The role of the PMA and barriers to the successful implementation of restorative clinical supervision

Recognition of systematic and structural areas of concern has led to significant changes to midwifery supervision to meet the needs of midwives and the service as a whole. The A-EQUIP (Advocating for Education and QUality ImProvement) model was created to enhance the emotional and physical wellbeing of those providing care and in turn the quality of care provided to women and their families. It is deployed by professional midwifery advocates (PMAs), who have undergone training to deliver restorative clinical supervision. This article aims to critically review the implementation of restorative clinical supervision in practice, examining the potential challenges to the successful implementation of the A-EQUIP model.

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Quality of Care in Pediatrics and Health Disparities: The Increasing Role of Quality Improvement Science

SpringerBriefs in Public Health - Disparities in Child Health ◽

10.1007/978-3-030-03210-4_2 ◽

2018 ◽

pp. 11-23

Author(s):

Jean L. Raphael ◽

Elissa Z. Faro ◽

Suzette O. Oyeku

Keyword(s):

Health Disparities ◽

Quality Improvement ◽

Quality Of Care ◽

Improvement Science

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Clients' understanding of the role of nurse practitioners

Australian Health Review ◽

10.1071/ah09688 ◽

2010 ◽

Vol 34 (1) ◽

pp. 59 ◽

Cited By ~ 19

Author(s):

Jane Allnutt ◽

Nissa Allnutt ◽

Rose McMaster ◽

Jane O'Connell ◽

Sandy Middleton ◽

...

Keyword(s):

Health Care ◽

Quality Of Care ◽

Nurse Practitioners ◽

Response Rate ◽

Urban Setting ◽

Successful Implementation ◽

Positive Contribution ◽

Australian Health

Nurse practitioners (NPs) have an emerging role in the Australian health care system. However, there remains a dearth of data about public understanding of the NP role. The aim of this study was to evaluate clients’ understanding of the role of the NP and their satisfaction with education received, quality of care and NP knowledge and skill. All authorised NPs working in a designated NP position in Western Australia and those working in three area health services in New South Wales were invited to recruit five consecutive clients to complete the self-administered survey. Thirty-two NPs (NP response rate 93%) recruited 129 clients (client response rate 90%). Two-thirds of clients (63%) were aware they were consulting an NP. The majority rated the following NP-related outcomes as ‘excellent’ or ‘very good’: education provided (89%); quality of care (95%); and knowledge and skill (93%). Less than half reported an understanding that NPs could prescribe medications (40.5%) or interpret X-rays (33.6%). Clients of NPs practising in a rural or remote setting were more likely than those in an urban setting to have previously consulted an NP (P = 0.005), and where applicable would to prefer to see an NP rather than a doctor (P = 0.022). Successful implementation and expansion of the NP role requires NP visibility in the community. Despite high levels of satisfaction, more awareness of the scope of the NP role is required. What is known about the topic?The role of nurse practitioners (NPs) in Australian health care is diverse and evolving. There is a dearth of research focusing on NPs, particularly looking at the client perception of their role. What does this paper add?This study investigates the client’s perception of the role of nurse practitioners and levels of confidence and satisfaction through the use of a self-administered questionnaire. What are the implications for practitioners?The results suggest that clients have a moderate awareness of the nurse practitioner role. Despite this, clients appear to have high levels of confidence and satisfaction after consultations with nurse practitioners. These results suggest that greater community awareness of the role may help maximise their positive contribution to health care in Australia.

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Going operational with health systems governance: supervision and incentives to health workers for increased quality of care in Tanzania

Health Policy and Planning ◽

10.1093/heapol/czz104 ◽

2019 ◽

Vol 34 (Supplement_2) ◽

pp. ii77-ii92 ◽

Cited By ~ 1

Author(s):

Igor Francetic ◽

Fabrizio Tediosi ◽

Paola Salari ◽

Don de Savigny

Keyword(s):

Quality Improvement ◽

Patient Satisfaction ◽

Quality Of Care ◽

Health Facility ◽

Health Systems ◽

Financial Incentives ◽

Health Workers ◽

Healthcare Quality

Abstract Improving the quality of care is increasingly recognized as a priority of health systems in low- and middle-income countries. Given the labour-intensive nature of healthcare interventions, quality of care largely depends upon the number, training and management of health workers involved in service delivery. Policies available to boost the performance of health workers—and thus the quality of healthcare—include regulation, incentives and supervision—all of which are typically included in quality improvement frameworks and policies. This was the case in Tanzania, where we assessed the role of selected quality improvement policies. To do so, we analysed data from a representative sample of Tanzanian government-managed health facilities, part of the 2014/15 Service Provision Assessment component of the Demographic and Health Survey. We constructed two healthcare quality indicators from data on patient visits: (1) compliance with Integrated Management of Childhood Illness (IMCI) guidelines and (2) patient satisfaction. Using multilevel ordered logistic regression models, we estimated the associations between the outcomes and selected indicators of incentives and supervisory activity at health worker and health facility level. We did not identify any association for the different indicators of top-down supervision at facility and individual level, neither with IMCI compliance nor with patients’ satisfaction. Bottom-up supervision, defined as meetings between community and health facility staff, was significantly associated with higher patient satisfaction. Financial incentives in the form of salary top-ups were positively associated with both IMCI compliance and patient satisfaction. Both housing allowances and government-subsidized housing were positively associated with our proxies of quality of care. Good healthcare quality is crucial for promoting health in Tanzania not only through direct outcomes of the process of care but also through increased care-seeking behaviour in the communities. The results of this study highlight the role of community involvement, better salary conditions and housing arrangements for health workers.

