The development of the Delivery Assessment Tool (DAT) to facilitate quality improvement in burns services in low-middle income countries

Potokar, Tom; Bendell, R.; Phuyal, Kamal; Dhital, A; Karim, Esgandari; Falder, Sian; Kynge, L; Price, PE

doi:10.1016/j.burns.2021.10.010

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…Strong community engagement was discussed as a core component of many of the projects [ 35 , 54 , 77 , 85 , 91 , 96 – 101 ], including the development of partnerships with local organizations, not just international funders [ 102 ]. Teams were able through local engagement to leverage existing local resources, which aided in conducting and sustaining projects in resource-constrained settings [ 24 – 26 , 31 , 48 , 59 , 61 , 89 , 103 , 104 ].…”

Section: Resultsmentioning

confidence: 99%

“…Team members valued the opportunities for peer-to-peer learning and the ability to learn directly from others working on similar projects in different settings [ 34 , 36 , 44 , 54 , 76 , 82 , 89 , 95 , 108 , 111 , 119 – 122 ]. QI tools could be applied to a wide variety of disciplines, and the teams benefitted from building QI capacity and learning techniques rather than focusing solely on one improvement project [ 36 , 47 , 69 , 77 , 94 , 99 , 122 – 124 ]. Many authors described the benefits of having coaches or external experts to teach QI methods, provide mentoring support, and motivate perseverance in the face of obstacles [ 51 , 58 , 63 , 92 , 93 , 124 ].…”

Section: Resultsmentioning

confidence: 99%

“…Many of the authors discussed the challenges they faced and the resilience that was needed to overcome organizational, cultural, and resource constraints. Barriers to effective QI programs are common in virtually all settings, but especially in LMICs [ 28 ] given limited resources [ 12 , 13 , 40 , 45 , 56 , 58 , 66 , 77 , 84 , 95 , 96 , 122 ], competing priorities [ 51 , 94 ], natural disasters [ 91 ], ambiguous governance [ 12 , 13 ], and political and social strife [ 29 , 30 , 44 , 46 , 75 , 77 , 105 ]. A common challenge noted in the included studies was high turnover of nurses, healthcare staff, and QI team members, which made ongoing leadership directions and sustained changes difficult [ 31 , 37 , 45 , 47 , 51 , 53 , 55 , 81 , 94 , 122 , 125 ] and led to loss of organizational memory and trust [ 15 ].…”

Section: Resultsmentioning

confidence: 99%

“…Many programs were challenged with capacity and resources to collect and analyze data [ 13 , 35 , 93 , 126 , 141 ]. There were concerns about the reliability of data and a need to create better data collection systems [ 15 , 37 , 44 , 55 , 77 , 81 , 88 , 94 ]. Some authors discussed the urgent need for better measurement and data analyses that required minimal technical support and leveraged existing resources [ 24 , 25 , 59 , 66 , 67 , 108 , 119 , 132 , 133 , 137 ].…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Quality improvement in public–private partnerships in low- and middle-income countries: a systematic review

Iroz,

Ramaswamy,

Bhutta

et al. 2024

BMC Health Serv Res

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Background Public–private partnerships (PPP) are often how health improvement programs are implemented in low-and-middle-income countries (LMICs). We therefore aimed to systematically review the literature about the aim and impacts of quality improvement (QI) approaches in PPP in LMICs. Methods We searched SCOPUS and grey literature for studies published before March 2022. One reviewer screened abstracts and full-text studies for inclusion. The study characteristics, setting, design, outcomes, and lessons learned were abstracted using a standard tool and reviewed in detail by a second author. Results We identified 9,457 citations, of which 144 met the inclusion criteria and underwent full-text abstraction. We identified five key themes for successful QI projects in LMICs: 1) leadership support and alignment with overarching priorities, 2) local ownership and engagement of frontline teams, 3) shared authentic learning across teams, 4) resilience in managing external challenges, and 5) robust data and data visualization to track progress. We found great heterogeneity in QI tools, study designs, participants, and outcome measures. Most studies had diffuse aims and poor descriptions of the intervention components and their follow-up. Few papers formally reported on actual deployment of private-sector capital, and either provided insufficient information or did not follow the formal PPP model, which involves capital investment for a explicit return on investment. Few studies discussed the response to their findings and the organizational willingness to change. Conclusions Many of the same factors that impact the success of QI in healthcare in high-income countries are relevant for PPP in LMICs. Vague descriptions of the structure and financial arrangements of the PPPs, and the roles of public and private entities made it difficult to draw meaningful conclusions about the impacts of the organizational governance on the outcomes of QI programs in LMICs. While we found many articles in the published literature on PPP-funded QI partnerships in LMICs, there is a dire need for research that more clearly describes the intervention details, implementation challenges, contextual factors, leadership and organizational structures. These details are needed to better align incentives to support the kinds of collaboration needed for guiding accountability in advancing global health. More ownership and power needs to be shifted to local leaders and researchers to improve research equity and sustainability.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Quality improvement in public–private partnerships in low- and middle-income countries: a systematic review

Iroz,

Ramaswamy,

Bhutta

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

Barriers and prospects for skin grafting in burn treatment across African countries

Bbaale,

Mohr,

Lindert

et al. 2024

Burns

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Quality Improvement in Public-Private Partnerships in Low- and Middle-Income Countries: A Systematic Review

Iroz,

Ramaswamy,

Bhutta

et al. 2023

Preprint

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Background Public-private partnerships (PPP) are often how health improvement programs are implemented in low-and-middle-income countries (LMIC). We therefore aimed to systematically review the literature about the aim and impact of quality improvement (QI) approaches in PPP in LMIC. Methods We searched SCOPUS and grey literature for studies published before March 2022. One reviewer screened abstracts and full-text studies for inclusion. Study characteristics, setting, design, outcomes, and lessons learned were abstracted using a standard tool and reviewed by a second author. Results We identified 9,457 citations, of which 144 met the inclusion criteria and underwent full-text abstraction. We identified five themes for successful QI projects in LMIC: 1) leadership support and alignment with overarching priorities, 2) local ownership and engagement of frontline teams, 3) shared authentic learning across teams, 4) resilience in managing external challenges, and 5) robust data and data visualization to track progress. We found great heterogeneity in QI tools, study designs, participants, and outcome measures. Most studies had diffuse aims and poor descriptions of the intervention components. Few studies discussed the response to the finding and their willingness to change. Conclusions Empirical research is needed to explore the implementation challenges and contextual factors that influence how a PPP can best be implemented to improve population health. Vague descriptions of the structure of the PPPs and roles of public and private entities made it difficult to draw conclusions about the impact of the organizational governance on the outcomes of QI programs in LMIC. We outline a rich area future research, including the need for a clearer description of the interventions, uniform outcome measures, and focus on response to the findings. To improve research equity, more ownership and power should be shifted to local leaders and researchers.

show abstract

The development of the Delivery Assessment Tool (DAT) to facilitate quality improvement in burns services in low-middle income countries

Cited by 3 publications

References 5 publications

Quality improvement in public–private partnerships in low- and middle-income countries: a systematic review

Quality improvement in public–private partnerships in low- and middle-income countries: a systematic review

Barriers and prospects for skin grafting in burn treatment across African countries

Quality Improvement in Public-Private Partnerships in Low- and Middle-Income Countries: A Systematic Review

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