scholarly journals Management of services in total quality management implemented and non-implemented health facilities

2021 ◽  
Vol 6 (4) ◽  
pp. 689-696
Author(s):  
Muhsina Begum ◽  
Ashees Kumar Saha ◽  
Sheuly Begum ◽  
Nasima Akhter ◽  
Pritikona Borua ◽  
...  

5S-CQI-TQM is a management technique that is aimed at bringing satisfaction of staff as well as the patients through improvement of working environment. A cross-sectional comparative study was carried out among 226 respondents who were selected purposively from the selected study place from 1st January to 31st December 2017. Among 226 respondents, 113 were taken from Dhaka Medical College and another 113 were taken from Mugdha Medical College. Among 113 respondents, 56 respondents were health care providers and 57 respondents were health care receivers. The purpose of this study to compare the management of services in Total Quality Management implemented (Dhaka Medical College and Hospital) and non-implemented (Mugdha Medical College and Hospital) health facilities. A Semi-structured interviewer administered questionnaire and an observational check list were developed to collect the data. Separate questionnaire was used for health care providers and health care receivers. The statistical analysis was conducted using SPSS (statistical package for social science) version 20 statistical software. Significant statistical differences were found between TQM implemented and TQM non-implemented hospital regarding workload (p=0.043), hospital authority always seriously consider staff’s suggestions for the improvement of quality of service (p<0.001), employees always respect to each other in the hospital (p<0.001) and 35 (62.5%) service providers expressed satisfactory opinion regarding management of the hospital. Asian J. Med. Biol. Res. December 2020, 6(4): 689-696

2012 ◽  
Vol 1 (1) ◽  
pp. 2-5
Author(s):  
Rawshan Ara Khanam ◽  
Kohinoor Begum ◽  
Abdul Halim ◽  
Khadiza Najneen

Challenges to the health of our children have been changing in recent decades as we have taken control over different diseases through immunization and child health program . But newer problems are uncovered. Child Abuse and Neglect is one of them . World community has given emphasis on this very old but unnoticed problem ,this problem is received very less emphasis in South East Asia. With the objectives -to assess the knowledge and skill of working doctors and nurses of concern department in managing child abuse and to help the service providers to improve their knowledge and skill to deal with child abuse and to identify the laps and gaps in the area where abused children are dealt with, this study was carried out in two Medical College Hospitals, two District Hospitals and two Upazilla Health Complexes from November 2005 to July 2006. Selected departments for study were - Obstetrics & Gynaecology, Paediatrics, Orthopaedics. Burn, Casualty, Psychiatry and OCC, (DMCH) in Medical College level; Obstetrics & Gynaecology, Paediatrics, Surgery in district level and all from Upazilla level. Working doctors of all level and senior staff nurses were included in this study. Assessment of knowledge and skill was done before and after intervention by observation and face to face interview by using a pre tested prepared questionairre .Laps and gaps were identified by observation and interview. Intervention was given by a one day workshop in each level of hospital . About 155 care providers participated in pre and post intervention interview . Of them- 109 were doctor and 46 were nurses. Among them 71 (Doc. 55 + Nurse 16) from two Medical College Hospitals, 42 (Doc. 33 + Nurse 9) from two District Hospitals & 42 (Doc. 21 + Nurse 21) from 2 Upazilla Health Complexes . It was surprising that only 11 % health care provides correctly knows that who are the children , only 10 % providers knows about the different types of abuse and only 15 % providers believe that they have sufficient knowledge to manage an abused child. Knowledge level is much higher among the doctors working in teaching hospitals and poorest in UHC. Nurses are less knowledgeable than doctors . Score of nurses is more or less similar in all level of hospitals. The pre and post intervention changes were analyzed by using unpaired student's t test and p value was significant .On job training of care providers on management of abused child is very important and inclusion of this issue in medical and nursing curricula is necessary. DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12166 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.2-5


2017 ◽  
Vol 6 (1) ◽  
pp. 40-47
Author(s):  
M Lopchan ◽  
G Gurung ◽  
L Rajbanshi ◽  
C Osti ◽  
A Baniya

Nosocomial infections (NIs) are one of the most important health issues, particularly in developing countries, because these infections cause high mortality and morbidity, and economic and human resource loss as a consequence Nosocomial infections can be defined as those occurring within 48 hours of hospital admission, 3 days of discharge or 30 days of an operation. Many studies have examined risk factors of nosocomial infections. However, knowledge of frontline workers (attendants) in infection prevention have been reported rarely in developing countries. The aim of this study was to investigate the knowledge of attendants working in different wards and OPDs about infection prevention. S: Data were collected from 100 attendants in Chitwan Medical College Teaching Hospital. Regarding the knowledge on hand washing, gloving and personal accessories for Infection Prevention, majority of the respondents had good knowledge ranging from 94-100%. Though hospital has established Infection Prevention Committee and regular training on infection prevention is provided to all the staffs, the data indicated that only 68% respondents were benefitted by the infection prevention training and proper use of virex solution to disinfect the equipment’s was found unsatisfactory. Infection control is the responsibility of all Health Care Facility (HCF) personnel. The goal of the infection control policies are to identify and reduce risks of acquiring and transmitting infections among patients, staff, students, volunteers, contract service workers, and visitors Although significant effort has been made to reduce the Nosocomial infections, regular training as well as monitoring supervision will enhance the capacity of the health care providers and front line workers for cleaning services they are our valued respondents.DOI: http://dx.doi.org/10.3126/jcmc.v6i1.55069


