P-OBS/GYN-S-121 Technicity Index as a Quality of Care Assessment Tool for the Evaluation of Hysterectomy Rates in a University Hospital Centre

Abstract Background Teamwork is fundamental to ensuring the quality of care and patient safety in operating rooms. It has been shown that the occurrence of adverse events is closely linked to a poor quality of teamwork in these settings. Thus, this study aimed to assess teamwork in different operating rooms of the university hospital of Sahloul Sousse (Tunisia). Methods It is a descriptive cross-sectional study with convenience sampling, conducted in operating rooms of the university hospital of Sahloul Sousse (Tunisia) between February and April 2018. The measuring instrument was the validated observation grid 'Communication and Teamwork Skills Assessment Tool (CATS) '. Teamwork is assessed through 4 domains (Situation awareness, Coordination, Communication, Cooperation). Behaviors are marked in rows each time they occur and are rated for quality in columns labeled “Observed and Good,” “Variation in Quality” (meaning incomplete or of variable quality), and “Expected but not Observed.” Results A total of 51 interventions were observed. Good coordination between the team members was noted, as well as good cooperation within the teams. A variation of quality level of communication with the patient was noted in 31.4% of cases, also communication about the context, the situation and recommendation among caregivers is not quite good with a percentage of 39.2%. Moreover, the work environment was rated as good in 84.3% of cases. Conclusions Some failures in teamwork were noted, hence it is important to take corrective measures for better practice and better patient management in such a complex environment, the operating rooms, where there is a strong need for team coordination. Key messages There is a direct relationship between the quality of care and the effectiveness of teamwork. It is necessary to eliminate the barriers to communication, in order to prevent adverse events.

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Assessing Quality of Newborn Care at District Facilities in Malawi

10.21203/rs.2.15647/v3 ◽

2020 ◽

Author(s):

Kondwani Kawaza ◽

Mai-Lei Woo Kinshella ◽

Tamanda Hiwa ◽

Jenala Njirammadzi ◽

Mwai Banda ◽

...

Keyword(s):

Quality Of Care ◽

Assessment Tool ◽

Newborn Care ◽

Neonatal Care ◽

District Level ◽

Sub Saharan Africa ◽

Standards Of Care ◽

District Hospitals ◽

Care Assessment

Abstract Background: Malawi is celebrated as one of the few countries in sub-Saharan Africa to meet the Millennium Development Goal of reducing under-5 mortality by two-thirds between 1990 and 2015. However, within this age range neonatal mortality rates are the slowest to decline, even though rates of facility births are increasing. Examining the quality of neonatal care at district-level facilities where most deliveries occur is warranted. Objective: The objective of this paper is to evaluate the quality of neonatal care in three district hospitals and one primary health centre in southern Malawi as well as to report the limitations and lessons learned on using the WHO integrated quality of care assessment tool. Methodology: These facility assessments were part of the “Integrating a neonatal healthcare package for Malawi” project, a part of the Innovating for Maternal and Child Health in Africa (IMCHA) initiative. The WHO integrated quality of care assessment tool was used to assess quality of care and availability and quantity of supplies and resources. The modules on infrastructure, neonatal care and labour and delivery were included. Facility assessments were administered in November 2017 and aspects of care were scored on a Likert scale from one to five (a score of 5 indicating compliance with WHO standards of care; one as lowest indicating inadequate care). Results: The continuum of labour, delivery and neonatal care were assessed to identify areas that required improvements to meet standards of care. Critical areas for improvements included infection control (mean score 2.9), equipment, supplies and setup for newborn care in the labor ward (2.3), in the surgical theater (3.3), and nursery (3.4 nursery facilities, 3.0 supplies and equipment), as well as for management of sick newborns (3.2), monitoring and follow-up (3.6). Only one of the 12 domains, laboratory, met the standards of care with only minor improvements needed (4.0). Conclusion: The WHO integrated quality of care assessment tool is a validated tool that can shed light on the complex quality of care challenges faced by district-level health facilities. The results reveal that the quality of care needs improvement, particularly for sick and vulnerable newborns.

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Quality of care for patients with Diabetes Mellitus in the More Doctors Program, in a municipality in the metropolitan region of Recife (PE), Brazil

Saúde em Debate ◽

10.1590/0103-1104202012508i ◽

2020 ◽

Vol 44 (125) ◽

pp. 384-399

Author(s):

Maria da Penha Rodrigues dos Santos ◽

Maria do Socorro Veloso de Albuquerque ◽

Tereza Maciel Lyra ◽

Antonio da Cruz Gouveia Mendes ◽

Fabiana Letícia da Silva ◽

...

