Dataset Information

Perceptions of hospital staff on the performance of Quality Improvement teams in the regional referral hospitals in Tanzania: A cross sectional study.

ABSTRACT:

Background

To ensure patient-centered quality care for all citizens, Quality Improvement (QI) teams have been established across all public hospitals in Tanzania. However, little is known about how hospital staff perceive the performance of hospital QI teams in Tanzania. This study assessed the perceptions of hospital staff of the performance of QI teams in selected regional referral hospitals in Tanzania.

Methods

This cross-sectional study was conducted in four selected regional referral hospitals between April and August 2018. A self-administered questionnaire was used to collect data from 385 hospital staff in the selected hospitals. Measures of central tendency, proportions and frequencies were used to assess level of perception of hospital staff. Bivariate and multivariate logistic regression was used to test the association between the perceptions of hospital staff of the performance of QI teams and their socio-demographic factors.

Results

The overall mean perception score of the performance of QI teams was 4.84 ± 1.25. Hospital staff aged 35 and over (n = 130; 68%), female hospital staff (n = 144; 64%), staff in clinical units (n = 136; 63%) and staff with post-secondary education (n = 175; 63%) perceived that the performance of QI teams was good. Improved hospital cleanliness was viewed as strength of QI teams, whilst inadequate sharing of information and inadequate reduction in patient waiting time were considered as weaknesses of QI team performance. Bivariate and multivariate logistic regression analyses showed that there was no statistical association between the perceptions of hospital staff and their socio-demographic characteristics.

Conclusion

The overall perception of hospital staff of the performance of QI teams was good, with the main limitation being sharing of hospital QI plans with hospital staff. Hospital staff should be involved in the development and implementation of hospital QI plans, which would promote a positive perception of staff of the performance of QI teams and enhance sustainability of QI teams.

SUBMITTER: Kacholi G

PROVIDER: S-EPMC7886151 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Perceptions of hospital staff on the performance of Quality Improvement teams in the regional referral hospitals in Tanzania: A cross sectional study.

Kacholi Godfrey G Mahomed Ozayr H OH

PloS one 20210216 2

<h4>Background</h4>To ensure patient-centered quality care for all citizens, Quality Improvement (QI) teams have been established across all public hospitals in Tanzania. However, little is known about how hospital staff perceive the performance of hospital QI teams in Tanzania. This study assessed the perceptions of hospital staff of the performance of QI teams in selected regional referral hospitals in Tanzania.<h4>Methods</h4>This cross-sectional study was conducted in four selected regional ...[more]

PMID: 33592051

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Project description:BACKGROUND:Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. METHODS:We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest. We selected six different clinical conditions for analyses, including acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), heart failure, hip/knee surgery, pneumonia, and stroke. Data included all acute care hospitals reporting in Hospital Compare in 2014. RESULTS:The number of hospitals with reported readmissions ranged from 2234 hospitals for AMI to 3758 hospitals for pneumonia. The average 30-day readmission rates ranged from 5.19% for knee/hip surgery to 22.7% for COPD. Patient experience of hospital-staff responsiveness as "top-box" ranged from 64% to 67% across the six clinical conditions, communication with nurses ranged from 77% to 79% and communication with doctors ranged from 80% to 81% (higher numbers are better). Our finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile. A ten-percentage-point increase in staff responsiveness led to a 0.03-0.18 percentage point decrease in readmission rates. We found that neither communication with physicians nor communication with nurses was significantly associated with hospital readmissions. CONCLUSIONS:Our findings suggest that elements of care related to staff responsiveness during patients' stay may influence rehospitalization rates. Changes in staff responsiveness may offer an additional tool for hospitals to employ ongoing efforts to achieve reductions in readmissions, an important objective both financially and for patient health outcomes.

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Project description:ObjectiveTo delineate the prevalence and factors associated with antimicrobial use across six referral hospitals in Tanzania using WHO point prevalence survey (PPS) methodology to inform hospital-specific antimicrobial stewardship programmes.DesignCross-sectional analytical study.SettingSix referral hospitals in Tanzania.ParticipantsPatients irrespective of age and gender (n=948) admitted in the six referral hospital wards before 8:00 hours on each day of the survey were included in December 2019. Using the WHO PPS methodology, data on hospitals, wards, patients, antibiotics, and indications for antibiotics were collected.Outcome measuresWe analysed the prevalence of antibiotic use by referral hospital, ward, indication and patient characteristics as the main outcomes. We also described adherence to the Tanzania Standard Treatment Guidelines (STG) and WHO's AWaRe categorisation of antibiotics.ResultsApproximately 62.3% of inpatients were prescribed antibiotics, predominantly from the Access group of antibiotics (ceftriaxone, metronidazole or ampicillin-cloxacillin). The overall adherence of antibiotic prescriptions to the Tanzania STG was high (84.0%), with the exception of Sekou Toure Regional Referral Hospital (68.0%) and Maweni Regional Referral Hospital (57.8%). The most common indication for antibiotic prescriptions was community-acquired infections (39.8%). Children less than 2 years of age (OR 1.73, 95% CI 1.02 to 2.92, p=0.039); admission to surgical wards (OR 4.90, 95% CI 2.87 to 8.36, p <0.001); and admission to paediatric wards (OR 3.93, 95% CI 2.16 to 7.15, p <0.001) were associated with increased odds of antibiotic use. Only 2 of 591 patients were prescribed antibiotics based on culture and antimicrobial susceptibility testing results.ConclusionsEmpirical use of antibiotics is common, and the Access group of antibiotics is predominantly prescribed in children less than 2 years and patients admitted to surgical and paediatric wards. Lack of utilisation of antimicrobial susceptibility testing services in these hospitals requires urgent interventions. Routine monitoring of antibiotic use is recommended to be part of antibiotic stewardship programmes in Tanzania.

Dataset Information

Perceptions of hospital staff on the performance of Quality Improvement teams in the regional referral hospitals in Tanzania: A cross sectional study.

Background

Methods

Results

Conclusion

Publications

Perceptions of hospital staff on the performance of Quality Improvement teams in the regional referral hospitals in Tanzania: A cross sectional study.

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