the quality of nursing work life and choose effective measures to improve the quality of nursing work life.

The Current Situation and Improvement Strategy of Physical Education in Colleges and Universities

At present,physical education is listed as the key teaching.This paper introduces the importance of physical education in Colleges and universities,analyzes the current situation of College Physical Education and explores the improvement strategies of College Physical Education at this stage.

Equilibrium Strategy of the Pursuit-Evasion Game in Three-Dimensional Space

The pursuit-evasion game models the strategic interaction among players, attracting attention in many realistic scenarios, such as missile guidance, unmanned aerial vehicles, and target defense. Existing studies mainly concentrate on the cooperative pursuit of multiple players in two-dimensional pursuit-evasion games. However, these approaches can hardly be applied to practical situations where players usually move in three-dimensional space with a three-degree-of-freedom control. In this paper,we make the first attempt to investigate the equilibrium strategy of the realistic pursuit-evasion game, in which the pursuer follows a three-degree-of-freedom control, and the evader moves freely. First, we describe the pursuer's three-degree-of-freedom control and the evader's relative coordinate. We then rigorously derive the equilibrium strategy by solving the retrogressive path equation according to the Hamilton-Jacobi-Bellman-Isaacs(HJBI) method, which divides the pursuit-evasion process into the navigation and acceleration phases. Besides, we analyze the maximum allowable speed for the pursuer to capture the evader successfully and provide the strategy with which the evader can escape when the pursuer's speed exceeds the threshold. We further conduct comparison tests with various unilateral deviations to verify that the proposed strategy forms a Nash equilibrium.

Integrating artificial intelligence and high-throughput phenotyping for crop improvement

Crop improvement is crucial for addressing the global challenges of food security and sustainable agriculture.Recent advancements in high-throughput phenotyping(HTP)technologies and artificial intelligence(AI)have revolutionized the field,enabling rapid and accurate assessment of crop traits on a large scale.The integration of AI and machine learning algorithms with HTP data has unlocked new opportunities for crop improvement.AI algorithms can analyze and interpret large datasets,and extract meaningful patterns and correlations between phenotypic traits and genetic factors.These technologies have the potential to revolutionize plant breeding programs by providing breeders with efficient and accurate tools for trait selection,thereby reducing the time and cost required for variety development.However,further research and collaboration are needed to overcome the existing challenges and fully unlock the power of HTP and AI in crop improvement.By leveraging AI algorithms,researchers can efficiently analyze phenotypic data,uncover complex patterns,and establish predictive models that enable precise trait selection and crop breeding.The aim of this review is to explore the transformative potential of integrating HTP and AI in crop improvement.This review will encompass an in-depth analysis of recent advances and applications,highlighting the numerous benefits and challenges associated with HTP and AI.

Evaluation and Improvement of an Organizational Resource Applying Strategy Patterns

For any software company that frequently performs quality assurance activities devoted to measurement, evaluation (ME) and change/improvement (MEC) projects, ME and MEC strategies can be valuable organizational assets. In this paper, we analyze the improvement of a ME strategy, which can be considered an organizational resource to be applied to quality assurance activities. This resource is called the GOCAME (Goal-Oriented Context-Aware Measurement and Evaluation) strategy. AME/MEC strategy embraces the next three integrated capabilities: 1) the ME/MEC domain conceptual base and framework;2) the process perspective specifications;and, 3) the method specifications. The improvement of GOCAME was performed instantiating two strategy patterns. A strategy pattern is a reusable solution to recurrent problems in ME/MEC projects. For an improvement goal, the selected MEC strategy pattern allows instantiating in a project a set of tailored activities and methods for measurement, evaluation, analysis and change. Particularly, we instantiate the GoME_1QV (Goal-oriented Measurement and Evaluation for One Quality View) strategy pattern to understand the GOCAME current quality state and compare it with the so-called GQM+ Strategies. First, this evaluation and analysis allows us to know the GOCAME strengths and weaknesses with regard to the quality of the three capabilities. Second, we instantiate the GoMEC_1QV (Goal-oriented Measurement, Evaluation and Change for One Quality View) strategy pattern to improve the GOCAME current state, producing as result a new version of the GOCAME strategy.

Comparative Geospatial Planning Model for “Location Specific” Intervention and Continuous Improvement Strategy

Sustainable development can only be achieved by conscious planning and implementation of action plans. Decision making requires a careful selection of the right conceptual framework and models for planning and implementation processes. Planning process models dictate in very clear terms what must be done and how it is done to achieve a successful completion of a process of activity [1]. Since about 80% of data used to support decisions are geographically related [3], it is necessary to put Geographic Information Systems (GIS) at the core of the planning and implementation model. There exists a great disparity in a heterogeneous world. The locational disparity in achieving sustainable development, therefore, necessitates a planning model that is “location specific” i.e. identifies areas (locations) requiring intervention and areas (locations) requiring continuous improvement strategies. This was achieved in this study by reviewing Bell’s Information System Strategic Planning Model and Kaufman’s Strategic Planning Model, and the designing of new model to overcome the limitation of existing models. Practical application of the new model was carried out in education planning and administration in order to achieve the global goals for sustainable development 4 (quality education). Finding shows that the Comparative Geospatial Planning Model for “Location Specific” Intervention and Continuous Improvement Strategy is useful to support the achievement of sustainable development goals in multidisciplinary, multi-sector applicable instances.