Keyword(s):

Diabetes Mellitus ◽

Primary Care ◽

Quality Of Care ◽

Assessment Tool ◽

Metropolitan Region ◽

Care Assessment ◽

Patients With Diabetes ◽

Primary Care Assessment Tool

RESUMO Avaliou-se a qualidade da atenção aos pacientes com diabetes nas equipes do Programa Mais Médicos. Tratou-se de um estudo quantitativo, transversal, realizado em Goiana, Pernambuco, entre novembro de 2016 e agosto de 2017. Utilizaram-se entrevistas estruturadas a partir do Primary Care Assessment Tool. Foram entrevistados 41 profissionais de Equipes de Saúde da Família ligadas ao Programa Mais Médicos e 437 usuários com Diabetes Mellitus acompanhados por essas equipes. Os achados demonstram que a presença regular dos médicos pode ter ocasionado bons resultados quanto à longitudinalidade (usuários: 7,1; profissionais: 8,2) e à utilização dos serviços (usuários: 8,5). A qualidade do componente sistema de informações (usuários: 7,6; profissionais: 9,2) indica preenchimento e disponibilidade de informações sobre pacientes. Deficiência estrutural do município pode ter contribuído para o baixo desempenho da acessibilidade (usuários: 3,6; profissionais: 3,9). Resultados insatisfatórios para orientação familiar (4,6) e comunitária (2,88), segundo usuários, reforçam a necessidade de fortalecimento desses atributos, peculiares à Estratégia Saúde da Família. Ademais, por tratar-se de um programa, existe a possibilidade de sua descontinuidade, sobretudo no cenário da Emenda Constitucional nº 95, de 2016, podendo comprometer o acesso e a continuidade dos cuidados, especialmente aos usuários com doenças crônicas que utilizam frequentemente o sistema de saúde.

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Quality of care assessment and adherence to the international guidelines considering dialysis, water treatment, and protection against transmission of infections in university hospital-based dialysis units in Cairo, Egypt

Hemodialysis International ◽

10.1111/j.1542-4758.2009.00398.x ◽

2010 ◽

Vol 14 (1) ◽

pp. 61-67 ◽

Cited By ~ 10

Author(s):

Salwa IBRAHIM

Keyword(s):

Quality Of Care ◽

Water Treatment ◽

University Hospital ◽

International Guidelines ◽

Care Assessment ◽

Dialysis Water

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Assessing Quality of Newborn Care at District Facilities in Malawi

10.21203/rs.2.15647/v1 ◽

2019 ◽

Author(s):

Kondwani Kawaza ◽

Mai-Lei Woo Kinshella ◽

Tamanda Hiwa ◽

Jenala Njirammadzi ◽

Mwai Banda ◽

...

Keyword(s):

Quality Of Care ◽

Assessment Tool ◽

Newborn Care ◽

Neonatal Care ◽

District Level ◽

Sub Saharan Africa ◽

Standards Of Care ◽

District Hospitals ◽

Care Assessment

Abstract Background: Malawi is celebrated as one of the few countries in sub-Saharan Africa to meet the Millennium Development Goal of reducing under-5 mortality by two-thirds between 1990 and 2015. However, within this age range neonatal mortality rates are the slowest to decline, even though rates of facility births are increasing. Examining the quality of neonatal care at district level facilities where most deliveries occur is warranted. Objective: The objective of this paper is to evaluate the quality of neonatal care in three district hospitals and one primary health centre in southern Malawi as well as to report the limitations and lessons learned on using the WHO integrated quality of care assessment tool. Methodology: These facility assessments were part of the “Integrating a neonatal healthcare package for Malawi” project, a part of the Innovating for Maternal and Child Health in Africa (IMCHA) initiative. The WHO integrated quality of care assessment tool was used to comprehensively assess quality of care in addition to availability and quantity of supplies and resources. Because this study focused on neonatal care, the modules on infrastructure, neonatal care and labour and delivery were included. Facility assessments were administered in November 2017. Results: The continuum of labour, delivery and neonatal care were all assessed and areas that required improvements to meet standards of care were identified. Critical areas for improvements included the facilities for delivery, including operations and newborn care; for equipment and supplies; for neonatal case management, including sick newborns and routine monitoring and follow-up. Only one of the 12 domains, laboratory, met the standards of care with only minor improvements needed. Conclusion: The WHO integrated quality of care assessment tool is a validated tool that can shed light on the complex quality of care challenges faced by district level health facilities. The results reveal that the quality of care needs improvement, particularly for sick and vulnerable newborns.

