Quality improvement baseline assessment in the African Neonatal Network
Keywords:
Quality Improvement; Needs Assessment; Capacity Building; Infant, Newborn; Infant, Premature; Neonatal Intensive Care Units; Africa South of the Sahara; Global HealthAbstract
Background: Achieving the Sustainable Development Goal target for neonatal mortality reduction requires improved access and quality of services globally. The extent to which neonatal teams in the African Neonatal Network (ANN) have knowledge, experience and capability in quality improvement (QI) is unknown. Methods: ANN team members completed baseline assessments with three standardized QI assessment tools: Beliefs, Attitudes, Skills and Confidence in QI (BASiC-QI), the Institute for Healthcare Improvement (IHI) Improvement Capability Self- Assessment Tool, and the IHI QI Knowledge Application Tool- Revised (QIKAT-R). Team leaders completed a focused assessment on the landscape of neonatal QI within their hospital, region and country.
Results: Ninety percent of ANN team members and 100% of team leaders completed the baseline assessment. 41% of participants reported prior experience in QI. Participants reported strong feelings or beliefs regarding QI on the BASiC-QI, including 72.7% strongly agreeing with ‘Using QI in the real world will make improvements’. The minority of participants agreed or strongly agreed that they were knowledgeable in fundamentals of QI. Just over half of participants reported that their hospital was in the ‘just beginning’ or ‘developing’ stages. The novel neonatal cases for the IHI QIKAT-R showed variation in applied knowledge (case scores: 0 to 9 of possible 9; median total score 11 of possible 27). 35% of teams reported collaboration on QI prior to ANN pilot.
Conclusion: The baseline assessment among ANN pilot sites documented gaps in QI knowledge, skills and their application. As ANN focuses on improving QI capability, learnings may have global relevance.
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