scholarly journals Perspectives on implementing a quality improvement collaborative to improve person-centered care for maternal and reproductive health in Kenya

2020 ◽  
Vol 32 (10) ◽  
pp. 671-676
Author(s):  
Katie Giessler ◽  
Avery Seefeld ◽  
Dominic Montagu ◽  
Beth Phillips ◽  
James Mwangi ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Health Facilities ◽  
Perceived Benefits ◽  
Structured Interviews ◽  
Quality Improvement Collaborative ◽  
High Quality ◽  
Public Health Facilities ◽  
Person Centered Care ◽  
Centered Care

Absrtact Objective To understand perspectives and experiences related to participation in a quality improvement collaborative (QIC) to improve person-centered care (PCC) for maternal health and family planning (FP) in Kenya. Design and setting Semi-structured qualitative interviews were conducted with members of the QIC in four public health facilities in Kenya. Participants Clinical and nonclinical public health facility staff who had participated in the QIC were purposively sampled to participate in the semi-structured interviews. Intervention A QIC was implemented across four public health facilities in Nairobi and Kiambu Counties in Kenya to improve PCC experiences for women seeking maternity or FP services. Main outcome measure Semi-structured interviews with participants of the QIC to understand perspectives and experiences associated with sensitization to and implementation of PCC behaviors in maternity and FP services. Results Respondents reported that sensitization to PCC principles resulted in multiple perceived benefits for staff and patients alike, including improved interactions with patients and clients, deeper awareness of patient and client preferences, and improved interpersonal skills and greater job satisfaction. Respondents also highlighted system-level challenges that impeded their ability to consistently provide high-quality PCC to women, namely staff shortages and frequent turnover, high patient volumes and lack of space in their respective health facilities. Conclusion Respondents were easily able to articulate perceived benefits derived from participation in this QIC, although they were equally able to identify challenges that hindered their ability to consistently provide high-quality PCC to women seeking maternity or FP services.

Mentoring of Community Service Nurses: Nurse Managers’ Perceptions

2020 ◽  
Vol 21 (2) ◽  
Author(s):  
Sisinyana Hannah Khunou
Keyword(s):  
Public Health ◽  
Community Service ◽  
Qualitative Data ◽  
Nurse Managers ◽  
Health Facilities ◽  
Structured Interviews ◽  
Group Discussions ◽  
North West ◽  
Public Health Facilities ◽  
The North

Community service nurses (CSNs) are newly qualified nurses (NQNs) with the least experience and who need constant support and mentoring. They experience numerous challenges, which include the lack of confidence, and feelings of incompetence and inadequacy. These challenges contribute to a difficult transition from the role of a student nurse to that of a professional nurse. This article reports on the qualitative data of a study conducted by Khunou and Rakhudu. The purpose of the study was to explore and describe the perceptions of nurse managers (NMs) regarding the mentoring of CSNs in public health facilities in the North West province (NWP) of South Africa. A qualitative, exploratory, descriptive and contextual research design was used to explore and describe the NMs’ perceptions regarding the mentoring of the CSNs. Three focus group discussions for 20 NMs and 7 individual semi-structured interviews were conducted. A tape recorder was used to capture the NMs’ perceptions regarding the mentoring of CSNs in public health facilities of the NWP. Tesch’s method of data analysis was used to analyse the collected qualitative data. The study revealed the following themes: CSNs lack skills; CSNs are mentored; and both CSNs and NMs have mentoring needs. These themes were supported by the following categories: CSNs lack practical skills; CSNs lack professional responsibility; CSNs lack confidence; CSNs are supported; CSNs need orientation; and CSNs need mentoring to bridge the practice-theory gap. NMs also need to be supported.

scholarly journals Whole-Person, Whole-Team Approach to Quality Improvement: Why Person-Centered Care Matters