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Evaluation of the health attention to pregnant women with HIV: comparison between primary and specialized service

Escola Anna Nery ◽

10.1590/2177-9465-ean-2018-0258 ◽

2019 ◽

Vol 23 (2) ◽

Author(s):

Raquel Einloft Kleinubing ◽

Daniel Gonzalo Eslava ◽

Stela Maris de Mello Padoin ◽

Cristiane Cardoso de Paula

Keyword(s):

Primary Care ◽

Health Care ◽

Quality Of Care ◽

Pregnant Women ◽

Assessment Tool ◽

Cross Sectional ◽

Care Assessment ◽

Specialized Care ◽

Women With Hiv

ABSTRACT The public network for health care of pregnant women with HIV, in Santa Maria, Rio Grande do Sul/Brazil, includes primary and specialized care services. Objective: Evaluating whether the type of service interferes in the quality score of the health care in the experience of the pregnant women with HIV. Methods: Cross-sectional study, with data collection from April-November/2014, with 78 participants. The Primary Care Assessment Tool-Brazil instrument was applied and the Pearson's Chi-square test and Fisher's exact test were used. Results: The quality of care received was evaluated as unsatisfactory both in primary care (6.50) and in specialized care (6.35). Conclusion: The type of service interferes with the quality of care, which can affect women's choice of service. It is necessary to improve the quality of both types of services and to search for the management of shared care to attend both the usual care of gestation and the specificity of infection.

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Assessing Quality of Newborn Care at District Facilities in Malawi

10.21203/rs.2.15647/v2 ◽

2020 ◽

Author(s):

Kondwani Kawaza ◽

Mai-Lei Woo Kinshella ◽

Tamanda Hiwa ◽

Jenala Njirammadzi ◽

Mwai Banda ◽

...

Keyword(s):

Quality Of Care ◽

Assessment Tool ◽

Newborn Care ◽

Neonatal Care ◽

District Level ◽

Sub Saharan Africa ◽

Standards Of Care ◽

District Hospitals ◽

Care Assessment

Abstract Background: Malawi is celebrated as one of the few countries in sub-Saharan Africa to meet the Millennium Development Goal of reducing under-5 mortality by two-thirds between 1990 and 2015. However, within this age range neonatal mortality rates are the slowest to decline, even though rates of facility births are increasing. Examining the quality of neonatal care at district-level facilities where most deliveries occur is warranted. Objective: The objective of this paper is to evaluate the quality of neonatal care in three district hospitals and one primary health centre in southern Malawi as well as to report the limitations and lessons learned on using the WHO integrated quality of care assessment tool. Methodology: These facility assessments were part of the “Integrating a neonatal healthcare package for Malawi” project, a part of the Innovating for Maternal and Child Health in Africa (IMCHA) initiative. The WHO integrated quality of care assessment tool was used to assess quality of care and availability and quantity of supplies and resources. The modules on infrastructure, neonatal care and labour and delivery were included. Facility assessments were administered in November 2017 and aspects of care were scored on a Likert scale from one to five (a score of 5 indicating compliance with WHO standards of care; one as lowest indicating inadequate care). Results: The continuum of labour, delivery and neonatal care were assessed to identify areas that required improvements to meet standards of care. Critical areas for improvements included infection control (mean score 2.9), equipment, supplies and setup for newborn care in the labor ward (2.3), in the surgical theater (3.3), and nursery (3.4 nursery facilities, 3.0 supplies and equipment), as well as for management of sick newborns (3.2), monitoring and follow-up (3.6). Only one of the 12 domains, laboratory, met the standards of care with only minor improvements needed (4.0). Conclusion: The WHO integrated quality of care assessment tool is a validated tool that can shed light on the complex quality of care challenges faced by district-level health facilities. The results reveal that the quality of care needs improvement, particularly for sick and vulnerable newborns.

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Gender discrimination as a barrier to high-quality maternal and newborn health care in Nigeria: findings from a cross-sectional quality of care assessment

BMC Health Services Research ◽

10.1186/s12913-021-06204-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chioma Oduenyi ◽

Joya Banerjee ◽

Oniyire Adetiloye ◽

Barbara Rawlins ◽

Ugo Okoli ◽

...

