Assessment of Quality Improvement Project Implementation Practices at Addis Ababa Public Hospitals

Abstract

To achieve better health outcomes at the societal level, it is important to emphasize quality across the spectrum of health systems from the sub-national to the national and across primary, secondary and tertiary levels of care. The quality issue in Ethiopian health system was given high prominence in Health Sector Transformation plan (2015/16-2019/2020). The objective of this study was to assess the quality improvement (QI) project implementation in Addis Ababa Public Hospitals. Cross sectional descriptive study design with quantitative approach was used. Self-administered structured questionnaire was used to collect primary data electronically from 12 Addis Ababa Public Hospitals. Out of 72 study participants for whom the questionnaire was sent 60 have responded making the response rate 83.3%. The questionnaire internal consistency was checked using Cronbach’s alpha. The data was analyzed using SPSS version 20 software. All 12 hospitals have started at least one new QI project while more than half of study participants (56.7%) have reported that their hospitals had graduated at least two QI projects within 12 months prior to the study. The QI team members have least influence on preparing project goal and resource allocation. The descriptive analysis shows that there is high perceived competency on QI implementation, QI team have positive attitude toward QI project, there is high level of team work on QI, there is gaps in using generated evidence for decision making and sustaining gains. The hospital leader’s and physician engagement on QI project implementation as well as resource allocation for QI project are sub optimal. The hospital management is recommended to further empower QI team, maximize use of evidence for decision making, improve resource allocation, sustaining gain from QI project implementation, and work to enhance physician engagement. Lastly encouraging new ideas, actively monitoring the QI project implementation and facilitating cross learning among employees were recommended as a means to improve leadership engagement.