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Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana.

Alhassan RK, Nketiah-Amponsah E, Spieker N, Arhinful DK, Ogink A, van Ostenberg P, Rinke de Wit TF - PLoS ONE (2015)

Bottom Line: Patient safety and quality care remain major challenges to Ghana's healthcare system.This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities.Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05).

View Article: PubMed Central - PubMed

Affiliation: Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, Netherlands.

ABSTRACT

Background: Patient safety and quality care remain major challenges to Ghana's healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE) in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed.

Purpose: This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities.

Methods: A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities.

Findings: Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05). Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period. Community groups that were gender balanced, religious/faith-based, and had structured leadership appeared to be better options for effective SCE in healthcare quality assessment.

Conclusion: Community engagement in healthcare quality assessment is a feasible client-centered quality improvement option that should be discussed for possible scale-up in Ghana and other resource poor countries in Africa.

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Related in: MedlinePlus

Human and material resources in intervention and control facilities in 2012 and 2014.
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pone.0142389.g001: Human and material resources in intervention and control facilities in 2012 and 2014.

Mentions: As shown in Table 1 the average human and material resource situation per health facility appeared to have improved during the follow-up survey. Significant increases were recorded in the number of nurses, laboratory technologists, pharmacists and support staff (p<0.05); likewise, though the average number of wards and laboratories per clinic increased significantly at follow-up (p<0.05) these increases may not be associated with the interventions because they were not within the control of the study (see Fig 1).


Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana.

Alhassan RK, Nketiah-Amponsah E, Spieker N, Arhinful DK, Ogink A, van Ostenberg P, Rinke de Wit TF - PLoS ONE (2015)

Human and material resources in intervention and control facilities in 2012 and 2014.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664410&req=5

pone.0142389.g001: Human and material resources in intervention and control facilities in 2012 and 2014.
Mentions: As shown in Table 1 the average human and material resource situation per health facility appeared to have improved during the follow-up survey. Significant increases were recorded in the number of nurses, laboratory technologists, pharmacists and support staff (p<0.05); likewise, though the average number of wards and laboratories per clinic increased significantly at follow-up (p<0.05) these increases may not be associated with the interventions because they were not within the control of the study (see Fig 1).

Bottom Line: Patient safety and quality care remain major challenges to Ghana's healthcare system.This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities.Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05).

View Article: PubMed Central - PubMed

Affiliation: Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, Netherlands.

ABSTRACT

Background: Patient safety and quality care remain major challenges to Ghana's healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE) in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed.

Purpose: This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities.

Methods: A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities.

Findings: Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05). Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period. Community groups that were gender balanced, religious/faith-based, and had structured leadership appeared to be better options for effective SCE in healthcare quality assessment.

Conclusion: Community engagement in healthcare quality assessment is a feasible client-centered quality improvement option that should be discussed for possible scale-up in Ghana and other resource poor countries in Africa.

Show MeSH
Related in: MedlinePlus