2007 ◽  
Vol 18 (7) ◽  
pp. 476-481 ◽  
Author(s):  
Li Li ◽  
Zunyou Wu ◽  
Sheng Wu ◽  
Sung-Jae Lee ◽  
Mary Jane Rotheram-Borus ◽  
...  

Health-care providers in China are facing an exponential increase in HIV testing and HIV-positive patients. A total of 1101 service providers were recruited to examine attitudes toward people living with HIV/AIDS (PLWHA) in China. Logistic regression models were used to assess factors associated with providers' attitudes toward mandatory HIV testing. Providers were most likely to endorse mandatory HIV testing for patients with high-risk behaviour and for all patients before surgery. Over 43% of providers endorsed mandatory testing for anyone admitted to hospital. Controlling for demographics, multivariate analyses indicated that providers with higher perceived risk of HIV infection at work, higher general prejudicial attitudes toward PLWHA, and previous contact with HIV patients were more likely to endorse mandatory HIV testing for anyone admitted to hospital. Results underscore the importance of implementing universal precautions in health-care settings and call attention to social and ethical issues associated with HIV/AIDS control and treatment in China.


2016 ◽  
Vol 4 (1) ◽  
pp. 16-25 ◽  
Author(s):  
Manijeh Pirdil ◽  
Leila Pirdel

Background: Maternal childbirth expectations play an important role in determining a woman’s response to her childbirth experience. Women need to be helped to develop realistic and positive expectations and identify the factors that influence these expectations.Objective: The aim of this study was to compare woman’s expectations and experiences of childbirth.Methods: This descriptive-comparative study was carried out in Tabriz Alzahra Hospital from 2006 to 2007. For this purpose, a total of 600 primiparas and multiparas women who were candidates for vaginal delivery, were randomly selected and interviewed. The data were collected by questionnaire.Results: Comparison of the means of mothers expectation and experience of labor and birth between the two groups demonstrated a statistically significant difference (p<0.05). The findings indicated a number of differences exist between primiparas and multiparas women in relation to expectations and experiences of birth when compare two groups. The majority of women had negative expectations and experiences of childbirth.Conclusion: The evaluation and understanding of birth expectations and experiences as positive and negative is priority of maternity system. Antenatal educators need to ensure that pregnant women are appropriately prepared for what might actually happen to limit this expectation-experience gap. Health-care providers should improve the quality of antenatal care which can change negative childbirth expectations and experiences of womenJournal of Kathmandu Medical College, Vol. 4(1) 2015, 16-25


2021 ◽  
pp. 246-249
Author(s):  
Lalit Sankhe ◽  
Chhaya Rajguru ◽  
Monali Kadam

Background: Malnutrition is a complex problem with double burden of undernutrition and overweight. India is no exception to it but there is a higher level of malnutrition in tribal blocks and to curb this situation,various activities have been undertaken but the slow pace of decline in malnutrition is a concern.The role of frontline health workers is crucial in strengthening primary health care.They serve as the bridge between the formal government health-care system and the community.The present study helps to seek the perception of primary health care service providers and challenges faced by them in reducing child deaths due to malnutrition. Method: A descriptive cross sectional qualitative study was conducted during August 2019 - February 2020 in three talukas of a tribal district. Focus group discussions (FGD) for each service providers Auxiliary Nurse midwife (ANM), Anganwadi worker (AWW) and Accredited Social Health activist (ASHA) were conducted. All the FGDs were audio recorded and transcripts were prepared,a thematic analysis framework was used for doing the analysis. Results: Most of the service providers were aware regarding their roles and responsibilities in implementation of schemes/ services related to malnutrition. The important factors influencing their performance were superstitions, more reliance on health seeking from unqualified health care providers and faith healers, poor road connectivity, network issues,lack of refresher training,overburdening with work,poor incentives. Conclusion: Specific training programs to tackle malnutrition along with frequent refresher training of the service providers,better infrastructure and human resources will help in achieving the desired results in future in dealing with child malnutrition.