Keyword(s):

Quality Of Care ◽

Family Planning ◽

Health Services ◽

Gender Discrimination ◽

Newborn Health ◽

Maternal And Newborn Health ◽

Gender Based Violence ◽

Cross Sectional ◽

Care Assessment

Abstract Background Poor reproductive, maternal, newborn, child, and adolescent health outcomes in Nigeria can be attributed to several factors, not limited to low health service coverage, a lack of quality care, and gender inequity. Providers’ gender-discriminatory attitudes, and men’s limited positive involvement correlate with poor utilization and quality of services. We conducted a study at the beginning of a large family planning (FP) and maternal, newborn, child, and adolescent health program in Kogi and Ebonyi States of Nigeria to assess whether or not gender plays a role in access to, use of, and delivery of health services. Methods We conducted a cross-sectional, observational, baseline quality of care assessment from April–July 2016 to inform a maternal and newborn health project in health facilities in Ebonyi and Kogi States. We observed 435 antenatal care consultations and 47 births, and interviewed 138 providers about their knowledge, training, experiences, working conditions, gender-sensitive and respectful care, and workplace gender dynamics. The United States Agency for International Development’s Gender Analysis Framework was used to analyze findings. Results Sixty percent of providers disagreed that a woman could choose a family planning method without a male partner’s involvement, and 23.2% of providers disagreed that unmarried clients should use family planning. Ninety-eight percent believed men should participate in health services, yet only 10% encouraged women to bring their partners. Harmful practices were observed in 59.6% of deliveries and disrespectful or abusive practices were observed in 34.0%. No providers offered clients information, services, or referrals for gender-based violence. Sixty-seven percent reported observing or hearing of an incident of violence against clients, and 7.9% of providers experienced violence in the workplace themselves. Over 78% of providers received no training on gender, gender-based violence, or human rights in the past 3 years. Conclusion Addressing gender inequalities that limit women’s access, choice, agency, and autonomy in health services as a quality of care issue is critical to reducing poor health outcomes in Nigeria. Inherent gender discrimination in health service delivery reinforces the critical need for gender analysis, gender responsive approaches, values clarification, and capacity building for service providers.

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Patient Satisfaction and Short-Term Outcome in Elective Cranial Neurosurgery

Neurosurgery ◽

10.1227/neu.0000000000000931 ◽

2015 ◽

Vol 77 (5) ◽

pp. 769-776 ◽

Cited By ~ 11

Author(s):

Elina Reponen ◽

Hanna Tuominen ◽

Juha Hernesniemi ◽

Miikka Korja

Keyword(s):

Patient Satisfaction ◽

Quality Of Care ◽

Health Status ◽

Patient Experience ◽

University Hospital ◽

Term Outcome ◽

Major Morbidity ◽

Patient Reported ◽

Relationship Of

Abstract BACKGROUND: Patient-reported experience is often used as a measure for quality of care, but no reports on patient satisfaction after cranial neurosurgery exist. OBJECTIVE: To study the association of overall patient satisfaction and surgical outcome and to evaluate the applicability of overall patient satisfaction as a proxy for quality of care in elective cranial neurosurgery. METHODS: We conducted an observational study on the relationship of overall patient satisfaction at 30 postoperative days with surgical and functional outcome (modified Rankin Scale [mRS] score) in a prospective, consecutive, and unselected cohort of 418 adult elective craniotomy patients enrolled between December 2011 and December 2012 at Helsinki University Hospital, Helsinki, Finland. RESULTS: Postoperative overall (subjective and objective) morbidity was present in 194 (46.4%) patients; yet almost 94% of all study patients reported high overall satisfaction. Low overall patient satisfaction at 30 days was not associated with postoperative major morbidity in elective cranial neurosurgery. Dependent functional status (mRS score ≥3) at 30 days, minor infections, poor postoperative subjective overall health status, and patient-reported severe symptoms (double vision, poor balance) may contribute to unsatisfactory patient experience. CONCLUSION: Overall patient satisfaction with elective cranial neurosurgery is high. Even 9 of 10 patients with postoperative major morbidity rated high overall patient satisfaction at 30 days. Overall patient satisfaction may merely reflect patient experience and subjective postoperative health status, and therefore it is a poor proxy for quality of care in elective cranial neurosurgery.

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