Ethiopian Health Care Quality Bulletin
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Federal Democratic Republic of Ethiopia Ministry of Health Ethiopian Health Care Quality Bulletin Continuous Health Care Quality Improvement through Knowledge Management Vol 1, May 2019 Ethiopian Health Care Quality Bulletin Continuous Health Care Quality Improvement through Knowledge Management Vol 1, May 2019 Table of Contents Message from Medical Service General Director .............................................................................................. ii Foreword ........................................................................................................................................................... iii Maternal Newborn and child health Quality of Care initiative.......................................................................... 2 Saving Lives through Safe Surgery (SaLTS) initiative .......................................................................................... 4 Learning Health Facility initiative ....................................................................................................................... 6 Quality Improvement for Better Vitamin A Uptake at Community Level, Ethiopia .......................................... 9 Improving Iron and Folic Acid Supplement Uptake by Pregnant Women at Primary Health Care Unit in Ethiopia ............................................................................................................................................................ 14 Quality improvement project to reduce ANC waiting time: the case of Woreta ............................................ 18 Improving pediatric Emergency Care Service Quality Score at St. Peter’s specialized Hospital ..................... 23 Improving Early Post Natal Care within the First 8 hours in Kebado Primary Hospital, Dara Woreda, Sidama zone, SNNP ....................................................................................................................................................... 28 Reduction of Neonatal Mortality at GebreTsadiq Shawo Hospital by Decreasing Neonatal Hypothermia .... 32 Quality of Maternal Screening and Counseling in Primary Health Care Units in Ethiopia .............................. 39 Increase Long Acting Reversible Family Planning In Manbuk Catchment Area Of Benishangul Gumz Region .............................................................................................................................................................. 44 Proper and Complete Use of Partograph to Improve Quality of Maternal and Neonatal Care Services at Durbetie Health Center, West Gojam zone, Amhara Region .......................................................................... 47 Improve Community TB detection in Wacha Primary Hospital ..................................................................... 50 Improving the quality of Nursing Care Plan at Pediatrics ward, Worabe Hospital .......................................... 55 Reducing Newborn Hypothermia at Birth in Chencha Primary Hospital, Gamo Zone, SNNPR, Ethiopia ........ 60 Utilization of Safe Childbirth Checklist to Improve Quality of Care Provided to the Mother and Newborn: A Case of Molalie Health Center, North Shoa Zone, Amhara Region ................................................................. 67 Increase Partograph Use through Quality Improvement Intervention in Bambasi Health Center, Benishangul Gumz Region, Ethiopia ..................................................................................................................................... 70 Reducing Outpatient waiting time to consultation at outpatient department, Worabe hospital .................. 73 Surge plan; a Quality Improvement Booster ................................................................................................... 78 QI project on improving elective surgical service access at Yekatit 12 Medical College ................................. 82 Expanding Access to Safe Surgery through A Multidisciplinary Mentorship Approach .................................. 88 Building Local Manufacturing Capacity to Improve Access to Critical MNCH Medicines................................ 92 Enhancing Healthcare Workers’ Infection Prevention and Patient Safety Awareness: In-service Training at Goba Referral Hospital ..................................................................................................................................... 95 Quality of Care in Patient-Physician Communications at Yekatit 12 Hospital: Cases and Medical Encounters ..................................................................................................................................................... 101 Level of Quality of Immediate Newborn Care Practices and Associated Factors among Newborns who have been delivered in public hospitals of Wolayta zone, South Ethiopia ............................................................ 106 Quality of Neonatal Resuscitation in Ethiopia: Implications for Policy and Practice ..................................... 114 i Message from Medical Service General Director Ethiopia has achieved significant gains in the series of HSDP, where universal health coverage given the priority to address the priority health problems of the country. Despite the gains, still a lot remain in quality of health care service. Cognizant of this, the FMOH made quality and equity one of the four priority agenda of the health sector transformation plan. Built on the plan, the National Health Care Quality Strategy was developed and launched in 2016. The strategy aims in transforming the quality of health care in the country and gives due emphasis for experience sharing across facilities and institutions. We all know that healthcare consists of many interlinked processes that result in a very complex system. And these complexities of healthcare operations and the vast amount of challenges we are facing make the undertaking of a quality improvement initiative seem like a distant possibility. But healthcare quality improvement is achievable when every organization identify the essential problems and begin the important work of addressing those challenges one by one by using an improvement model based on scientific methodology for which the quality improvement projects included in this bulletin are good examples. We all play a crucial role in recognizing quality deficits within our organizations, identifying potential solutions, and driving quality improvement activities. To guide these activities and make efficient use of limited improvement resources, we need to know what works and what does not within a particular topic area. We need to engage in collaborative thinking and learn from each other to deploy proactive improvement methods. Accordingly, we believe this healthcare quality bulletin will give us information about which QI interventions are effective and in what situations for possible adaptation in to our own context. This being the start, we envision to develop and make it a journal in the near future. Thus, we look forward to more of your contribution in future publications. Yakob Seman Director General, Medical Service General Directorate ii Foreword In the national quality strategy, sharing best practices across facilities and institutions through which facilities and providers identify quality gap and solutions for the quality improvement has been given due emphasis. To this end, this quality bulletin is prepared and presented in two sections that includes: Major initiatives under the health service quality directorate and quality improvement projects and studies selected for learning. There are a lot of good ideas tested as presented in this bulletin and I hope it will help to further develop our collective knowledge and understanding of quality improvement in the healthcare. This publication is made possible by the integrated effort of different individuals and organizations. Accordingly, I would like to acknowledge authors of the selected quality improvement projects and studies and their affiliated organization for sharing information and innovation. I also like to extend my appreciation to the Health Service Quality Directorate experts and the technical core group who played the crucial role in materializing this bulletin. Special thanks go to Dr Fitsume K. for coordinating and leading the core group in the review and editorial process. Lastly, I thank the World Health Organization for financially supporting the printing. We can accomplish more when we share ideas and work together! Dr. Hillina Tadesse Director, Health Service Quality Directorate iii Ethiopian Health care quality Bulletin core team Name Organization Position Mr Yakob Seman FMOH Director General/MSGD Dr. Hillina Tadesse FMOH Director/HSQD Dr. Fitsume Kibret FMOH MNCH/QoC TA Mr. Esayas Mesele FMOH Senior Advisor for Quality and Patient Safety Prof. Telahun Teka FMOH Senior National Quality Advisor Mrs Mekdes Assefa FMOH Monitoring and Evaluation Specialist Dr. Mikiyas Teferi FMOH Case team coordinator Dr. Berhane Redae FMOH Surgical care Advisor Dr. Yunis Mussema USAID Child Health Advisor/ Program Development Specialist Mr. Gizachew Tadele JSI/L10K Senior Monitoring, Evaluation and Research Advisor Dr. Manuel K. Sibhatu Jhpiego Director/Safe Surgery 2020 Dr Berhanu Tekle ICAP Senior Quality Advisor Dr Haimanot Ambelu WHO NPO/MPS Dr. Azmach Hadush WHO MCH Coordinator iv SECTION ONE: MAJOR INITIATIVES UNDER HEALTH SERVICE QUALITY DIRECTORATE 1 | P a g e Maternal Newborn and child health Quality of Care initiative