Quality Improvement Commons^™

Estimating Costs Of Post-Abortion Services. General Hospital Aurelia Valdivieso, Oaxaca, Mexico, Population Council

Reproductive Health

Health care systems around the world are facing problems providing quality care with increasingly constrained resources. While modern practices and diagnostic tests have made pregnancy a much less risky event than in the past, not all pregnancies have a favorable outcome. Spontaneous abortion occurs in 15–45% of all known pregnancies, and studies show that 25% of all obstetric/gynecology hospital admissions are for incomplete abortion. Given the high level of resources devoted to treating this condition, it is imperative to develop cost-effective methodologies to provide quality care. Unsafe abortion performed by untrained and inexperienced providers is the fourth leading cause of …

Comparing Quality Of Reproductive Health Services Before And After Clinic-Strengthening Activities: A Case Study In Rural Burkina Faso, Direction De La Santé Et De La Famille (Dsf), University Of Ouagadougou Demographic Research Unit (Uerd), Mwangaza, Population Council

Reproductive Health

Much literature has been written about improving the quality of reproductive health (RH) care at service delivery points (SDPs) because women deserve quality services, and as a means of increasing use of family planning (FP) and other RH services. There are six fundamental dimensions of quality of care: choice of methods, information given to clients, technical competence, interpersonal relations, mechanisms to encourage continuity, and an appropriate constellation of services. Improving these elements is thought to increase client satisfaction, resulting in an increase in contraceptive use and eventually fertility decline. Existing research has not convincingly demonstrated this link between quality of …

Monitoring Of Macro-Level Family Planning Quality Of Care Indicators, Meiwita B. Iskandar

Reproductive Health

The success of population development in Indonesia can be seen partly from success in reducing population growth. Population growth has declined from 2.32 percent (1971–80) to 1.98 percent (1980–90), and then to 1.66 percent (1990–95). The continued slowing of population growth is expected to bring expanded opportunities for economic development and improved quality of life. The success of family planning (FP) programs cannot be judged solely on reduction of population growth but should also be judged in terms of quality of care (QOC) and success in helping women achieve their reproductive goals. The Indonesian National Family Planning Coordinating Board (BKKBN) …

Improving Quality Of Care In Fp/Rh Of Selected Communities Of Pangasinan Province: An Intervention Study, Zelda C. Zablan, Josefina V. Cabigon, Luzviminda Muego, Marilou P. Costello, Chona R. Echavez

Reproductive Health

This intervention study was designed to improve the quality of family planning (FP) services within the Integrated Family Planning and Maternal Health Program of the Pangasinan Population and Family Planning Program in the Philippines. It addresses high unmet need and studies the feasibility of enhancing quality of services by training service providers in fixed clinics and orienting outreach workers on the method of identifying women who have unmet need for FP. Four municipalities were chosen from the 47 municipalities comprising the province of Pangasinan and randomly assigned to experimental and control groups. Four indicators were used to match the chosen …

Using A Rapid Assessment Approach To Evaluate The Quality Of Care In An Integrated Program: The Experience Of The Family Health Division, Ministry Of Health, Botswana, Lucy Sejo Maribe, Baker Ndugga Maggwa, Ian Askew, Kate Miller

Reproductive Health

To strengthen existing efforts by the Government of Botswana in responding to the HIV/AIDS epidemic, USAID provided financial and technical assistance through the Botswana Population Assistance (BOTSPA) project. BOTSPA’s goal was to improve the quality and availability of family planning (FP) and sexually transmitted infection (STI) services through designing, implementing, and monitoring activities that would lead to the eventual institutionalization and sustainability of high-quality FP and STI/HIV/AIDS services. The Ministry of Health requested assistance from the Africa OR/TA Project II to develop and test an approach for routinely measuring the quality of service delivery and assessing skills retention by staff …

Quality Of Family Planning Programme In India: A Review Of Public And Private Sector, Dileep V. Mavalankar

Reproductive Health

Increasing attention has been paid to quality of care (QOC) in family planning (FP) during the last few years, and there have been several initiatives to strengthen QOC in FP in the developing world. This paper reviews the quality of the FP program in India’s public and private sectors, and examines six elements: choice of methods, information given to clients, technical competence, interpersonal relations, continuity of care and follow-up, and appropriate constellation of services. Overall, the paper finds that not much attention has been paid to QOC and hence the level is quite low. Evidence and observations indicate that QOC …

A Synthesis Of Research Findings On Quality Of Services In The Indian Family Welfare Programme, Gillian H.C. Foo

Reproductive Health

In recent years, there has been growing recognition among researchers and policymakers that the quality of care provided by family planning (FP) programs in developing countries is an important determinant of whether couples adopt contraception and continue as contraceptive users, or whether these programs are underutilized. A major initiative to identify and implement improvements in the quality of services within the Indian program calls for a systematic analysis, organization, and presentation of the available data to the policymakers and program managers concerned. Additional data is also required on issues such as user's perception of quality of care, the relative importance …

Program Evaluation: A Look At A Case Management Program Of Big Spring State Hospital Community Services, Sharon Root Treadway

Graduate Theses

Case management services are an expanding program in the Texas Department of Mental Health and Mental Retardation (TXMHMR) system's treatment for chronically mentally ill individuals (CMI). CMI’s are individuals who are unable to maintain a stable adjustment to community life because of persistent and serious emotional disabilities. Previous research findings as to the effectiveness of this type of service in other programs have been mixed, and because of differences in program guidelines are not directly applicable to the TXMHMR program. The hypotheses of this study, which was a program evaluation of one specific program of case management, were two-fold; one, …

Patient Satisfaction Among Users Of The After Hours Program, Helen L. Larocco

Community & Environmental Health Theses & Dissertations

The problem of increasing health care costs and decreasing access to health care services is a major crisis in the U.S. today. One factor contributing to the rising cost of health care is the inappropriate use of emergency rooms, (ERs). In response to escalating costs a local health care corporation implemented a telephone triage program called the After Hours Program, (AHP). The goal of the program was to reduce inappropriate utilization of emergency rooms, and to educate patients to recognize and treat specific health problems independently, i.e., home treatment.

