Ada’a Health Center: leading change in healthcare performance in Saudi Arabia

Saudi Arabia’s healthcare system, faced challenges in access to care, care quality and patient responsiveness. The Ministry of Health (MOH) initiated the Ada’a Program in 2017 to improve and standardize healthcare performance, by implementing change management framework, healthcare workforce empowerment, performance measurement and review, application of internationally recognized quality improvement frameworks and implementing data-guided focused improvements at national and facility levels. Ada’a has become a key enabler of the Vision 2030 and the Health Sector Transformation Program (HSTP). This paper provides an overview of the Ada’a program. The central administrative directorate of Ada’a program is based in the Ministry of Health. It coordinates with the regional and hospital Performance Improvement Units (PIUs). Capacity building of the (PIUs) in change management and frontline staff, use of data and quality improvement frameworks has been the cornerstone of the program. Baseline data has been used to identify focused improvement opportunities. Lean, six sigma, and FOCUS-PDSA frameworks have been used. Implementation has followed an agile, phased implementation. Real-time dashboards and regular reports have guided focused improvement initiatives, at facility and national levels. To sustain engagement and motivation, the Ministry introduced the Annual ‘Ada’a Award.’ Ada’a has advanced through the initial implementation of the program in 33 MOH hospitals, 3 domains, 10 Key performance indicator (KPIs) in 2017–2018 to 291 MOH hospitals, 110 private hospitals, and 2000 primary healthcare centers across 11 domains in 2025, implementing more than 3000 focused improvement projects. The program has achieved substantial performance improvements across emergency, outpatient, inpatient, operation room, laboratory, radiology, primary healthcare, mental healthcare, and home-healthcare services. There has been greater adherence to clinical guidelines; enhanced workforce capability; reduction in Acute myocardial infarction, sepsis, and venous thrombo-embolism related mortality. Patient-experience scores have improved across all service delivery areas. Ada’a program of the Saudi Arabian Ministry of Health has been able to institutionalize healthcare performance management, quality, patient safety, accessibility, efficiency, effectiveness, and continuous performance improvement of healthcare services. The program has trained a generation of performance managers and clinical healthcare professionals across the country in performance management, as well as utilizing performance data for continuous quality improvement. The further gains of the program were change management, transparency in data collection and reporting, standardization of healthcare performance, and making data-driven informed decision making at all levels of healthcare for improved patient care and outcomes.