scholarly journals Implementing the WHO Safe Childbirth Checklist: lessons learnt on a quality improvement initiative to improve mother and newborn care at Gobabis District Hospital, Namibia

2017 ◽  
Vol 6 (2) ◽  
pp. e000145 ◽  
Author(s):  
Leonard Kabongo ◽  
Jonathon Gass ◽  
Beatrice Kivondo ◽  
Nabihah Kara ◽  
Katherine Semrau ◽  
...  
Keyword(s):  
Quality Improvement ◽  
District Hospital ◽  
Newborn Care ◽  
Quality Improvement Initiative ◽  
Lessons Learnt ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth

scholarly journals Using the WHO Safe Childbirth Checklist to Improve Essential Care Delivery as Part of the District -Wide Maternal and Newborn Health Quality Improvement Initiative, a Time Series Study

2020 ◽  
Author(s):  
Befikadu Bitewulign ◽  
Dereje Abdissa ◽  
Zewdie Mulissa ◽  
Abiyou Kiflie ◽  
Mehiret Abate ◽  
...  
Keyword(s):  
Time Series ◽  
Quality Improvement ◽  
Newborn Health ◽  
System Level ◽  
Maternal And Newborn Health ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth ◽  
Over Time ◽  
Maternal And Newborn

Abstract Background: Care bundles are a set of three to five evidence-informed practices which, when performed collectively and reliably, may improve health system performance and patient care. To date, many studies conducted to improve the quality of essential birth care practices (EBPs) have focused primarily on provider- level and have fallen short of the predicted impact on care quality, indicating that a systems approach is needed to improve the delivery of reliable quality care. This study evaluates the effectiveness of integrating the use of the World Health Organization Safe Childbirth Checklist (WHO-SCC) into a district-wide system improvement collaborative program designed to improve and sustain the delivery of EBPs as measured by "clinical bundle" adherence over-time.Methods: The WHO-SCC was introduced in the context of a district-wide Maternal and Newborn Health (MNH) collaborative quality of care improvement program in four agrarian Ethiopia regions. Three "clinical bundles" were created from the WHO-SCC: On Admission, Before Pushing, and Soon After Birth bundles. The outcome of each bundle was measured using all- or- none adherence. Adherence was assessed monthly by reviewing charts of live births.A time-series analysis was employed to assess the effectiveness of system-level interventions on clinical bundle adherence. STATA version 13.1 was used to analyze the trend of each bundle adherence overtime. Autocorrelation was checked to assess if the assumption of independence in observations collected overtime was valid. Prais-Winsten was used to minimize the effect of autocorrelation.Findings: Quality improvement interventions targeting the three clinical bundles resulted in improved adherence over time across the four regions. In Tigray region, adherence to “On Admission” bundle was increased monthly on average by B =1.39 (95% CI; 0.47 - 2.32; P<0.005).Similarly, adherence to the “Before Pushing” bundle in Southern Nations, Nationalities and People’s (SNNP) region increased monthly on average by B = 2.3 (95% CI; 0.89 - 3.74; P<0.005). Conclusion: Use of the WHO-SCC paired with a system-wide quality improvement approach improved and sustained quality of EBPs delivery. Further studies should be conducted to evaluate the impact on patient-level outcomes.

scholarly journals Quality improvement initiative: improving proportion of preterm infants on mothers only milk at the time of discharge

2019 ◽  
Vol 6 (6) ◽  
pp. 2334
Author(s):  
Sumandeep Kaur ◽  
Gurmeet Kaur ◽  
H. C. L. Rawat ◽  
Prajjwal Bansal ◽  
Amanpreet Sethi
Keyword(s):  
Quality Improvement ◽  
Birth Weight ◽  
Preterm Infants ◽  
Growth And Development ◽  
Newborn Care ◽  
Kangaroo Mother Care ◽  
Baseline Data ◽  
Quality Improvement Initiative ◽  
Intervention Phase ◽  
Level 3

