The impact of data feedback on continuous quality improvement projects in Rwanda: A mixed methods analysis
| Autor: | Jean Claude Byiringiro, Sudha Jayaraman, Robert Riviello, Rebecca G. Maine, John W. Scott, Zeta Mutabazi, Ignace Kabagema, Helen E. Noble, Theophile Dushime, Jean Marie Uwitonze, Jeanne D’Arc Nyinawankusi, Samuel Enumah, Yiyuan Hu |
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| Rok vydání: | 2020 |
| Předmět: |
Quality management
lcsh:Medicine Organizational commitment Mixed methods analysis Likert scale 03 medical and health sciences 0302 clinical medicine Geochemistry and Petrology Health care Medicine 030212 general & internal medicine Continuous quality improvement Medical education lcsh:R5-920 Healthcare worker motivation business.industry Professional development lcsh:R Rwanda 030208 emergency & critical care medicine Employee motivation Pre-hospital emergency care Emergency Medicine Original Article business lcsh:Medicine (General) Gerontology Social status |
| Zdroj: | African Journal of Emergency Medicine African Journal of Emergency Medicine, Vol 10, Iss, Pp S78-S84 (2020) |
| ISSN: | 2211-4203 |
| Popis: | Background Injuries are a leading cause of death and disability globally. Over 90% of injury-related mortality happens in low- and middle- income countries (LMICs). Rwanda's pre-hospital emergency system – Service d'Aide Medicale Urgente (SAMU) – and their partners created an electronic pre-hospital registry and Continuous Quality Improvement (CQI) project in 2014. The CQI showed progress in quality of care, sparking interest in factors enabling the project's success. Healthcare workers (HCW) are critical pieces of this success, yet we found a void of information linking pre-hospital HCW motivation to CQI programs like SAMU's. Methods Our mixed methods approach included a 40-question survey using questions regarding HCW motivation. We scored the surveys to compare SAMU staff motivation with other HCWs in LMICs, and used a Likert scale to elicit agreement or disagreement. A semi-structured interview based on employee motivation theory qualitatively explored SAMU staff motivation using constructivist grounded theory. To find interview themes, two researchers independently performed line-by-line analysis. Results SAMU staff received 5–21% higher motivation scores relative to other cohorts of HCWs in LMICs. Questions showing disagreement (five) asked about reprimand, damaged social standing, and ease of using the CQI technology. Three questions did not show consensus. Questions showing agreement (23) and strong agreement (nine) asked about organizational commitment, impact, and research improving patient care. Major themes were: improvements in quality of care, changes in job expectations, views on research, and positive experiences with data feedback. Conclusions The CQI project provides constant feedback vital to building and sustaining successful health systems. It encourages communication, collaboration, and personal investment, which increase organizational commitment. Continuous feedback provides opportunities for personal and professional development by uncovering gaps in knowledge, patient care, and technological understanding. Complete, personalized data input encouraged by the CQI improves resource allocation, building robust health systems that improve HCW agency and motivation. |
| Databáze: | OpenAIRE |
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