Quality Improvement

This chapter gives an account of one relatively modest but effective intervention in an orthopaedic outpatient clinic at the New Somerset Hospital (NSH) in Cape Town in 2013. This project aimed to reduce patient waiting times in the clinic, and improve patient satisfaction.

The science of team performance and training can help the medical community improve patient safety. This report, commissioned by the Agency for Healthcare Research and Quality (AHRQ), assesses the status of relevant team training research from aviation and other domains and applies this research to the field of medicine. It additionally provides a comprehensive review and evaluation of current medical team training initiatives and their effectiveness. [from resource]

While it is recognised that effective health care teams are associated with quality patient care, the literature is comparatively sparse in defining the outcomes of effective teamwork. This literature review of the range of organisational, team and individual benefits of teamwork complements an earlier article which summarised the antecedent conditions for (input) and team processes (throughput) of effective teams. This article summarises the evidence for a range of outcome measures of effective teams. [from abstract]

In this study, an intervention to enhance teamwork and staff engagement was tested on a medical unit in an acute care hospital. The results showed that the intervention resulted in a significantly lower patient fall rate, staff ratings of improved teamwork on the unit, and lower staff turnover and vacancy rates. Patient satisfaction ratings approached, but did not reach, statistical significance. [from abstract]

To prepare this report, an interprofessional research team conducted in-depth interviews with key informants and
undertook a wide-ranging survey of peer-reviewed and grey literature on the components of teamwork; effectiveness of teams; types of interventions; healthcare team dynamics; and the impact of government infrastructure, legislation,
and policy on teamwork in the Canadian healthcare system. [from summary]

This review examines current research on teamwork in highly dynamic domains of healthcare such as operating rooms, intensive care, emergency medicine, or trauma and resuscitation teams with a focus on aspects relevant to the quality and safety of patient care. [from abstract]

This chapter gives an account of one relatively modest but effective intervention in an orthopaedic outpatient clinic at the New Somerset Hospital (NSH) in Cape Town in 2013. This project aimed to reduce patient waiting times in the clinic, and improve patient satisfaction. [from introduction]

Quality of care can be significantly improved by engaging teams of frontline workers to identify problems and find local solutions for those problems. Based on the results achieved in Kunduz, Balkh, and Kabul, the collaborative improvement work was expanded from 2010–2012 to seven more provinces. The results achieved on the ground also led the MoPH to establish a unit for quality and a national health care quality improvement strategy for Afghanistan. [from abstract]

Medicines are a major driver of quality, safety, equity, and cost of care in low and middle-income country health systems. Universal health coverage implementers must explicitly address appropriate use of medicines to realize the health benefits of medicines, avoid wasting scarce resources, and sustain the financial viability of universal health coverage schemes. [from abstract]

Patient’s satisfaction is one indicator of healthcare quality. Few studies have examined the inpatient experiences in resource-scarce environments in sub-Saharan Africa. This paper examines patient’s satisfaction on the public medical wards at a Kenyan referral hospital, we performed a cross-sectional survey focused on patient’s satisfaction with medical information and their relationship with staffing and hospital routine. Ratings of communication with providers, efforts to protect privacy, information about costs, food, and hospital environment were also elicited. [adapted from abstract]

Quality of care is at the heart of any health care program, and yet it is defined in different ways and is difficult to measure. It is determined not only by the capabilities of health facilities and health providers but also by many other variables. Even among formal research studies, the variables measured differ from study to study. [from introduction]

The purpose of this study was to identify the various problems with surgical care in the developing world and enumerate identified strategies or propose solutions. We also sought to rank these strategies in order of potential impact. [from abstract]

This study aimed to evaluate the influence of a national child survival quality improvement project, on key maternal and child health outcomes. [adapted from abstract]

This study evaluates the impact of an intervention that improve the quality of services to prevent mother-to-child transmission of HIV at its health facilities, which included provider training, supportive supervision, detailed performance standards, repeated assessments of service quality, and task shifting of group education to lay workers. [adapted from abstract]

The study contributes to quality improvement programs responsible for accelerating reduction of maternal and neonatal morbidity and mortality in Uganda. It documents and informs clinicians, hospital managers, and policy makers about quality of care aspects that need to be improved in promoting newborns and maternal survival and well being during labor to promote women’s utilization of skilled attendance at birth. [from author]

This randomized trials was conducted to test the effectiveness of patient feedback on quality improvement of nursing care in English hospitals. [adapted from abstract]

This study involves an evaluation of a quality-improvement programme for the long-term care in The Netherlands and deals with seven quality-improvement collaboratives focusing on patient safety and client autonomy in order to explore whether differences between collaboratives with respect to type of topic, type of targets and measures (systems) are also reflected in the degree of effectiveness. [adapted from author]

This learning resource package for supervisors in medium-to-large facilities and for district-level supervisors is developed around aspects of performance improvement and quality of healthcare services, focusing on essential skills required to work with staff and members of the community in establishing standards and problem solving. [from publisher]

This report outlines a project to apply a quality improvement approach to Ethiopia’s Health Extension Program, which was designed to improve access and utilization of quality preventive, promotive and curative health care services in an accessible and equitable manner to reach all segments of the population, with special attention on mothers and children. [adapted from author]

Determinants of practice are factors that might prevent or enable improvements. Several checklists, frameworks, taxonomies, and classifications of determinants of healthcare professional practice have been published. In this paper, we describe the development of a comprehensive, integrated checklist of determinants of practice. [from abstract]

The authors undertook a qualitative study, along with a large census and health-provider survey in to understand priorities for quality in health care from the perspectives of health workers and community members in Tororo District, Uganda and factors potentially amenable to change that could enable these qualities to be enacted to increase equitable access to quality health care for the local population. [adapted from author]

The authors surveyed medical students to assess preferences and attitudes about quality improvement and patient safety education to determine how these important skills could best be integrated into the curiculum. [adapted from abstract]

This report details the results and impact of a human resources for health quality improvement intervention in Niger. The approach focused on teaching evidence-based human resources interventions that will improve health outcomes. [adapted from author]

This document is an introduction to the optimizing performance and quality process for analyzing the performance of health workers, organizations, and systems, and setting up interventions to improve performance and quality or build on strengths and successes. [adapted from author]

This compendium of health information technology (HIT) seeks to inform the implementation of HIT to facilitate continuous quality improvement of antiretroviral therapy programs and improved patient outcomes in low and middle income countries. [from author]

This report describes pioneering work where quality improvement methods are being applied to strengthen human resources management and performance at the facility, district, and regional management levels to improve maternal care in Niger’s Tahoua Region. [from summary]

This report summarizes a quality assurance project and explains how citizens were engaged at the facility level in improving health service quality, while also contributing to increased responsiveness and accountability on the part of health providers. [adapted from author]

This manual was designed to be a resource and guide for exploring and planning quality improvement activities through partnership activities involving service providers and the community members that they are meant to serve. [from introduction]

This facilitation guide is designed as a training supplement to the Partnership Defined Quality manual (PDQ) to enable a facilitator to conduct a PDQ training that will enhance the participants’ understanding of when and how PDQ can be used to strengthen quality and access, and equip them with the skills necessary to adapt and implement PDQ in their programs. [from introduction]

The objective of this study was to evaluate the impact of a quality improvement initiative for reproductive health providers on service qualtiy and related outcomes. [adapted from abstract]