Essentials for Quality and Safety Improvement in Health Care

Patient safety and quality improvement in health care remain a global priority. Subpar performance in health care, however, is still common more than a decade after the christening of patient safety in Africa. The core principle of safety and quality improvement systems is to identify and assess the root cause of failures in order to learn from them and devise a means to improve and to avoid recurrence. This book is designed to encourage, facilitate and empower healthcare workers in the development and implementation of strategically driven patient safety and quality improvement initiatives for safer healthcare systems and healthcare facilities in low- and middle-income countries (LMICs) of Africa. It also highlights some of the profound challenges and barriers to designing and implementing patient safety and quality improvement interventions or programmes in the region and reiterates the need to remain focused and determined to work out solutions with confidence and overcome these barriers. In the book, chapters highlight six essential components crucial for achieving evolutionary progress in safety and quality improvement in a healthcare system:

• Standard operating procedure
• Audit
• Research
• Safety management
• Quality management
• EvaluationPractical steps in planning and conducting these six essential components are outlined with some specific features to aid learning and facilitate their implementation. The authors have experience and expertise in the medical practice gained in Africa and a decade of knowledge and experience from consultancy work in safety and quality improvement in health care within and outside the region. Essentials for Quality and Safety Improvement in Health Care: A Resource for Developing Countries is authored for both medical professionals and those from other professions who are interested in and enthusiastic about patient safety and healthcare quality and therefore willing to build a career in this field. It is relevant to all health institutions, health and non-health workers, and can be used as a checklist while rendering quality and safe health care.

Auteur

Christopher Ente is Patient Safety and Healthcare Quality Improvement Consultant and a founder of Patient Safety and Quality Care for Africa (PASQUA). He specialises in the use of information technology to drive safety and quality in health care. His background includes Information Communication Technology (ICT), quality control, quality assurance and quality improvement, healthcare risk management, clinical incident investigation and prevention, and the use of research, auditing and monitoring tools. He works as a research regulatory facilitator in the Research Governance and Integrity team, Imperial College London, UK. He was one of the external reviewers of the World Health Organization (WHO) Patient Safety Research A guide for developing training programmes published in 2012. He worked as a consultant for Synensys, a US-based healthcare consulting firm, with the Qatar Ministry of Public Health Project in the Middle East. He has years of experience working in various roles in the National Health Service (NHS) and Higher Education Institutions in the United Kingdom. He worked in several ICT industries in different roles and as a System Engineer in Shell Petroleum Development Company (SPDC) in various departments including high hazardous offshore oil rigs. He earned a Master's degree in Quality and Safety in Healthcare from Imperial College London and Computer Network and Communication from Westminster University London. He has a Bachelor of Science degree in Computer Science and Statistics from the University of Uyo in Nigeria and he holds a certificate in Prince 2 Project Management. He is a member of Research Quality Association (RQA) in the United Kingdom and the Society of Quality in Healthcare in Nigeria.

Dr. Michael Ukpe is a Consultant Obstetrician and Gynaecologist, a Fellow of the West African College of Surgeons. He has fellowship in minimal access surgery and assisted reproductive technology. He is an experienced medical practitioner who has practised medicine in and outside Nigeria. The greater part of his practice has been in the low-resource settings. He has attended several health-related conferences on primary and secondary health care. He is currently the Chief Medical Director, Romivic Specialists Hospital Limited, Eket, Akwa Ibom State, Nigeria. The delivery of safe and easily accessible quality health care to the people is his heart beat. He brings to bear the challenges and next steps to the issues affecting the safety of health workers and patients in the course of delivering quality health care covered in this book. He obtained his MBBCH from the University of Calabar, Calabar in Cross River State, Nigeria. This book is very relevant to all health institutions, health and non-health workers, and can be used as a checklist while rendering quality and safe health care to the people.

Contenu

Chapter 1 - Concept of Quality and Safety Improvement in Health Care. 16 Introduction. 16

Healthcare and Healthcare System in Africa. 16

Impact of Medical Errors and Adverse Events in the Healthcare System in Africa. 17

Patient Safety. 18

Patient Safety in the African Healthcare System.. 19 The Importance of Patient Safety. 19

Quality and Safety Improvement in Healthcare. 20

The Costs of Poor Quality of Care and Services in Africa. 20

The Challenges of Safety and Quality of Care Improvement in Africa. 21

Poor Infrastructure. 22 Workforce Shortage. 22

Health Policies, National and Local Guidelines. 22

Weak Legal Mandates, Accreditation, and Administrative Regulations. 23

Weak Legal and Judicial System.. 23

Organisational and Institutional Influencing Factors. 23 Poor Quality Data in Healthcare. 24

Leadership and Governance Problem.. 24

Prerequisite for the Essentials for Quality and Safety Improvement in Healthcare. 24

Creating and Sustaining Patient Safety Culture. 25

Secure Organisational Supports at all Levels. 26 Create Safety and Quality Department (SQD). 26

Effective Healthcare Management. 27

Conclusion. 30

References. 31

Chapter 2 - Standard Operating Procedure. 37

Introduction. 37

Standard Operating Procedure. 37

Development of Standard Operating Procedure (SOP). 38

Testing and Reviewing of Standard Operating Procedure. 42

Implementation of Standard Operating Procedure. 42 Benefits of Standard Operating Procedure in Healthcare Settings. 42

Optimising Healthcare Data Quality and Documentation. 43

Improving Healthcare Facility and Environment. 45

Improving of Procurement Management. 45

Enhancing Training and Development. 47 Barriers and Enablers to Implementation of SOPs in Healthcare in Africa. 47

Conclusion. 47

References. 49

Chapter 3 - Audit. 52

Introduction. 52

Audit. 53

Remote Audit. 53

Remote Audit in African Healthcare Settings. 54

Audit Design, Conduct and Implementation of Findings. 54

Step 1: Choosing a Topic. 54

Step 2: Defining Standards. 56 Step 3: Data Collection. 58

Step 4: Data Analysis. 60

Step 5: Finding Presentation. 60

Steps 6: Change Implementation. 62

Step 7: Re-Audit. 62 Benefits of Audit in Healthcare in Africa. 63

Encouraging the use of Modern Medicine in the Region. 63

Evaluating Health Policies and Guidelines. 64

Designing Educational and Training Programme. 64

Improving the Quality of Medical Records. 64 Barriers and Enablers for Effective Audit in Healthcare in Africa. 65

Conclusion. 66

References. 67

Chapter 4 - Research. 71

Introduction. 71

Healthcare Research. 72

Research Ethics, Governance and Integrity Training. 72

Planning, Designing, Conducting, Recording and Reporting Healthcare Research. 75

Planning and Designing Healthcare Research. 75

Identificat…