scholarly journals Referral of sick children and levels of adherence by carers: implications on quality health care in the middle belt of Ghana

2021 ◽  
Vol 55 (1) ◽  
pp. 43-51
Author(s):  
Mathilda Tivura ◽  
Samuel Afari-Asiedu ◽  
Martin Adjuik ◽  
Frank Baiden ◽  
Seth Owusu-Agyei
Keyword(s):  
Healthcare Providers ◽  
Health Facilities ◽  
Quality Health Care ◽  
Healthcare Facilities ◽  
District Hospitals ◽  
Adherence Assessment ◽  
Quality Health ◽  
Sick Children ◽  
Adequate Management

Introduction: Severely sick-children presenting at primary healthcare facilities need referral to higher level facilities for better care. Adherence to referrals and quality of care received by those referred could serve as critical steps towards their survival.Objective: To describe experiences with severely sick children referred to higher-level health facilities for care and reasons for non-adherence to referral; to explore healthcare provider’s perspectives to referral.Methods: Referrals among 3046 young children were followed for adherence. Assessment of children referred from a PHC facility adhering to referral advice and reasons for non-adherence to referral was determined. Agreement on reported diagnoses at PHC centres and health-facilities receiving patients was assessed. Perspectives of healthcare providers were assessed.Results: 212 children were referred from PHC centres to various hospitals with 14.2% non-adherence. Reasons given: 48.3% of carers adhering felt child’s condition was severe; 43.3% complied with healthcare provider directive. The main reasons for non-adherence to referral were no money for transport (50%) and child condition not serious (30.0%). 69.0% of anaemia cases diagnosed at PHC facilities and hospitals. 65.7% fever diagnosed at a PHC centres were confirmed as malaria at the hospitals. Healthcare providers referred patients for severity, perceivedcomplication and non-response to treatment.Conclusion: Adherence was generally good. The level of agreement in diagnosis of common diseases such as malaria and anaemia at PHC centres and district hospitals was high and low for rarer diseases. Capacity should be provided at PHC levels for adequate management of cases presented to reduce referrals carers have to make

scholarly journals First experiences of accrediting district hospitals for excellence in newborn care in KwaZulu-Natal, South Africa: Successes and challenges

2018 ◽  
Vol 7 (3) ◽  
pp. 25 ◽  
Author(s):  
Lyn Haskins ◽  
Dolly Nyasulu ◽  
Ruth Davidge ◽  
Neil McKerrow ◽  
Christiane Horwood
Keyword(s):  
South Africa ◽  
Health Care ◽  
Newborn Care ◽  
Health Facilities ◽  
Quality Health Care ◽  
District Hospitals ◽  
Kwazulu Natal ◽  
Quality Health ◽  
Successes And Challenges

Objective: Providing quality health care is what all health facilities seek to achieve. Accreditation of health services are used to assess and improve the quality of health care in different settings. This study describes experiences of developing and conducting accreditation for excellence in newborn care in district hospitals in KwaZulu-Natal (KZN), South Africa following a 3-year programme of support to all nurseries in KZN.Methods: A facility review was conducted in district hospitals in KZN to evaluate the quality of care provided to newborn babies to accredit hospitals in newborn care. Multiple tools were used to assess different components of care from different perspectives, including record reviews, assessment of staff skills and interviews with mothers. Awarding accreditation was based on scores achieved in various domains, which contributed to an overall score. Compliance with key priority indicators was required for accreditation to be awarded.Results: Overall scores for accreditation ranged between 57%-93%. Mothers reported high levels of satisfaction with care received. Record reviews identified shortfalls in care provided, and skills assessments showed poor resuscitation skills in labour wards in some hospitals. Of 39 district hospitals, eight were awarded silver and five were awarded gold accreditation status.Conclusions: This accreditation of newborn care provides a workable model for undertaking accreditation in district hospitals and can be used by managers to identify and address shortfalls in care. Regular accreditation would support ongoing quality improvement (QI) in neonatal care and such a process could be applied to other aspects of care in health facilities.

scholarly journals Smoking behaviour among adult patients presenting to health facilities in four provinces of Vietnam

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wan-Chun Huang ◽  
Ngoc Yen Pham ◽  
Thu Anh Nguyen ◽  
Van Giap Vu ◽  
Quy Chau Ngo ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Smoking Behaviour ◽  
Health Facilities ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
District Hospitals ◽  
Quit Attempts

