Design: Study design was a retrospective single-center review of hospital data.Setting: The study was conducted at the COVID-19 Treatment Center of the Department of Medicine and Therapeutics of the Korle-Bu Teaching hospital in Accra, Ghana.Participants and study tools: A total of fifty patients with laboratory (rRT-PCR) confirmed COVID-19 infection were involved in the study. A chart review of the medical records of the patients was conducted and the data obtained was documented using a data extraction form.Results: The median age was 53 years and most (36% (18/50)) of the patients were at least 60 years of age. Eighty percent (40/50) of the patients were symptomatic, with cough and difficulty in breathing being the commonest presenting symptoms. The mean duration of hospitalization was 12.3 ± 7.3 days. Hypertension and Diabetes Mellitus were the commonest co-morbidities occurring in 52% (26/50) and 42% (21/50) of patients respectively. Fifty percent of patients developed COVID-19 pneumonia as a complication. The mortality rate was 12% (6/50).Conclusion: In this study, SARS-CoV2 infection affected older adults with hypertension and diabetes mellitus being the common comorbidities. Patients with these comorbid conditions should be counselled by their clinicians to strictly observe the COVID-19 prevention protocols to reduce their risk of acquiring the infection. There is a need to pay critical and prompt attention to the management of patients with COVID-19 pneumonia particularly among people with diabetes to improve outcomes.
BackgroundHealthcare quality improvement (QI) is a global priority, and understanding the perspectives of frontline healthcare workers can help guide sustainable and meaningful change. We report a qualitative investigation of emergency department (ED) staff priorities for QI at a tertiary care hospital in Ghana. The aims of the study were to educate staff about the World Health Organization’s (WHO) definition of quality in healthcare, and to identify an initial focus for building a departmental QI program.MethodsSemi-structured interviews were conducted with ED staff using open-ended questions to probe their understanding and valuation of the six dimensions of quality defined by the WHO. Participants were then asked to rank the dimensions in order of importance for QI. Qualitative responses were thematically analyzed, and ordinal rank-order was determined for quantitative data regarding QI priorities.ResultsTwenty (20) members of staff of different cadres participated, including ED physicians, nurses, orderlies, a security officer, and an accountant. A majority of participants (61%) ranked access to emergency healthcare as high priority for QI. Two recurrent themes - financial accessibility and hospital bed availability - accounted for the majority of discussions, each linked to all the dimensions of healthcare quality.ConclusionsED staff related all of the WHO quality dimensions to their work, and prioritized access to emergency care as the most important area for improvement. Participants expressed a high degree of motivation to improve healthcare quality, and the study helped with the development of a departmental QI program focused on the broad topic of access to ED services.Electronic supplementary materialThe online version of this article (10.1186/s12873-017-0139-0) contains supplementary material, which is available to authorized users.
Maternal mortality is the bane of obstetric practice in sub-Saharan Africa. The delay in receiving care upon arrival in a hospital is a significant contributor to maternal mortalities. Obstetric triaging allows the prioritization of care based on patient acuity. This allows orderly access to care and reduces delays in the health facility.
This study was a quality improvement project that set out to establish an obstetric triaging system in the department of Obstetrics and Gynaecology of the Korle Bu Teaching Hospital (KBTH) starting in December 2016, and assess its impact primarily on the pre-implementation waiting time of 4.2 hours, one year on after implementation.
The project was scheduled in phases which included training, development of an Obstetric Emergency System, development of process maps and reorganization of care, infrastructural works all culminating in the establishment of a Triage System.
Results from data collected one year on showed an average reduction in waiting time from 4.2 hours (252 minutes) to an average of 138.8 minutes.
Triaging has helped to improve the timeliness and has added a patient-centered approach to care offered in the Obstetric Emergency of the Korle Bu Teaching Hospital.
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