Rationale and protocol for estimating the economic value of a multicomponent quality improvement strategy for diabetes care in South Asia

Background:Economic dimensions of implementing quality improvement for diabetes care are understudied worldwide.We describe the economic evaluation protocol within a randomised controlled trial that tested a multicomponent quality improvement(QI)strategy for individuals with poorly-controlled type 2 diabetes in South Asia.Methods/design:This economic evaluation of the Centre for Cardiometabolic Risk Reduction in South Asia(CARRS)randomised trial involved 1146 people with poorly-controlled type 2 diabetes receiving care at 10 diverse diabetes clinics across India and Pakistan.The economic evaluation comprises both a within-trial cost-effectiveness analysis(mean 2.5 years follow up)and a microsimulation model-based cost-utility analysis(life-time horizon).Effectiveness measures include multiple risk factor control(achieving HbA1c<7%and blood pressure<130/80 mmHg and/or LDL-cholesterol<100 mg/dl),and patient reported outcomes including quality adjusted life years(QALYs)measured by EQ-5D-3 L,hospitalizations,and diabetes related complications at the trial end.Cost measures include direct medical and non-medical costs relevant to outpatient care(consultation fee,medicines,laboratory tests,supplies,food,and escort/accompanying person costs,transport)and inpatient care(hospitalization,transport,and accompanying person costs)of the intervention compared to usual diabetes care.Patient,healthcare system,and societal perspectives will be applied for costing.Both cost and health effects will be discounted at 3%per year for within trial cost-effectiveness analysis over 2.5 years and decision modelling analysis over a lifetime horizon.Outcomes will be reported as the incremental cost-effectiveness ratios(ICER)to achieve multiple risk factor control,avoid diabetes-related complications,or QALYs gained against varying levels of willingness to pay threshold values.Sensitivity analyses will be performed to assess uncertainties around ICER estimates by varying costs(95%CIs)across public vs.private settings and using conservative estimates of effect size(95%CIs)for multiple risk factor control.Costs will be reported in US$2018.Discussion:We hypothesize that the additional upfront costs of delivering the intervention will be counterbalanced by improvements in clinical outcomes and patient-reported outcomes,thereby rendering this multi-component QI intervention cost-effective in resource constrained South Asian settings.Trial registration:ClinicalTrials.gov:NCT01212328.

Dynamic plugging regulating strategy of pipeline robot based on reinforcement learning

Pipeline isolation plugging robot (PIPR) is an important tool in pipeline maintenance operation. During the plugging process, the violent vibration will occur by the flow field, which can cause serious damage to the pipeline and PIPR. In this paper, we propose a dynamic regulating strategy to reduce the plugging-induced vibration by regulating the spoiler angle and plugging velocity. Firstly, the dynamic plugging simulation and experiment are performed to study the flow field changes during dynamic plugging. And the pressure difference is proposed to evaluate the degree of flow field vibration. Secondly, the mathematical models of pressure difference with plugging states and spoiler angles are established based on the extreme learning machine (ELM) optimized by improved sparrow search algorithm (ISSA). Finally, a modified Q-learning algorithm based on simulated annealing is applied to determine the optimal strategy for the spoiler angle and plugging velocity in real time. The results show that the proposed method can reduce the plugging-induced vibration by 19.9% and 32.7% on average, compared with single-regulating methods. This study can effectively ensure the stability of the plugging process.

Enhancing IELTS Speaking Scores:A Comparative Analysis of High and Low Performers and Effective Strategies for Improvement

This paper examines the challenges of achieving high IELTS Speaking scores,particularly due to preparation constraints and subjectivity in assessment.It contrasts speaking features of high and low scorers across four key areas:fluency and coherence,lexical resource,grammatical range and accuracy,and pronunciation.The study offers strategies for improvement,focusing on topic development,vocabulary,and grammar,aiming to enhance candidates’performance.

Need of Practical Strategy for Improving Awareness of Acceptance of Tuberculosis Preventive Treatment among the Public and the Healthcare Workers

Since the emergence of COVID-19 in 2020,the threaten of emerging infectious diseases(EIDs)has attracted great attentions and echoes either from professional institutions,governments or public.The conceptualization of“Disease X”,which covers more than 30 families of viruses,has strongly actuated various resources into the development of medical countermeasures and the research across all families of pathogens.On the other hand,the endemic even pandemic old communicable diseases,such as tuberculosis(TB),malaria,HIV/AIDS,etc.,should never be neglected.Globally in 2023,the estimated TB cases was 10.8 million and the estimated deaths was 1.25 million according to the Global Tuberculosis Report 2024 by World Health Organization(WHO)[1].The most affected countries are India,Indonesia,China,the Philippines,Pakistan,Nigeria,Bangladesh,and the Democratic Republic of the Congo.

