Implementation of Research for Quality of Care Project! Measuring and Improving Physician Compliance with WHO Clinical Practice Guidelines for ‘Iron Deficiency Anemia in Children’

Abstract

Abstract:Iron deficiency anemia (IDA) is the most prevalent anemia globally. As per WHO, 600 million children worldwide have IDA. Additionally, National Nutrition Survey 2011, Pakistan revealed 61.9% children are anaemic. In our project we measure and improve physicians compliance with WHO Clinical practice guidelines for 'Iron deficiency anemia in children'. Juran's Problem Solving Methodology was applied. Pre-survey results suggest 81.1% children are anemic. Only 11.4% and 10.6% are on regular Iron supplementation and deworming agents respectively. Though (93.4%) physicians surveyed have comprehensive knowledge. Moreover, merely 13.7% parents have some knowledge about IDA. We choose Ishikawa Fish Bone Diagram for cause and effect analysis and 'Gant Chart' to allocate timelines. We implement certain strategies like Physician's questionnaire form, refresher courses, information material for parents, and sustain supply of medicines. Post survey analysis concluded significant increased prescription rate of Iron supplementation and deworming agents as well as parents knowledge for IDA. For long-term sustainability, we established Policy, Quality indicators, Posters/Brochures and regular refresher courses. We also ensure adequate and sustain supply of iron supplementations and deworming agents at subsidized rates in hospital pharmacy. In responses to our project, we found under-practice of WHO recommendations despite comprehensive physician's knowledge.