Background: Availability of mothers only milk (MOM) for preterm infants is a boon for their growth and development. Authors found that in our Special Newborn Care Unit (SNCU), the availability of MOM was very less with excessive use of formula feed. So, authors planned a quality improvement (QI) study to improve availability of MOM for preterms in level 3 SNCU catering to both in-born and out-born neonates.Methods: Authors aimed to improve availability of MOM to preterm infants admitted in SNCU from the current 10% to 80% at day 7 of admission over a period of 8 weeks. Authors included preterm and mother dyads with <34 weeks of gestation or having birth weight <1800 gm. and likely to stay in SNCU for at least a week. For this initiative a QI team was formed. Baseline data was collected for a period of 3 weeks and analysis was performed of various constrains in providing MOM to preterms was later an interventional package was implemented which included counselling to mothers, Kangaroo mother care (KMC), demonstration of milk expression techniques. Intervention phase was implemented for the period of 8 weeks followed by sustenance phase for 2 months.Results: Proportion of preterm infants on MOM increased from 10% to 81% during intervention phase at day 7 of admission and remained 66% during sustenance phase.Conclusion: QI initiative has the potential to bring a tremendous change in making mothers milk available to both inborn and out-born preterms. With existing resources simple interventions can increase availability of MOM to preterm infants.

scholarly journals Using the WHO safe childbirth checklist to improve essential care delivery as part of the district-wide maternal and newborn health quality improvement initiative, a time series study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Befikadu Bitewulign ◽  
Dereje Abdissa ◽  
Zewdie Mulissa ◽  
Abiyou Kiflie ◽  
Mehiret Abate ◽  
...  
Keyword(s):  
Time Series ◽  
Quality Improvement ◽  
Newborn Health ◽  
System Level ◽  
Maternal And Newborn Health ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth ◽  
Over Time ◽  
Maternal And Newborn

Abstract Background Care bundles are a set of three to five evidence-informed practices which, when performed collectively and reliably, may improve health system performance and patient care. To date, many studies conducted to improve the quality of essential birth care practices (EBPs) have focused primarily on provider- level and have fallen short of the predicted impact on care quality, indicating that a systems approach is needed to improve the delivery of reliable quality care. This study evaluates the effect of integrating the use of the World Health Organization Safe Childbirth Checklist (WHO-SCC) into a district-wide system improvement collaborative program designed to improve and sustain the delivery of EBPs as measured by “clinical bundle” adherence over-time. Methods The WHO-SCC was introduced in the context of a district-wide Maternal and Newborn Health (MNH) collaborative quality of care improvement program in four agrarian Ethiopia regions. Three “clinical bundles” were created from the WHO-SCC: On Admission, Before Pushing, and Soon After Birth bundles. The outcome of each bundle was measured using all- or- none adherence. Adherence was assessed monthly by reviewing charts of live births. A time-series analysis was employed to assess the effectiveness of system-level interventions on clinical bundle adherence. STATA version 13.1 was used to analyze the trend of each bundle adherence overtime. Autocorrelation was checked to assess if the assumption of independence in observations collected overtime was valid. Prais-Winsten was used to minimize the effect of autocorrelation. Findings Quality improvement interventions targeting the three clinical bundles resulted in improved adherence over time across the four MNH collaborative. In Tankua Abergele collaborative (Tigray Region), the overall mean adherence to “On Admission” bundle was 86% with β = 1.39 (95% CI; 0.47–2.32; P <  0.005) on average monthly. Similarly, the overall mean adherence to the “Before Pushing” bundle in Dugna Fango collaborative; Southern Nations, Nationalities and People’s (SNNP) region was 80% with β = 2.3 (95% CI; 0.89–3.74; P <  0.005) on average monthly. Conclusion Using WHO-SCC paired with a system-wide quality improvement approach improved and sustained quality of EBPs delivery. Further studies should be conducted to evaluate the impact on patient-level outcomes.

scholarly journals Strategies to sustain a quality improvement initiative in neonatal resuscitation

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Carlien Van Heerden ◽  
Carin Maree ◽  
Elsie S. Janse van Rensburg
Keyword(s):  
Quality Improvement ◽  
Neonatal Mortality ◽  
District Hospital ◽  
Neonatal Resuscitation ◽  
World Health ◽  
Quality Improvement Initiative ◽  
Neonatal Deaths ◽  
Early Neonatal Mortality ◽  
District Hospitals ◽  
Resuscitation Training

