Impact of accreditation on health care services performance in Kiryandongo district, Uganda: a longitudinal study

Abstract

Background The COVID-19 pandemic has emphasised the need for quality laboratory services worldwide. There is renewed focus to strengthen country capacities and laboratories to effectively respond to public health emergencies and patient outcomes. Uganda launched the accreditation program for public health facilities in 2016 with sixteen laboratories. As of June 2021, twenty-three public laboratories have attained ISO 15189:2012 accreditation status. Despite the tremendous achievements of accrediting laboratories in Uganda, laboratory services still face challenges like stock out of commodities and limited testing scopes. We conducted this study to evaluate the impact of accreditation on health care services performance in Kiryandongo district, Uganda. Methods We conducted a longitudinal study from January 1, 2020- April 30, 2021 at ten health facilities in Kiryandongo district. We collected health care services performance data from the MoH dhis-2 on selected indicators for HIV, TB, Malaria, Laboratory, Maternal & child health and dhis-2 reporting. We used Generalized Estimating Equations to estimate the impact of accreditation on health care services performance at the different health facilities. Results The odds at the accredited facility in comparison to the non-accredited public facilities were; 14% higher for ART enrolment (OR = 1.14, 95% CI: 1.04–1.25), 9% lower for determine testing kits stock out (OR = 0.91, 95% CI: 0.85–0.97), 28% higher for TB case diagnosis (OR = 1.28, 95% CI: 1.10–1.49), 19% higher for TB case enrolment (OR = 1.19, 95% CI: 1.04–1.36), 104% higher for maternity admissions (OR = 2.04, 95% CI: 1.60–2.59), 63% higher for maternity deliveries (OR = 1.63, 95% CI: 1.39–1.90) and 17% higher for reporting hmis 10:01 data to dhis-2 (OR = 1.17, 95% CI: 1.04–1.31). The odds at the accredited facility in comparison to the non-accredited PNFP facilities were; 26% higher for ART enrolment (OR = 1.26, 95% CI: 1.17–1.36), 33% higher for TB case diagnosis (OR = 1.33, 95% CI: 1.15–1.55), 24% higher for TB case enrolment (OR = 1.24, 95% CI: 1.09–1.42), 136% higher for maternity admissions (OR = 2.36, 95% CI: 1.89–2.94), 76% higher for maternity deliveries (OR = 1.76, 95% CI: 1.51–2.04) and 2% higher for reporting of hmis-10:01 data to dhis-2 (OR = 1.02, 95% CI: 1.01–1.03). Conclusions HIV, TB, laboratory, MCH, and reporting to dhis-2 selected indicators were positively impacted by accreditation. This impact translated into increased health care services performance at the accredited facility as compared to the non-accredited facilities.

Key success factors for the implementation of quality management systems in developing countries

“…Numerous medical laboratories that have met the standard’s requirements and received accreditation have shown improvements in the quality of medical services and patient safety. 1 , 7 , 8 , 9 , 10 , 11 , 12 , 13 …”

Upholding Quality and Patient Safety during COVID-19 Pandemic—A Jordanian Case Study

“…These standards require establishing and adhering to clear administrative and clinical practices that establish clear standards and encourage information exchange and staff and/or patient issue resolution. Studies have shown that such standards support the development of a "culture of quality" and motivate personnel to perform to the best of their abilities [12][13][14].…”

“…Staff ongoing education, staff wellbeing promotion, use of evidence-based practices, internal and external coordination, risk management, staff and patient safety, etc., are part of the IEEA requirements. Accordingly, emergency preparedness, in general, is a core element of the accreditation standards [5,10,12,14].…”

“…Another study by Hussein et al [13] reported that accreditation stimulated performance improvement and patient safety. Moreover, a study in Uganda to assess the influence of laboratory accreditation on the performance of healthcare services reflected that there was a positive impact of accreditation on increasing healthcare services performance in accredited facilities [14].…”

Excellent Service and Patient Satisfaction in Health Clinic Services

“…Patient satisfaction is something that must be maintained by a hospital or health clinic so that the image of the service can remain of high quality and its existence can continue to survive in society (Lee & Lee, 2022;Li et al, 2022). Patient satisfaction is a global indicator of a health service accreditation standard (Organization, 2022), without patient satisfaction, it cannot be ascertained whether a health service is of good standing (Matovu et al, 2022). The increasing number of patients who are satisfied with a health service means that the service provided by a hospital or health clinic is good or very good (Mohan, 2023).…”