COPE (client-oriented, provider-efficient), a model for building community partnerships that improve care in East Africa.

This article describes how a mission hospital in East Africa expanded its quality improvement (QI) process by promoting partnership with the community in order to better meet the community's needs. The partnership evolved from the hospital's existing COPE (client-oriented, provider-efficient) self-assessment approach. In addition to seeking the views of clients, the hospital embarked on a process to engage community members in a dialogue, implement improvements suggested by the community, and gradually ensure community representation on its QI committee. The importance of considering the cultural diversity of the community was reinforced by the outcome of the COPE initiative.