tailieunhanh - Quality improvement and clinical audits

This chapter is intended to provide managers and healthcare providers with basic information for establishing and implementing quality improve- ment measures of services and care in resource- limited settings. | 34 Quality Improvement and Clinical Audits Baltazar J. Ngoli INTRODUCTION This chapter is intended to provide managers and healthcare providers with basic information for establishing and implementing quality improvement measures of services and care in resourcelimited settings. Although the focus of this book is on gynecological services the reader will realize that the principles of quality improvement are the same irrespective of whether one intends to apply them to a unit department or the whole health facility. The methodologies are derived from those described by experts in quality improvement and have been successfully applied in facilities with resource constraints. Whenever possible experiences resulting from application of such approaches are elaborated. Health facilities are composite units whether they are small stand-alone clinics or large multi-specialist hospitals. A functioning health facility is a complete system composed of interacting elements which form a complex whole1. By understanding the components of a system in the context of health service delivery and health facilities it is possible to appreciate its dynamics and ultimately recognize the reason for its current performance status. This information is essential in designing improvement measures. There are many opportunities for a facility to embark on quality improvement. It is good to realize that these opportunities are always there waiting to be utilized. Below are listed events or situations which can trigger initiation of quality improvement programs. The list serves only as example. Demands from users and society These include introduction of payment systems for health services introduction of a complaint system in a health facility political or media pressure and boycott of bad health services. Demands from staff Healthcare providers including the health institutions managers would like to work in a safe environment have the necessary basic equipment and materials to enable them to