2021 ◽  
Author(s):  
Kidist Gizachew ◽  
Tewodros Getinet ◽  
Delayehu Bekele

Abstract Background: Birth companions have been shown to improve quality of care provided to laboring women. Various studies have shown the benefits of companion during child birth. The objective of this study was to assess the knowledge, attitude and practice of health care providers towards the involvement of birth companions during child birth in St Paul’s Hospital Millennium Medical College (SPHMMC) and its selected catchment health centers. Methods: The study used a cross-sectional study which was supplemented by qualitative study design which employed phenomenological design was conducted using in depth interview of health care providers who were on practice during the study period in SPHMMC. Result: The study included a total 58 health care providers. The finding from the study showed that great proportion of health care providers involved in the study (90 %) have positive attitude towards involvement of birth companions but majority 82.4 % didn’t allow birth companions. The commonest reasons mentioned for not involving companions include fear of breach of privacy, interference with routine medical care and risk of litigation/complaints.Conclusion and Recommendation: The findings from this study showed that majority of the health care providers are against the practice of involving birth companions. Since involvement of birth companions is one way to ensure the quality of care provided there should be an effort to increase the knowledge of health professionals on benefits of birth companions. There is also a need for improvement of the work setup. Simple measures like providing screens, providing separate rooms for laboring and post-partum women will have a significant impact on the quality of care provided.


2019 ◽  
Author(s):  
ASAGA MAC PETER ◽  
JUDE OSAGIE Aighobahi.

Abstract Background: Tuberculosis (TB) coexists with other non-communicable diseases (NCDs), including Diabetes Mellitus (DM). Smoking increases the risk of TB as well as DM. Health systems are poorly prepared in many low middle income countries (LMICs) and are currently facing the "triple burden of smoking, TB, and DM" that drives these countries into the vicious cycle of poverty. Methods: A cross-sectional study method was carried out to assess the proportion of TB care centers that included integration measures for diabetic care as well as those providing DM care that included integration measures for TB. A list of 49 health care centers in Lagos offering TB care and managing Diabetes patients were recruited. A focus Group Discussion(FGD) and Individual interviews were conducted to investigate health care providers ' knowledge, attitudes and practices and the barriers encountered in the process of integrating TB and DM care. Results: Out of the 49 health care centres recruited in this study, 6% of health care units are aware of a surveillance to screen for diabetes in tuberculosis patients, while 2% of health facilities confirmed awareness of a surveillance to screen for tuberculosis in diabetes patients. 91% of health centres either verified the lack of or no understanding of monitoring of both diseases. The percentage of health facilities that have existing guideline on TB and DM screening was evaluated, it was perceived that 8% of health facilities had implemented a guideline to screen for DM in TB patients, while 4% of these Care Centres have implemented a guideline for diabetes patients to be screened for TB. Conclusion TB/DM integrative screening, treatment and management could be better attained if both co-morbidities integration program is initiated in the healthcare centres and policies of western states and Nigeria as a whole.


Author(s):  
Ibitoye O. F. ◽  
Adamolekun M. M. ◽  
Adamolekun P. A. ◽  
Amuwa T.

Background: The Nigerian health system as a whole has been plagued by problems associated with the quality of service, including but not limited to unfriendly staff attitudes to patients, inadequate skills, decaying infrastructures, and chronic shortages of essential drugs. Approximately two-thirds of all Nigerian women deliver outside of health facilities and without the presence of medically skilled attendants.  The study was carried out to assess the awareness and knowledge of women regarding their rights during pregnancy and childbirth, and to explore the extent to which women’s rights were respected during pregnancy and childbirth.Methods: This descriptive study was conducted among randomly selected 140 women at Mother and Child Hospital, Akure, Ondo state, Nigeria. Data was collected with a pretested questionnaire and was analysed using Statistical Packages for Social Sciences (SPSS) version 21.Results: Findings revealed that majority (76.9%) of the women had a fair knowledge of their rights in pregnancy and childbirth, with the source of knowledge majorly from their friends. Right to information, informed consent and refusal, even distribution of healthcare services, maintenance of attainable level of health regarding proper monitoring were fairly observed by the health care providers. Right of women against verbal and physical abuse, privacy, treatment with dignity and respect were least accorded to women.Conclusions: Respective Maternity Care remains a challenge that demands policy interventions in most public health facilities to enhance positive endorsement and utilisation of maternal and health care services.


1992 ◽  
Vol 38 (5) ◽  
pp. 615-618 ◽  
Author(s):  
K Castañeda-Méndez

Abstract Public concern over increasing health-care costs plus dramatized testing errors, has resulted in CLIA '88 with its more stringent rules governing laboratory performance. The purpose of the 1990 U.S. Health Care Financing Administration Final Rules for Proficiency Tests is to separate the quality laboratory from the poorly performing one. From the perspective of total quality management, the customer (patient) defines quality as virtually error-free test results. The current proficiency testing format defeats this. Its effective purpose is not to identify quality laboratories but to shut down the most prolific laboratories--regardless of their quality. There are two reasons for this. First, the proficiency testing format is incomplete: it is missing a minimum frequency criterion. Second, the data for determining the quality of a laboratory's performance (the degree of error-free results) are not being used. I propose a solution based on continuous improvement that promotes voluntarism, favors the quality laboratory, and reduces federal regulation.


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