Abstract Background Attendance at healthcare facilities provides an opportunity for smoking cessation interventions. However, the smoking behaviours of patients seeking healthcare in Vietnam are not well-understood. We aimed to evaluate behaviours related to smoking among patients presenting to health facilities in Vietnam. Methods We conducted a cross-sectional study in 4 provinces of Vietnam. Consecutive patients aged ≥15 years presenting to 46 health facilities were assessed. Current smokers were randomly selected to complete a full survey about smoking behaviour, quit attempts, and preparedness to quit. Results Among 11,245 patients who sought healthcare, the prevalence of current smoking was 18.6% (95% CI: 17.8–19.4%) overall, 34.6% (95% CI: 33.2–36.0%) among men and 1.1% (95% CI: 0.8–1.3%) among women. Current smokers who were asked about smoking by healthcare providers in the last 12 months were more likely to make quit attempts than those not asked (40.6% vs 31.8%, p = 0.017). Current smokers who attempted to quit in the past 12 months made limited use of cessation aids: counselling (1.9%) and nicotine replacement therapy (10%). A higher proportion of patients wanted to quit in the next month at national/provincial hospitals (30.3%) than those visiting district hospitals (11.3%, p < 0.001) and commune health centres (11.1%, p = 0.004). Conclusions Smoking is common among male patients presenting to healthcare facilities in Vietnam. Formal smoking cessation supports are generally not used or offered. This population is likely to benefit from routine smoking cessation interventions that are integrated within the routine healthcare delivery system.

scholarly journals Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Manon Haemmerli ◽  
Timothy Powell-Jackson ◽  
Catherine Goodman ◽  
Hasbullah Thabrany ◽  
Virginia Wiseman
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Poor Quality ◽  
Health Facilities ◽  
Quality Health Care ◽  
Public And Private ◽  
The Poor ◽  
Service Readiness ◽  
Quality Health

Abstract Background For many low and middle-income countries poor quality health care is now responsible for a greater number of deaths than insufficient access to care. This has in turn raised concerns around the distribution of quality of care in LMICs: do the poor have access to lower quality health care compared to the rich? The aim of this study is to investigate the extent of inequalities in the availability of quality health services across the Indonesian health system with a particular focus on differences between care delivered in the public and private sectors. Methods Using the Indonesian Family Life Survey (wave 5, 2015), 15,877 households in 312 communities were linked with a representative sample of both public and private health facilities available in the same communities. Quality of health facilities was assessed using both a facility service readiness score and a knowledge score constructed using clinical vignettes. Ordinary least squares regression models were used to investigate the determinants of quality in public and private health facilities. Results In both sectors, inequalities in both quality scores existed between major islands. In public facilities, inequalities in readiness scores persisted between rural and urban areas, and to a lesser extent between rich and poor communities. Conclusion In order to reach the ambitious stated goal of reaching Universal Health Coverage in Indonesia, priority should be given to redressing current inequalities in the quality of care.

scholarly journals Barriers to quality patient care in rural district hospitals

Curationis ◽  
2012 ◽  
Vol 35 (1) ◽  
Author(s):  
Johanna E. Eygelaar ◽  
Ethelwynn L. Stellenberg
Keyword(s):  
Pilot Study ◽  
Patient Care ◽  
Rural District ◽  
Extensive Literature ◽  
Quality Health Care ◽  
District Hospitals ◽  
Quality Of Patient Care ◽  
Quality Health ◽  
Quantitative Descriptive

Currently barriers exist in delivering quality health care. This study aimed to investigate such barriers in the eight rural district hospitals of the West Coast Winelands Region, three type A and five type B hospitals. A quantitative descriptive design was applied which included the total population of nursing staff (n = 340) working at the time of data collection. A self-administered questionnaire was distributed with a response rate of 82%.Reliability of the instrument was verified using the Cronbach alpha coefficient and a pilot study. The validity, specifically construct and content validity, were assured by means of an extensive literature review, pilot study and use of experts. Ethics approval was obtained from the relevant stakeholders.Results showed that 272 participants (97%) disagreed that provision of staff was adequate, with staff above 40 years of age more likely to disagree (p = <0.01). A statistically significant association was shown between availability of doctors and staff not being able to cope with emergencies (p = <0.01). Most participants (n =212; 76%) indicated that they were not receiving continuing education, with the registered nurses more likely to disagree (χ² test, p = 0.02). Participants in both hospital types A (n = 131; 82%) and B (n = 108; 91%) also disagreed that provision of equipment and consumables was adequate.The research showed that inadequacies relating to human resources, professional development, consumables and equipment influenced the quality of patient care. Urgent attention should be given to the problems identified to ensure quality of patient care in rural hospitals.