A program evaluation was completed in which different dimensions of patient …

A Cipp Evaluation Of The Administrative Associate Training Program Through Sentara, Patricia A. Criswell

Community & Environmental Health Theses & Dissertations

Hospitals are facing change in today's environment. In order to meet these growing challenges, they are responding by providing value added services. Value added services have been defined as reducing inefficiencies and improving quality and service. Operational restructuring in the form of a new concept called patient-focused care has become the paradigm shift and structural revamping at several hospitals across the nation. Sentara Hospitals have adopted this program to improve the clinical and service quality delivered to the patient. An integral component of this new approach is the multiskilling of staff to reduce duplication, inefficiencies, and improve the quality provided …

An Analysis Of Quality Assessment Efforts In Health Care, Margaret M. Curran

Community & Environmental Health Theses & Dissertations

The purpose of this research was to determine whether consensus could be reached by experts in the field of quality assurance on the most important indicators of health care quality and to determine whether cause and effect relationship could be attributed to the process and outcome indicators suggested in our survey. We invited participation by a representative sample of experts in a Delphi Panel to address these issues. There were 49 respondants to our Round One Questionnaire and they evaluated the relative importance of 50 process and 50 outcome indicators. Panelists were asked to establish cause and effect relationships between …

Correlates Of Knowledge And Locus Of Control On Burden In Professional Caregivers Of Alzheimer's Disease Victims In Three Institution Types, Ruth A. Manning-Gay

Community & Environmental Health Theses & Dissertations

In assessing professional caregivers of Alzheimer's Disease victims, this study tested whether, 1) knowledge would influence perceptions of burden in providing care to such patients, and if 2) individual locus of control would influence perceptions of burden in caring for; Alzheimer's I patients. Professional nurses (BSN's, RN's, and LPN's) from nursing banes, hospitals and psychiatric facilities were asked to complete a three part survey. Three instruments were utilized in this study: the Burden Self-Interview by Zarit, Reeves and Bach-Peterson and adapted for professional caregivers, a 15 item knowledge quiz and the North Carolina Internal External scale (short form) by Schopler, …

Telephone Inquiries, Types Of Calls : Are Emergency Service Nurses Qualified To Give Answers?, Constance M. Boskin

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract not included]

Hospital Situations In Which Male Patients Prefer A Male Nurse, Norma Groome White

Loma Linda University Electronic Theses, Dissertations & Projects

This was a study of the preferences of men patients for the sex of the nurse desired to meet their physical, social, spiritual, and emotional needs. The purposes of the study were: (1) to identify the hospital situations in which a male nurse is preferred to give care, (2) to provide information that could be used in the utilization of male personnel, and (3) to provide information that could be used to possibly provide for better fulfillment of the needs of male patients.

The descriptive survey was chosen as the method of study. A questionnaire of thirty-five hospital situations was …

Nursing Care Given To Hemiplegic Patients, Margaret Eugenia Messer

Loma Linda University Electronic Theses, Dissertations & Projects

Statement of the Problem: The purpose of this study was to ascertain whether nursing care currently being given to hemiplegic patients in the area of body mechanics was adequate; to develop a standard from current literature in the field of medicine, physical therapy, and nursing by which nursing care given to hemiplegic patients could be evaluated; and to learn if better prepared nursing personnel were giving better nursing care.

Method: The descriptive survey was the method used in this study. The data were gathered by making actual observations of nursing care given to hemiplegic patients in the area of body …

Incidents Which Threaten Patient Safety Classified For Use In Teaching Operating Room Nursing, Elsie Dorothy Vivian Wendth

Loma Linda University Electronic Theses, Dissertations & Projects

The study was conducted in an attempt to identify incidents threatening the safety of patients in the care of operating room personnel and to classify them for use in teaching safety in operating room nursing.

Literature was reviewed to find concepts of safety and to aid in classification of safety hazards which are applicable to hospital patient safety. Need was shown for safe working conditions and for personnel with attitudes of safety as well as skills and knowledge. Safety included freedom from mechanical, thermal, chemical, bacteriological, and psychological injury.

The descriptive method of research using the critical incident technique was …

An Investigation Into Nursing Students' Awareness Of Emotional Needs Of Patients In A General Hospital, Sadie Sinclair

Loma Linda University Electronic Theses, Dissertations & Projects

Nursing educators consider that awareness of the emotional needs of a patient is a prerequisite to the formulation of a nursing problem. The problem of this study was to discover if the senior student in a specific college program in nursing is aware of the emotional needs of patients. A collection of senior research papers written over a period of sic [sic] years in a specific course assignment was studied. The attention was focused on the portion of the paper which dealt with the personality description of the patient. The direction given by the instructor did not emphasize any particular …