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Improving the Quality of Care Following an Acute Cardiac Event—The Role of Cardiac Rehabilitation in the Care Continuum

US Cardiology Review ◽

10.15420/usc.2009.6.2.79 ◽

2009 ◽

Vol 6 (2) ◽

pp. 79-83

Author(s):

Marjorie L King ◽

Keyword(s):

Quality Of Care ◽

Cardiac Rehabilitation ◽

Cardiac Event ◽

Care Continuum ◽

Acute Cardiac Event

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Improving nursing documentation for surgical patients in a referral hospital in Freetown, Sierra Leone: protocol for assessing feasibility of a pilot multifaceted quality improvement hybrid type project

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00768-5 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Nataliya Brima ◽

Nick Sevdalis ◽

K. Daoh ◽

B. Deen ◽

T. B. Kamara ◽

...

Keyword(s):

Quality Improvement ◽

Quality Of Care ◽

Sierra Leone ◽

Referral Hospital ◽

Audit And Feedback ◽

Health System Strengthening ◽

Theory Of Change ◽

Improve Quality ◽

Nursing Documentation

Abstract Background There is an urgent need to improve quality of care to reduce avoidable mortality and morbidity from surgical diseases in low- and middle-income countries. Currently, there is a lack of knowledge about how evidence-based health system strengthening interventions can be implemented effectively to improve quality of care in these settings. To address this gap, we have developed a multifaceted quality improvement intervention to improve nursing documentation in a low-income country hospital setting. The aim of this pilot project is to test the intervention within the surgical department of a national referral hospital in Freetown, Sierra Leone. Methods This project was co-developed and co-designed by in-country stakeholders and UK-based researchers, after a multiple-methodology assessment of needs (qualitative, quantitative), guided by a participatory ‘Theory of Change’ process. It has a mixed-method, quasi-experimental evaluation design underpinned by implementation and improvement science theoretical approaches. It consists of three distinct phases—(1) pre-implementation(project set up and review of hospital relevant policies and forms), (2) intervention implementation (awareness drive, training package, audit and feedback), and (3) evaluation of (a) the feasibility of delivering the intervention and capturing implementation and process outcomes, (b) the impact of implementation strategies on the adoption, integration, and uptake of the intervention using implementation outcomes, (c) the intervention’s effectiveness For improving nursing in this pilot setting. Discussion We seek to test whether it is possible to deliver and assess a set of theory-driven interventions to improve the quality of nursing documentation using quality improvement and implementation science methods and frameworks in a single facility in Sierra Leone. The results of this study will inform the design of a large-scale effectiveness-implementation study for improving nursing documentation practices for patients throughout hospitals in Sierra Leone. Trial registration Protocol version number 6, date: 24.12.2020, recruitment is planned to begin: January 2021, recruitment will be completed: December 2021.

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CQI: Meeting the Mandate for Quality

Otolaryngology ◽

10.1016/s0194-5998(05)80278-5 ◽

1995 ◽

Vol 112 (5) ◽

pp. P111-P111

Author(s):

Carl A. Patow

Keyword(s):

Quality Improvement ◽

Patient Satisfaction ◽

Quality Of Care ◽

Continuous Quality Improvement ◽

Educational Objectives ◽

Continuous Quality

Educational objectives: To understand the principles of continuous quality improvement and to use these principles to enhance patient satisfaction through increased efficiency and improved quality of care.

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Value-based dentistry: Putting the patient first

Faculty Dental Journal ◽

10.1308/rcsfdj.2016.126 ◽

2016 ◽

Vol 7 (3) ◽

pp. 126-129 ◽

Cited By ~ 2

Author(s):

Sreenivas Koka ◽

Galya Raz

Keyword(s):

Risk Management ◽

Quality Improvement ◽

Quality Of Care ◽

Dental Care ◽

Time Cost ◽

Safety Risk ◽

The Cost ◽

Over Time

What does ‘value’ mean? In the context of dental care, it can be defined as the quality of care received by a patient divided by the cost to the patient of receiving that care. In other words: V =Q/C, where Q equals the quality improvement over time, which most patients view in the context of the outcome, the service provided and safety/risk management, and C equals the financial, biological and time cost to the patient. Here, the need for, and implications of, value-based density for clinicians and patients alike are explored.

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