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 267-267
Author(s):  
Ryann Engle ◽  
A Lynn Snow ◽  
Valerie Clark ◽  
Shibei Zhao ◽  
Christopher Gillespie ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Homes ◽  
Team Approach ◽  
Post Intervention ◽  
High Quality ◽  
Frontline Staff ◽  
Individualized Care ◽  
Person Centered Care ◽  
Whole Person ◽  
Centered Care

Abstract The Department of Veterans Affairs (VA) began its culture transformation journey in 2006, supporting its nursing homes in providing high-quality, person-centered care in person-centered environments. We implemented a quality improvement intervention to support frontline staff from low-performing VA nursing homes in providing high-quality care using a whole-person, whole-team approach. The intervention consisted of a bundle with four components: 1) specialized frontline staff huddles that encouraged high-quality frontline staff communication and collaboration, 2) micro-root cause analyses and targeted interventions to promote resident sleep and reduce resident falls through individualized care, 3) in-depth frontline conversations regarding residents’ distress behaviors and mobility, and 4) targeted, team-based, person-centered performance improvement projects. The intervention was implemented at 8 low-performing VA nursing homes (August 2018 - April 2019) via in-person and virtual sessions and facilitated through CLC-based champions and intervention team-based coaches. We monitored the intervention’s impact using pre-post Centers for Medicare and Medicaid Services quality star ratings. We also conducted 17 post-intervention interviews with key informants at 7 participating nursing homes and conducted a content analysis of the data. Pre intervention, all 8 nursing homes had a history of being 1 or 2 stars in overall quality. Post intervention, 3 homes increased 1 star; 1 home increased 2 stars; 2 homes increased 3 stars; 2 homes increased 4 stars. Post intervention, participants perceived improved delivery of person-centered care (e.g., providing individualized sleep hygiene, de-implementing alarms). Our findings suggest a whole-person, whole-team intervention can effectively and efficiently improve both person-centered care and care quality.

scholarly journals Strengthening the use of partograph in high caseload public health facilities in India through an integrated quality improvement approach

2020 ◽  
Vol 45 (4) ◽  
pp. 486
Author(s):  
Enisha Sarin ◽  
Devina Bajpayee ◽  
Saumyadripta Chaudhuri ◽  
SouravGhosh Dastidar ◽  
Anil Gupta ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Health Facilities ◽  
Public Health Facilities

scholarly journals Provider-perceived benefits and constraints of complete adherence to antenatal care guideline among public health facilities, Ethiopia: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255297
Author(s):  
Tewodros Seyoum ◽  
Mekuriaw Alemayehu ◽  
Kyllike Christensson ◽  
Helena Lindgren
Keyword(s):  
Public Health ◽  
Health Care ◽  
Qualitative Study ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Health Facilities ◽  
Perceived Benefits ◽  
Care Providers ◽  
Public Health Facilities ◽  
Gondar Town

Background In Ethiopia, health care providers’ level of adherence to the national Antenatal Care (ANC) guideline is relatively low. The reasons why they do not follow the guidelines are not well known. Therefore, this study aimed to explore the provider-perceived benefits and constraints associated with using the guideline for ANC in public health facilities in Gondar town. Methods A qualitative study was conducted using a semi-structured interview guide. The interview was conducted among a purposive sample of nine health care providers working in four public health facilities in Gondar town. After the interviews were transcribed and coded, a content analysis was done using Atlas ti version 7.5 software packages. Result Decreasing provider’s workload and maximizing performance, improving safe motherhood, and improving the process of service delivery were reported as the perceived benefits of following ANC guideline. Organizational problems, care providers’ existing knowledge, attitude, and skills and availability of training and mentorship were the three main identified groups of factors that hinder complete providers’ adherence to ANC guideline. Conclusion Although providers acknowledged the benefits of following ANC guideline, the guideline is not fully implemented. Refresher training should be given at the start of the updated eight-contact ANC guideline and continuing education and supervision throughout the implementation process. Health care providers call for profound and urgent revisions of the supply chain system for supplies and equipment.

