A national system for monitoring the performance of hospitals in Ethiopia

McNatt, Zahirah; Linnander, Erika; Endeshaw, Abraham; Tatek, Dawit; Conteh, David; Bradley, Elizabeth H.

doi:10.2471/blt.14.151399

Cited by 32 publications

(31 citation statements)

References 39 publications

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“…A broad base of research and experience underscores the centrality of QI projects in ensuring effective health care delivery (27). Our findings support the linkage of project outcomes to financial incentives supported by QI capacity building and creating a community of sharing rather than solely competition as an effective strategy for promoting collaboration across sites, particularly under the ‘no loser’ framework for payouts.…”

Section: Discussionmentioning

confidence: 99%

Race to the Top: evaluation of a novel performance-based financing initiative to promote healthcare delivery in rural Rwanda

Nahimana

McBain

Manzi

et al. 2016

Global Health Action

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BackgroundPerformance-based financing (PBF) has demonstrated a range of successes and failures in improving health outcomes across low- and middle-income countries. Evidence indicates that the success of PBF depends, in large part, on the model selected, in relation to a variety of contextual factors.ObjectivePartners In Health∣Inshuti Mu Buzima aimed to evaluate health outcomes associated with a novel capacity-building model of PBF at health centers throughout Kirehe district, Rwanda.DesignThirteen health centers in Kirehe district, which provide healthcare to a population of over 300,000 people, agreed to participate in a PBF initiative scheme that integrated data feedback, quality improvement coaching, peer-to-peer learning, and district-level priority setting. Health centers’ progress toward collectively agreed upon site-specific health targets was assessed every 6 months for 18 months. Incentives were awarded only when health centers met goals on all three priorities health centers had collectively agreed upon: 90% coverage of community-based health insurance, 70% contraceptive prevalence rate, and zero acute severe malnutrition cases. Improvement across all four time points and facilities was measured using mixed-effects linear regression.FindingsAt 6-month follow-up, 4 of 13 health centers had met 1 target. At 12-month follow-up, 7 centers had met 1 target, and by 18-month follow-up, 6 centers had met 2 targets and 2 centers had met all 3. Average health center performance had improved significantly across the district for all three targets: mean insurance coverage increased from 68% at baseline to 93% (p<0.001); mean number of acute malnutrition cases in the previous 6 months declined from 24 to 5 per facility (p<0.001); and contraceptive prevalence increased from 42 to 59% (p<0.001). A number of innovative improvement initiatives were identified.ConclusionThe combining of PBF, district engagement/support, and peer-to-peer learning resulted in significant improvements despite resource constraints and is now being considered as a model for scale-up in other districts of Rwanda.

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Section: Discussionmentioning

confidence: 99%

Race to the Top: evaluation of a novel performance-based financing initiative to promote healthcare delivery in rural Rwanda

Nahimana

McBain

Manzi

et al. 2016

Global Health Action

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“…Today, emergencies faced with a large volume of patients and health IT has a key role in the management of patients. Using IT can be useful to improve the performance evaluation results [29][30][31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Effect of Information Technology on ED’s Performance Indicators

Ajami¹,

Rezaee²

2016

J Inform Tech Softw Eng

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IntroductionThe Emergency Department (ED) is the heart of the hospital. Regular workflows in this department can save many lives. Without active emergency and properly performance any hospital can be regarded as an ideal treatment center. And with such shortfalls other hospital services would be affected by the large defect [1]. The ED is the key point of the hospital and the relationship between hospital and community. Quick care, efficiency and effectiveness of this department can save the lives of many people and reduce the severity of disease [2]. The ED is the key point of the hospital and the relationship between hospital and community. Quick care, efficiency and effectiveness of this department can save the lives of many people and reduce the severity of disease. 75% of hospital admissions are referred to the emergency department so attention to the current processes of emergency and management of this department is very important [3]. In emergency department activities is facing with Stress and certain complexities. Dissatisfaction from the services is more visible than everywhere, especially in both pre-hospital emergency and hospital emergency room [4]. In about of the patients satisfaction factors in emergency in their research showed that among the patient dissatisfaction factors in emergency that include the physical environment, staffing, equipment and management factors, patrons expressed equipment and medical equipment as the first factor of their dissatisfaction. And accordingly to this emergency managers can use with medical equipment and new technologies in order to create the basic steps to take patient satisfaction [5]. Current age is called information age and information technology (IT) explosion affect all of the life and business aspects [6]. In fact, the first distinction between developed and developing countries, are the production, application and utilization of information [7][8][9]. Nowadays, with the development of hospital information systems in healthcare centers, the use of software, hardware and new methods in order to increase the speed and quality of health care services is growing [10]. The advantages of using these technologies is extent that not only reduce errors and increase the speed and accuracy of providing health services to the patients, But also reduces costs through coordination of services and improve the quality of health care [11]. The ED is an exceptional environment, where visits are unscheduled, patients undifferentiated, and care decentralized. Workflows vary from ED to ED and even patient to patient. It is clear that the Health Information Technology (HIT) presents ongoing opportunities to improve the quality of emergency care, promote patient safety, reduce medical errors, and enhance the efficiency of emergency departments [12]. So by considering the critical role of the ED in health care to avoid duplication, improve quality and care, and reduce costs it is worthy this department and other related provisions of service units to be Effect of Informatio...

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“…We undertook the study in Ethiopia, where facility-based births are increasing, 9 and where the country has invested in hospital quality improvement since 2003 10 , 11 . Although we were unable to measure patient outcomes, we examined both processes of care and the capacity of facilities to provide quality-of-care processes, with a focus on elements of intrapartum care.…”

Section: Introductionmentioning

confidence: 99%

Maternal and neonatal services in Ethiopia: measuring and improving quality

Canavan

Brault

Tatek

et al. 2017

Bull. World Health Organ.

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ProblemMaternal and neonatal mortality remains high in low- and middle-income countries, with poor quality of intrapartum care as a barrier to further progress.ApproachWe developed and tested a method of measuring the quality of maternal and neonatal care that could be embedded in a larger national performance management initiative. The tool used direct observations and medical record reviews to score quality in nine domains of intrapartum care. We piloted and evaluated the tool in visits to the 18 lead hospitals that have responsibility to promote and coordinate quality improvement efforts within a hospital cluster in Ethiopia. Between baseline and follow-up assessments, staff from a national quality collaborative alliance provided hospital-based training on labour and delivery services.Local settingEthiopia has invested in hospital quality improvement for more than a decade and this tool was integrated into existing quality improvement mechanisms within lead hospitals, with the potential for scale-up to all government hospitals.Relevant changesSignificant improvements in quality of intrapartum care were detected from baseline (June–July 2015) to follow-up (February–March 2016) in targeted hospitals. The overall mean quality score rose from 65.6 (standard deviation, SD: 10.5) to 91.2 (SD: 12.4) out of 110 items (P < 0.001).Lessons learntThe method was feasible, requiring a total of 3 days and two to three trained data collectors per hospital visit. It produced data that detected substantial changes made during 8 months of national hospital quality improvement efforts. With additional replication studies, this tool may be useful in other low- and middle-income countries.

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A national system for monitoring the performance of hospitals in Ethiopia

Cited by 32 publications

References 39 publications

Race to the Top: evaluation of a novel performance-based financing initiative to promote healthcare delivery in rural Rwanda

Race to the Top: evaluation of a novel performance-based financing initiative to promote healthcare delivery in rural Rwanda

Effect of Information Technology on ED’s Performance Indicators

Maternal and neonatal services in Ethiopia: measuring and improving quality

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