Quality of health Care assessment Presentation

Assessing the quality of health services provided by primary

healthcare centers in IDP camps Iraq, 2018

Quality of Care (QoC)

“Quality can be defined as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”

WHO

Background

During Mosul operation, the primary focus was on emergency life-saving services.

– the country is in a transitional phase towards “Early Recovery and Development”

– therefore, it is important to strengthen basic health services and ensure that adequate quality standards are being maintained in the provision of primary healthcare services.

Methodology

Objective: to assess the quality of health care services

provided at PHCCs in IDP camps in Iraq and to to identify the

factors impeding the achievement of basic minimum

standards.

Assessment tool: The tool is contextualized to Iraq with

standard indicators to measure the primary functions related to

the PHCCs.

o The tool consists of 15 short-listed indicators, grouped into

5 domains (technical competence, patient care,

management, environment safety and satisfaction).

o The data was collected by trained health care providers

through 2 approaches (observations and interviews).

Assessment tool

Health Cluster Quality of Healthcare

assessment

Categories: 5

Indicators: 15

Questions: 45

PHCCs in IDP camps

Analysis

Quality of Healthcare Assessment

Feedback to PHCCs/health

partners

Follow-up

Target PHCCs: in 59 IDP camps planned; 55 implemented across 8 governorates in Iraq:

• 13 teams of 2 two people each, were trained and sent to the field to complete the QoC survey.

• Each team had one tablet connected to the internet and each completed assessment was directly submitted to an electronic platform.

1. Anbar

2. Dahuk

3. Diyala

4. Erbil

5. Kirkuk

6. Ninawa

7. Salahdin

8. Sulimaniyah

Methodology

GPS location of IDP camps in Iraq

Health Cluster Quality of healthcare assessment

Using Kobo-toolbox

Electronic form

28 June, 2018

Introduction

• Each team will receive one tablet;

• All tablets have internet sim-cards.

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Application Interface

Get Blank Form

Download fresh blank form by clicking on “Get Blank Form”

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Once selected, click on “Get Selected” to download the form from the server

Press OK

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Select “Fill Blank Form” and the form you just download will appear here.

Select the “Health Cluster Quality Care” electronic form.

This will be the start page of the electronic assessment, swipe to move to the next page.

Note: swipe the screen to go backward or forward.

General Information

Write your team #: 1, 2, 3 or 4

Write telephone no. of data collector #1

Note: enter 11 digit number starting with 07 or 08.

Write full name of data collector #1

Then write the full name and phone number for data collector #2

Press on “Select one answer” and choose the governorate from the list.

Press on “Select one answer” and choose the district from the list.

Press on “Select one answer” and ALWAYS choose IDP camp.

Press on “Select one answer” and choose the IDP camp name.

Put the tablet on a flat surface and select “Record Location” and wait for few minutes.

NOTE: In order to Record Location you have to move outdoors to have a satellite signal.

Once you see the GPS reading swipe the screen to go to the next page.

NOTE: If you want to repeat the GPS reading, select “Replace Location”.

Write Health Facility Name

Select who is running/supporting the health facility.

NOTE: If you select the options: NGOs, INGOs or Other, you have to write the name…

Swipe the screen to move to the next page; Note that you will not be able to move forward if you do not choose an answer; All questions are mandatory to be filled.

PART 1: Health Facility Observation

Go through each observation (General physician, Nurse, Pharmacist and laboratory technician) and answer the specific answers under each.

Keep in mind that you will not be able to move forward if you do not choose an answer; All questions are mandatory to be filled.

PART 2: Health Worker Observation

PART 3: Health Worker Interview

NOTE: If the answer is “Yes” the physician Interview questions will appear when you swipe the screen.

IF the answer is “NO” when you swipe the screen you will be automatically directed to the next health worker interview. Same conditions apply to the

other health worker interviews (Nurse, Pharmacist and Laboratory Technician).

PART 4: Patient Exist Interview

YOU HAVE TO CONDUCT INTERVIEWS WITH SIX (6) Patients

Go through the six patient interviews and keep in mind that you will not be able to move forward if you do not choose an answer; All questions are mandatory to be filled.

Once selected, click on “Save Form and Exit”

NOTE: Choosing “ Save Form and Exit” doesn’t mean that the filled assessment is submitted. It only means it is finalized and saved on the tablet.

Click on “Send Finalized Form”

Once selected, click on “Send Selected”

Preliminary Results

Availability of IEC material in the waiting area, physician room & MCH room

Availability of Oral rehydration points in PHCs

Governorate Total PHCs ORPs

Anbar 6 1

Dahuk 11 6

Diyala 3 1

Erbil 4 3

Kirkuk 5 1

Ninewa 19 7

Salah Al-Din 2 0

Sulaymaniah 5 5

Infection Prevention and Control measures at PHCs in IDP camps

78% of PHCs in IDP camps

have separate water faucets and

toilets for patients

Practice of hand hygiene by healthcare providers

Deliver of health messages and ensure client understood? • Diet, • Smoking, • Medication, • Exercise • Follow up care

Physician performing: 1. Physical Assessment 2. Medical History 3. Explaining Treatment

Privacy conditions were met for

62% of the patients interviewed

84%

15%

22%

0% 20% 40% 60% 80% 100%

Get medical history

Perform physicalassessment/examination

Explain treatment/patientunderstood

Physician performing physical assessment/obtaining medical history/expaining treatment for patients visiting PHCs in IDP camps

YES PARTIAL NO

Did the pharmacist write on the package: 1. Patients name, 2. Medicine Name, 3. Dosage 4. Way of administration

Infection prevention practices by laboratory technicians

Did the technician tell the client when to return for the results?

Laboratory results were

explained to 100% of the concerned patients

Capacity Building of health care providers

Patient Satisfaction

Reason for visiting the PHC today

Availability of needed services

85% of the patients

interviewed were satisfied in the health services provided at PHCs in IDP camps.

Prescribed Medication available today