Interpretation of Chinese Expert Consensus on the Diagnosis and Management Strategy of Patients with Statin Intolerance: A guiding file for helping to lipid management for Chinese population

It is well-known that elevated low-density lipoprotein cholesterol(LDL-C)is a causal risk factor for atheroscler-otic cardiovascular disease(ASCVD),statins are cornerstone drugs for the cause-based treatment of ASCVD,which has created a new era for ASCVD therapy.However,statin intolerance is not clinically uncommon,which there are several issues with confu-sion and misunderstandings.Hence,a file named Chinese Expert Consensus on the Diagnosis and Management Strategy of Pa-tients With Statin Intolerance,like a navigator,has recently been published written by a team of experts from the Cardiovascular Metabolic Medicine Professional Committee,Expert Committee of the National Center for Cardiovascular Diseases aiming to en-hance the standardized clinical application of statins and improve the prevention and clinical outcome.In this article,author briefly summarized the key points of above consensus in order to helping to comprehending the content of the consensus sugges-tions.

Anti-aging performance improvement and enhanced combustion efficiency of boron via the coating of PDA

Boron is an ambitious fuel in energetic materials since its high heat release values,but its application is prohibited by low combustion efficiency and oxidization during storage.The polydopamine(PDA)was introduced into boron particles,investigating the impact of PDA content on the energetic behavior of boron.The results indicated that the PDA coating formed a fishing net structure on the surface of boron particles.The heat release results showed that the combustion calorific value of B@PDA was higher than that of the raw boron.Specifically,the actual combustion heat of boron powder in B@10%PDA increased by 38.08%.Meanwhile,the DSC peak temperature decreased by 100.65℃under similar oxidation rate compared to raw boron.Simultaneously,the B@PDA@AP and B@AP composites were prepared,and their combustion properties were evaluated.It was demonstrated that B@10%PDA@AP exhibited superior performance in terms of peak pressure and burning time,respectively.The peak pressure is 12.43 kPa more than B@AP and burning time is 2.22 times higher than B@AP.Therefore,the coating of PDA effectively inhibits the oxidization of boron during storage and enhances the energetic behavior of boron and corresponding composites.

Epigenetic regulation of targeted ferroptosis: A new strategy for drug development

Ferroptosis is a newly discovered form of cell death that is influenced by iron levels and is triggered by cellular metabolism and excessive lipid peroxidation.Epigenetic regulation plays a crucial role in the development and progression of diseases,making it essential to understand these mechanisms in order to identify potential targets for drug development and clinical treatment.The intersection of ferroptosis and epigenetics has opened up new avenues for research in drug development,offering innovative strategies for combating diseases.Recent studies have shown that epigenetic modifications can impact pathways related to ferroptosis,potentially leading to organ dysfunction.Despite the increasing focus on this relationship,the role of epigenetic regulation in drug development remains largely unexplored.This article explores current research on the interplay between epigenetic regulation and ferroptosis,delving into their regulatory mechanisms and discussing the effects of existing epigenetic modification regula-tors on diseases.Additionally,we highlight ongoing research on epigenetic factors involved in targeting ferroptosis in cancer,providing new insights for the development of cancer treatments.

Deterioration Reason and Improvement Measure of the Retarding Effect of Protein Retarder on Phosphorus Building Gypsum

The retarding effect of protein retarder on phosphorus building gypsum(PBG)and desulfurization building gypsum(DBG)was investigated,and the results show that protein retarder for DBG can effectively prolong the setting time and displays a better retarding effect,but for PBG shows a poor retarding effect.Furthermore,the deterioration reason of the retarding effect of protein retarder on PBG was investigated by measuring the pH value and the retarder concentration of the liquid phase from vacuum filtration of PBG slurry at different hydration time,and the measure to improve the retarding effect of protein retarding on PBG was suggested.The pH value of PBG slurry(<5.0)is lower than that of DBG slurry(7.8-8.5).After hydration for 5 min,the concentration of retarder in liquid phase of DBG slurry gradually decreases,but in liquid phase of PBG slurry continually increases,which results in the worse retarding effect of protein retarder on PBG.The liquid phase pH value of PBG slurry can be adjusted higher by sodium silicate,which is beneficial to improvement in the retarding effect of the retarder.By adding 1.0%of sodium silicate,the initial setting time of PBG was efficiently prolonged from 17 to 210 min,but little effect on the absolute dry flexural strength was observed.

Enhancing Private Healthcare Effectiveness in Lagos State, Nigeria: An Overview of the Effect of Quality Improvement Initiatives and Implications for Sustainable Healthcare Delivery

Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents cited tangible improvements, particularly in staff management and patient care processes, validating the positive influence of quality improvement projects. Financial constraints emerged as a significant challenge, aligning with existing literature emphasizing the pragmatic difficulties faced by private healthcare providers. Conclusions: This study illuminates the complex landscape of private healthcare provision in Lagos State, emphasizing the positive impact of donor-funded quality improvement projects. The findings provide nuanced insights, guiding policymakers, healthcare managers, and practitioners toward collaborative, sustainable improvements. As Nigeria progresses, these lessons will be crucial in shaping healthcare policies prioritizing population well-being.