scholarly journals Effectiveness of a quality improvement intervention to increase adherence to key practices during female sterilization services in Chhattisgarh and Odisha states of India

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244088
Author(s):  
Ashish Srivastava ◽  
Geeta Chhibber ◽  
Neeta Bhatnagar ◽  
Angela Nash-Mercado ◽  
Jyoti Samal ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Service Providers ◽  
Health Facilities ◽  
Quality Improvement Intervention ◽  
Female Sterilization ◽  
Public Health Facilities ◽  
Operative Care ◽  
Urine Testing ◽  
The Impact

Background In response to longstanding concerns around the quality of female sterilization services provided at public health facilities in India, the Government of India issued standards and quality assurance guidelines for female sterilization services in 2014. However, implementation remains a challenge. The Maternal and Child Survival Program rolled out a package of competency-based trainings, periodic mentoring, and easy-to-use job aids in parts of five states to increase service providers’ adherence to key practices identified in the guidelines. Methods The study employed a before-and-after quasi-experimental design with a matched comparison arm to examine the effect of the intervention on provider practices in two states: Odisha and Chhattisgarh. Direct observations of female sterilization services were conducted in selected public health facilities, using a checklist of 30 key practices, at two points in time. Changes in adherence to key practices from baseline to endline were compared at 12 intervention and 12 comparison facilities using a difference in difference analysis. Results Several key practices were well-established prior to the intervention, with adherence levels over 90% at baseline, including hemoglobin and urine testing, use of sterile surgical gloves and instruments, and recommended surgical technique. However, adherence to many other practices was extremely low at baseline. The program significantly increased adherence to nine practices, including those related to ascertaining client’s medical eligibility, client-provider interaction, the consent process, and post-operative care. The greatest improvement was observed in the provision of written instructions for clients prior to discharge. At endline, however, adherence remained below 50% for 14 practices. Conclusion Low adherence to key practices at baseline confirmed the need for quality improvement interventions in female sterilization services. While the intervention improved adherence to certain practices around admission and post-operative care, inadequate human resources and infrastructure, among other factors, may have blunted the impact of the intervention.

scholarly journals Provider-Perceived Benefits and Constraints of Complete Adherence to Antenatal Care Guideline Among Public Health Facilities, Ethiopia: A Qualitative Study

2020 ◽  
Author(s):  
Tewodros Seyoum ◽  
Mekuriaw Alemayehu ◽  
Kyllike Christensson ◽  
Helena Lindgren
Keyword(s):  
Public Health ◽  
Health Care ◽  
Qualitative Study ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Health Facilities ◽  
Perceived Benefits ◽  
Care Providers ◽  
Public Health Facilities ◽  
Gondar Town

Abstract Background: In Ethiopia, health care providers’ level of adherence to the national Antenatal Care (ANC) guideline is relatively low. The reasons why they do not follow the guidelines are not well known. Therefore, this study aimed to explore the provider-perceived benefits and constraints associated with using the guideline for ANC in public health facilities in Gondar town.Methods: A qualitative study was conducted using a semi-structured interview guide. The interview was conducted among a purposive sample of nine health care providers working in four public health facilities in Gondar town. After the interviews were transcribed and coded, a content analysis was done using Atlas ti version 7.5 software packages.Result: Decreasing provider’s workload and maximizing performance, improving safe motherhood, and improving the process of service delivery were reported as the perceived benefits of following ANC guideline. Organizational problems, care providers' existing knowledge, attitude, and skills and availability of training and mentorship were the three main identified groups of factors that hinder complete providers’ adherence to ANC guideline.Conclusion: Although providers acknowledged the benefits of following ANC guideline, the guideline is not fully implemented. Refresher training should be given at the start of the updated eight-contact ANC guideline and continuing education and supervision throughout the implementation process. Health care providers call for profound and urgent revisions of the supply chain system for supplies and equipment.

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