Baseline assessment of therapeutic injection practices in Pakistan in 2020: a cross-sectional study

2021 ◽  
pp. 16-21
Author(s):  
Syed Sharaf Ali Shah ◽  
Safdar Pasha ◽  
Nikhat Iftikar ◽  
Altaf Ahmed Soomro ◽  
Nazia Farrukh ◽  
...  
Keyword(s):  
Public Sector ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Injection Equipment ◽  
Public And Private ◽  
Healthcare Facilities ◽  
The Public ◽  
Injection Safety

Objective: To assess the magnitude of the problem of injection safety in public and private health facilities in two districts of Sindh and Punjab provinces of Pakistan. Methods: A cross-sectional observational study was conducted between October and December 2020 among public and private health facilities of two districts of Pakistan: Gujarat in Punjab and Larkana in Sindh provinces. A convenient sample size of 60 healthcare facilities (30 from each district) was taken due to time and resource constraint. Six data collection tools were used which included structured observations and interviews with injection prescribers and providers based on WHO Revised Tool C, which were finalised after piloting. Results: Reuse of injection equipment was not observed in any of the 60 health facilities. In exit interviews of 120 patients, it was found that 27 (22.5%) patients reported receiving an injection, while 11 (9.2%) were prescribed intravenous (IV) drips. More injections and drips were prescribed in the private sector (n=15; 25.0%) in comparison with the public sector (n=12; 20.0%). Slightly higher proportion of IV drips were prescribed by the private providers when compared to public sector healthcare providers: 6 (10.0%) vs 5 (8.3%) respectively. Most of the prescribers (n=58; 96.7%) reported that patients who attended public and private health facilities demanded injectable medicines. Used syringes and drips were noted to be visible in open containers and buckets for final disposal in 20 (33.3%) assessed health facilities. Continuou...

scholarly journals Quality indicators of dental health care in Serbia

2019 ◽  
Vol 66 (1) ◽  
pp. 36-42
Author(s):  
Svetlana Jovanović ◽  
Maja Milošević ◽  
Irena Aleksić-Hajduković ◽  
Jelena Mandić
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health System ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Care Quality ◽  
System Quality ◽  
Quality Health Care ◽  
Quality Health

Summary Health care has witnessed considerable progresses toward quality improvement over the past two decades. More precisely, there have been global efforts aimed to improve this aspect of health care along with experts and decision-makers reaching the consensus that quality is one of the most significant dimensions and features of health system. Quality health care implies highly efficient resource use in order to meet patient’s needs in terms of prevention and treatment. Quality health care is provided in a safe way while meeting patients’ expectations and avoiding unnecessary losses. The mission of continuous improvement in quality of care is to achieve safe and reliable health care through mutual efforts of all the key supporters of health system to protect patients’ interests. A systematic approach to measuring the process of care through quality indicators (QIs) poses the greatest challenge to continuous quality improvement in health care. Quality indicators are quantitative indicators used for monitoring and evaluating quality of patient care and treatment, continuous professional development (CPD), maintaining waiting lists, patients and staff satisfaction, and patient safety.

scholarly journals Assessment of the quality of sexual and reproductive health services delivered to adolescents at Ujala clinics: A qualitative study in Rajasthan, India

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261757
Author(s):  
Radhika Dayal ◽  
Mukta Gundi
Keyword(s):  
Reproductive Health ◽  
Service Delivery ◽  
Health Care Services ◽  
Reproductive Health Services ◽  
Quality Health Care ◽  
Care Services ◽  
Sexual Reproductive Health ◽  
Global Standards ◽  
Quality Health

