Ethiopian Health Care Quality Initiative

Transcription

1 Ethiopian Health Care Quality Initiative IHI Africa Forum on Quality and Safety in Healthcare Abiyou Kiflie, MD, MPH Deputy Country Director IHI Ethiopia

2 Aim Reduce maternal and newborn mortality by 3% over a period of 5 years in engaged facility while institutionalizing culture of quality.

3 Project Design MNH Learning Collaborative as part of three interrelated project components: Quality Strategy Capability Building towards a habit and culture of continuous improvement MNH Collaborative three phases Core Indicators: HMIS Indicators routine indicators Bundle Indicators newly introduced

4 Cases/1 Cases/1 Cases/1 Syphilis screening: measure of quality of ANC Data validation QI training for leaders Lemu Bilbilu LS2,QI project of 4HFs LS1,QI project of 2HFs Stock-out of test kit Data validation Tanqua Abergele LS1,QI project of 3HFs QI training for leaders LS2, QI project of 4HFs Data validation Duguna Fango QI training for leaders LS1,QI LS Data validation Aggregate LS2,QI project of 9HFs LS1,QI project of 7HFs Stock-out of test kit(lb)

5 Oct-16 Jan- Feb Mar Apr-17 May Jun- Jul-17 Aug Sep Oct-17 Oct-16 Jan- Feb Mar Apr-17 May Jun- Jul-17 Aug Sep Oct-17 Oct-16 Jan-17 Feb- Mar- Apr-17 May Jun-17 Jul-17 Aug Sep Oct-17 Bundle: Measures of Quality of Delivery Process 1 On Admission Median 1 Before Pushing Median % SCC distributed,men torship started LS2,QI project of 8HFs % 4 2 SCC distributed,mento rship started LS2 1 8 Soon After Birth Median 6 LS2 % 4 2 SCC distributed,men torship started

6 Cases/1 Cases/1 Cases/1 Cases/1 PNC Within 48 Hrs U Charts Inflated Data Lemu Bilbilu QI training for Data validation LS1 LS2,QI project of 2HFs First Generate a valid data Data validation Valid Data Tanqua Abergele LS1,QI project of 6HFs QI training for leaders LS2, QI project of 6HFs Improvement Duguna Fango LS2,QI project Data validation of 5HFs LS1,QI project of 4HFs QI training for leaders Aggregate Data validation LS1,QI project of 1HFs LS2,QI project of 13HFs

7 Changes tested Facility teams tested various changes over the course of the project for the multiple projects they prioritized Changes leading to improvement were included into the package Some change ideas were recommended for further testing Some dropped The change package will be utilized in the next phase of work and get further refined for broader implementation

8 Team Facility Multidisciplinary Team Members QI team Do the actual QI work QI coaches from Woreda (district) and IHI Provide coaching support to facility teams Improvement Advisors Advise coaches while providing support and evaluating progress

9 Lessons Learned Quality improvement work begins by: Building trust for better data quality and genuine reporting Collaboratives empowers facility teams to improve care Teams that never utilized information in their hand started to design QI projects Improvements could be achieved fast, but sustaining it would need critical planning to make the system capable of absorbing it ex: stock-out of supplies Balance between use of existing indicator and introduction of new quality indicators prevent data collection fatigue, save energy for the improvement effort

10 Thank you!