Quality Assurance

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.

This study aimed to examine the effect of quality of services provided in private hospitals on the patient’s trust. [from abstract]

Optimizing Performance and Quality (OPQ) is a stakeholder-driven, cyclical process for analyzing human and organizational performance and setting up interventions to improve performance and quality or build on strengths and successes. The OPQ process is a seven-stage process to builds capacity within an organization to recognize and address problems or performance gaps on an ongoing basis. [from resource]

Current indicators used to measure efforts and progress in HRH are limited and often unreliable. These limitations constrain country, donor, and program efforts to identify and address gaps in HRH and to track progress over time. CapacityPlus developed the HRH Effort Index to enable countries, program implementers, and donors to more readily assess and measure national HRH inputs and potentially to predict workforce performance, service use, and quality. [from abstract]

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]

Our research brings mixed findings on the effectiveness of user fee subsidisation as a strategy to increase the utilisation of services. Future work should focus on feasibility issues associated with the removal or reduction of user fees and how to sustain its effects on utilisation in the longer term. [from abstract]

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]

Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH) to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF).

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 health sector is characterized by a human resource base lacking in numbers, specialized skills, and management skills. West African Health Organization (WAHO) recognizes the need within the West Africa sub-region for bilingual professionals who are skilled in public health, management, leadership, and information technology to build human capacity in public health and developed the Young Professionals Internship Program (YPIP). Our study explores the evolution of the programme. [from abstract]

This study was undertaken to assess perceived service quality in hospitals located in the Greater Accra Region of Ghana. The research was a cross-sectional survey which employed the use of a modified SERVQUAL questionnaire that was administered to 400 outpatients in the Greater Accra region of Ghana. Data obtained from the study was analyzed quantitatively using descrip
tive statistics, exploratory factor analysis and multiple regressions. [from abstract]

The Chatham House Working Group on Health Governance was formed to consider, in the first instance, the role of the World Health Organization (WHO) in the international system that supports global health. This was done in the knowledge that the WHO had recently embarked on a programme of reform, which had its roots in the acute funding pressures that it was experiencing. It was therefore
envisaged as a complementary exercise to the internal reform process. [from preface]

This study investigates patient views of physicians (Medical Officers) and NPCs in terms of patient satisfaction, perceived quality, and provider trust. [from abstract]

Many low and middle-income countries have pluralistic health systems with a variety of providers of health-related goods and services in terms of their level of training, their ownership (public or private) and their relationship with the regulatory system. The development of institutional arrangements to influence their performance has lagged behind the spread of these markets. This paper presents a framework for analysing a pluralistic health system. [adapted 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]

The objective of this study is to provide information on the current state of physician tracking systems in the region, highlighting emerging themes and innovative practices. [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 directive outlines the systematic organization of the fragmented continuing professional development (CPD) activities of health professionals in Ethiopia and describes the CPD requirements and roles for health workers and the government offices responsible for standardizing and accrediting CPD and health worker licensing. [adapted from author]

With the ultimate aim of improving the health status of Ethiopians through the delivery of quality health services by competent health professionals, this guideline helps to establish a CPD system in the country through outlining the process of accreditation of CPD courses and CPD providers and linking CPD with re-licensure. [from author]

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]

This brief discusses accreditation of health worker education programs, evidence on accreditation models, the importance of accreditation in the Pacific and the policy implications. [adapted from author]

This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. [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]