The Adolescent Friendly Health Clinic (AFHCs), a key component of the Government of India’s National Adolescent Health Programme a.k.a. Rashtriya Kishor Swasthya Karyakram (RKSK), aims to increase the accessibility and utilization of sexual-reproductive health services by adolescents and youth. However, low quality of care provided at AFHCs by counsellors calls for attention. We, thus, explore both the clients’ and providers’ perspectives using the World Health Organization’s (WHO) global standards for quality health-care services for adolescents to assess the quality of the sexual reproductive health service delivery at AFHCs in Rajasthan, India. We conducted a qualitative study, comprising observation of the service delivery using mystery clients (MCs) (n = 12) and in-depth interviews with the counsellors (n = 4) in four AFHCs. Interviews were transcribed in local language and were translated in English. The transcripts were coded thematically. Our study, using five of the eight WHO global standards for quality health-care services for adolescents highlighted several gaps in the quality-of-service delivery at AFHCs. We unearth various intricacies related to the quality of the services provided at the AFHCs by referring to the relevant input, process, and the output criteria of WHO global standards I, III, IV, V and VI. Our study calls for efforts to improve- (i) the counsellors’ competencies to increase adolescents’ health literacy on sensitive topics, (ii) the facilities at the clinic to ensure privacy, comfort and confidentiality of the adolescents seeking services, (iii) the referrals to improve appropriate package of services, and (iv) an overall environment to ensure an equity and non-discrimination for all the adolescents. Our findings unearth the barriers that both the service providers and the adolescents face at the AFHCs and underscore the need for regular monitoring and evaluation of the AFHCs to strengthen the facility-based intervention of the RKSK programme.

Cloud Computing Location-Based Services for Quality Health Care Services Delivery

2014 ◽  
pp. 171-185
Author(s):  
Jalel Akaichi
Keyword(s):  
Cloud Computing ◽  
Health Care Services ◽  
Location Based Services ◽  
Dynamic Changes ◽  
K Nearest Neighbors ◽  
Quality Health Care ◽  
Care Services ◽  
Services Delivery ◽  
Quality Health

This chapter proposes a cloud computing location-based services system able to query points of interest, according to mobile users' preferences and contexts, under dynamic changes of locations. The contribution consists of providing software as a service based on Delaunay Triangulation on road (DTr) able to establish the Continuous k-Nearest Neighbors (CkNNs) on road, while taking into account the dynamic changes of locations from which queries, enhanced by users' preferences and contexts, are issued. The proposed software, implemented on a mobile cloud and exploited by mobile physicians for healthcare institutions localization and selection, considerably improves the quality of services provided for patients in critical situations by permitting real time localization of adequate resources that may contribute to save patients' lives.

scholarly journals How to do (or not to do) … using the standardized patient method to measure clinical quality of care in LMIC health facilities

2019 ◽  
Vol 34 (8) ◽  
pp. 625-634 ◽  
Author(s):  
Jessica J C King ◽  
Jishnu Das ◽  
Ada Kwan ◽  
Benjamin Daniels ◽  
Timothy Powell-Jackson ◽  
...  
Keyword(s):  
Clinical Care ◽  
Healthcare Providers ◽  
Sampling Strategy ◽  
Ethical Challenges ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Rich Data ◽  
Mystery Shoppers ◽  
Key Steps

Abstract Standardized patients (SPs), i.e. mystery shoppers for healthcare providers, are increasingly used as a tool to measure quality of clinical care, particularly in low- and middle-income countries where medical record abstraction is unlikely to be feasible. The SP method allows care to be observed without the provider’s knowledge, removing concerns about the Hawthorne effect, and means that providers can be directly compared against each other. However, their undercover nature means that there are methodological and ethical challenges beyond those found in normal fieldwork. We draw on a systematic review and our own experience of implementing such studies to discuss six key steps in designing and executing SP studies in healthcare facilities, which are more complex than those in retail settings. Researchers must carefully choose the symptoms or conditions the SPs will present in order to minimize potential harm to fieldworkers, reduce the risk of detection and ensure that there is a meaningful measure of clinical care. They must carefully define the types of outcomes to be documented, develop the study scripts and questionnaires, and adopt an appropriate sampling strategy. Particular attention is required to ethical considerations and to assessing detection by providers. Such studies require thorough planning, piloting and training, and a dedicated and engaged field team. With sufficient effort, SP studies can provide uniquely rich data, giving insights into how care is provided which is of great value to both researchers and policymakers.

Infection Control and Cost Control in the Era of Managed Care

2002 ◽  
Vol 23 (7) ◽  
pp. 407-410 ◽  
Author(s):  
David P. Calfee ◽  
Barry M. Farr
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Infection Control ◽  
Cost Containment ◽  
Cost Control ◽  
Low Cost ◽  
Quality Health Care ◽  
Healthcare Facilities ◽  
The Past ◽  
Quality Health

During the past several years, major changes have occurred in the way in which health care is provided and financed. One of the outcomes of these changes has been a greater emphasis on providing quality health care at a low cost. This has led many healthcare facilities to question the necessity of all expenditures and to reduce spending when at all possible. Many healthcare facilities have solicited the services of consulting groups to provide recommendations regarding cost-containment strategies appropriate for their particular institution.

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