Conducting an audit to improve the facilitation of emergency maternal and newborn referral in northern Ghana
| Autor: | Peter Baffoe, Francis Yeji, John Koku Awoonor-Williams, Sarah Mercer, Afua Williams, Patricia E. Bailey, Ayire Emmanuel Adongo |
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| Rok vydání: | 2015 |
| Předmět: |
Program evaluation
Clinical audit Patient Transfer Referral Maternal-Child Health Services Quality Assurance Health Care Population Psychological intervention Staffing Audit Ghana Infant Newborn Diseases Nursing Pregnancy Medicine Humans education Emergency Treatment Referral and Consultation education.field_of_study Clinical Audit business.industry Public Health Environmental and Occupational Health Infant Newborn Service provider Obstetric Labor Complications Perinatal Care Transportation of Patients Female business |
| Zdroj: | Global public health. 10(9) |
| ISSN: | 1744-1706 |
| Popis: | Ghana Health Service conducted an audit to strengthen the referral system for pregnant or recently pregnant women and newborns in northern Ghana. The audit took place in 16 facilities with two 3-month cycles of data collection in 2011. Midwife-led teams tracked 446 referred women until they received definitive treatment. Between the two audit cycles, teams identified and implemented interventions to address gaps in referral services. During this time period, we observed important increases in facilitating referral mechanisms, including a decrease in the dependence on taxis in favour of national or facility ambulances/vehicles; an increase in health workers escorting referrals to the appropriate receiving facility; greater use of referral slips and calling ahead to alert receiving facilities and higher feedback rates. As referral systems require attention from multiple levels of engagement, on the provider end we found that regional managers increasingly resolved staffing shortages; district management addressed the costliness and lack of transport and increased midwives' ability to communicate with pregnant women and drivers; and that facility staff increasingly adhered to guidelines and facilitating mechanisms. By conducting an audit of maternal and newborn referrals, the Ghana Health Service identified areas for improvement that service providers and management at multiple levels addressed, demonstrating a platform for problem solving that could be a model elsewhere. |
| Databáze: | OpenAIRE |
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