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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

Error bars showing average deltas in patient risk areas between 2012 and 2014.Legend: Risk area 1 (Leadership processes and accountability); Risk area 2 (Competent and capable workforce); Risk area 3 (Safe environment for staff and patients); Risk area 4 (Clinical of patients); Risk area 5 (Quality improvement and safety).
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pone.0142389.g004: Error bars showing average deltas in patient risk areas between 2012 and 2014.Legend: Risk area 1 (Leadership processes and accountability); Risk area 2 (Competent and capable workforce); Risk area 3 (Safe environment for staff and patients); Risk area 4 (Clinical of patients); Risk area 5 (Quality improvement and safety).

Mentions: Assessment scores in risk area 1 (leadership and accountability) show that intervention health facilities recorded relatively higher marginal increases between 2012 and 2014 (mean = 22) than control facilities (mean = 13) (p<0.0001); likewise, intervention facilities (mean = 16) improved more than control facilities (mean = 10) in risk area 2 (i.e. competent/capable workforce) (p<0.0001). Overall score in all risk areas was relatively higher in intervention (mean = 16) than control facilities (mean = 13) (p<0.05). There were no significant differences between intervention and control health facilities in risk areas 3, 4 and 5 which are predominantly medical technical areas (see Fig 4).


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)

Error bars showing average deltas in patient risk areas between 2012 and 2014.Legend: Risk area 1 (Leadership processes and accountability); Risk area 2 (Competent and capable workforce); Risk area 3 (Safe environment for staff and patients); Risk area 4 (Clinical of patients); Risk area 5 (Quality improvement and safety).
© Copyright Policy
Related In: Results  -  Collection

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

pone.0142389.g004: Error bars showing average deltas in patient risk areas between 2012 and 2014.Legend: Risk area 1 (Leadership processes and accountability); Risk area 2 (Competent and capable workforce); Risk area 3 (Safe environment for staff and patients); Risk area 4 (Clinical of patients); Risk area 5 (Quality improvement and safety).
Mentions: Assessment scores in risk area 1 (leadership and accountability) show that intervention health facilities recorded relatively higher marginal increases between 2012 and 2014 (mean = 22) than control facilities (mean = 13) (p<0.0001); likewise, intervention facilities (mean = 16) improved more than control facilities (mean = 10) in risk area 2 (i.e. competent/capable workforce) (p<0.0001). Overall score in all risk areas was relatively higher in intervention (mean = 16) than control facilities (mean = 13) (p<0.05). There were no significant differences between intervention and control health facilities in risk areas 3, 4 and 5 which are predominantly medical technical areas (see Fig 4).

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