Background: Many neonatal deaths can be prevented globally through effective resuscitation. South Africa (SA) committed towards attaining the Millennium Development Goal 4 (MDG4) set by the World Health Organization (WHO). However, SA’s district hospitals have the highest early neonatal mortality rates. Modifiable and avoidable causes associated with patient-related, administrative and health care provider factors contribute to neonatal mortality. A quality improvement initiative in neonatal resuscitation could contribute towards decreasing neonatal mortality, thereby contributing towards the attainment of the MDG4.Aim: The aim of this study was, (1) to explore and describe the existing situation regarding neonatal resuscitation in a district hospital, (2) to develop strategies to sustain a neonatal resuscitation quality improvement initiative and (3) to decrease neonatal mortality. Changes that occurred and the sustainability of strategies were evaluated.Setting: A maternity section of a district hospital in South Africa.Methods: The National Health Service (NHS) Sustainability Model formed the theoretical framework for the study. The Problem Resolving Action Research model was applied and the study was conducted in three cycles. Purposive sampling was used for the quantitative and qualitative aspects of data collection. Data was analysed accordingly.Results: The findings indicated that the strategies formulated and implemented to address factors related to neonatal resuscitation (training, equipment and stock, staff shortages, staff attitude, neonatal transport and protocols) had probable sustainability and contributed towards a reduction in neonatal mortality in the setting.Conclusion: These strategies had the probability of sustainability and could potentially improve neonatal outcomes and reduce neonatal mortality to contribute toward South Africa’s drive to attain the MDG4.

scholarly journals A case for updating the WHO Safe Childbirth Checklist to improve newborn care: Experience from seven Asia and Pacific countries

2020 ◽  
Author(s):  
Howard L. Sobel ◽  
John C. S. Murray ◽  
Priya Mannava ◽  
Matthews Mathai ◽  
Maria Asuncion A. Silvestre
Keyword(s):  
Newborn Care ◽  
Care Experience ◽  
Safe Childbirth Checklist ◽  
Safe Childbirth

scholarly journals Ethiopian Pediatric Society Quality Improvement Initiative: a pragmatic approach to facility-based quality improvement in low-resource settings

2021 ◽  
Vol 10 (1) ◽  
pp. e000927
Author(s):  
Jacquelyn Patterson ◽  
Bogale Worku ◽  
Denise Jones ◽  
Alecia Clary ◽  
Rohit Ramaswamy ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Addis Ababa ◽  
Contextual Factors ◽  
Newborn Care ◽  
Secondary Outcome ◽  
Quality Improvement Initiative ◽  
Pragmatic Approach ◽  
Low Resource Settings ◽  
Low Resource ◽  
Pediatric Society

ObjectivesTo describe critical features of the Ethiopian Pediatric Society (EPS) Quality Improvement (QI) Initiative and to present formative research on mentor models.SettingGeneral and referral hospitals in the Addis Ababa area of Ethiopia.ParticipantsEighteen hospitals selected for proximity to the EPS headquarters, prior participation in a recent newborn care training cascade and minimal experience with QI.InterventionsEducation in QI in a 2-hour workshop setting followed by implementation of a facility-based QI project with the support of virtual mentorship or in-person mentorship.Primary and secondary outcome measuresPrimary outcome—QI progress, measured using an adapted Institute for Healthcare Improvement Scale; secondary outcome—contextual factors affecting QI success as measured by the Model for Understanding Success in Quality.ResultsThe dose and nature of mentoring encounters differed based on a virtual versus in-person mentoring approach. All QI teams conducted at least one large-scale change. Education of staff was the most common change implemented in both groups. We did not identify contextual factors that predicted greater QI progress.ConclusionsThe EPS QI Initiative demonstrates that education in QI paired with external mentorship can support implementation of QI in low-resource settings. This pragmatic approach to facility-based QI may be a scalable strategy for improving newborn care and outcomes. Further research is needed on the most appropriate instruments for measuring contextual factors in low/middle-income country settings.

scholarly journals Quality Improvement Initiative to Improve Hand Hygiene Compliance in Indian Special Newborn Care Unit

2021 ◽  
Vol 6 (6) ◽  
pp. e492
Author(s):  
Reena Rai ◽  
Amanpreet Sethi ◽  
Amarpreet Kaur ◽  
Gurmeet Kaur ◽  
Harsh Vardhan Gupta ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Newborn Care ◽  
Quality Improvement Initiative ◽  
Improve Hand Hygiene ◽  
Hygiene Compliance
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