Hospital and Health Care Administration

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Browsing Hospital and Health Care Administration by Author "Adiam Nega"

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    Improving Ethical Practice at Neonatal Intensive Care Unit in Buee Primary Hospital.
    (Addis Abeba University, 2020-05) Hiwot Alemayehu; Mesfine Addise; Adiam Nega
    Introduction: Ethics is defined as a moral philosophy or code of morals practiced by a person or group of people. There agreed ethical principles are autonomy, beneficence, non-maleficence, and justice, which are widely accepted in the neonatal practice.However, within the context of diverse values, beliefs and interests’ fundamental variations exist and they hugely influence the plans of new born management. There is limited information in Ethiopia regarding the practice of these ethical principles. The ethical principles of new born care are not clearly stated and not applied well by NICU staffs, in Buee Primary Hospital (BPH). The parents are not part of decision making and treatment of choice. Objectives: The objective of the project is to improve the practice of ethical principles at NICU in Buee Primary Hospital. Methods: Pre-post interventional study and descriptive qualitative approach was conducted to explore the practice of ethical principles at NICU in Buee Primary Hospital. The study populations are all health professionals working in the hospital. Key informant interview guide was conducted face to face by the investigator. The recorded audio note interviews were transcribed, and analyzed thematically using open code software version 4.2. Result: In the pre-intervention we conducted observation, document review and discussion to verify the root cause of the problem. In the- post intervention we developed implementation plan and the health professionals started to implement the plan. During this period, we evaluated the problem whether it has improved or not .Qualitative finding: The key informant interviews indicated gaps in the practice of ethical principles in NICU.The results of the selected strategies showed a significant improvement on the practice of low ethical principles in the unit. This was objectively measured using the observational checklist from 27% to 80% during the evaluation period of pre and post intervention. Conclusion and Recommendation: The results of this project suggested that a simple set of intervention was effective on improving the practice of ethical principles.The finding also proved the effectiveness of selected strategies, but it will be better to implement in a large scale in the hospital.
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    Improving Outpatient and Inpatient Medical Recording Data Quality in Yerer General Hospital,2021
    (Addis Abeba University, 2021-07) Hanna Aboye; Mesfin Addise; Wondimu Ayele; Adiam Nega
    Background: Medical recording is an essential part of information use, dissemination, decision making for the health needs of the community health care system and quality service delivery. The medical recording quality is a serious issue to be addressed, especially in Africa which has been measured using different data quality dimensions, and the percentage result is below standard. In Ethiopia, the ministry of health (MoH) has focused on information revolution setting a five-year transformation plan, and has developed tools on a standard of data quality measurement. Those tools are used to measure the medical recording data quality in Yerer General Hospital for selected dimension. Objective: To improve medical recording of outpatient and inpatient data quality in Yerer General Hospital by the end of 2021 EC. Method: It is a pre post study, we carried out a pre intervention; with baseline assessment using an infinite sample size calculation and proportional simple random sampling of cards which was admitted to the hospital between end of 2018 to end of 2019 time frame, and post intervention was in 2021 January to measure the improvement. After the intervention, a finite population sample size was used and a proportional random sampling method was applied for those admitted from January 21 to February 21 2021. Result: Training on health management information system was given as an intervention after pre intervention result was observed .pre intervention total completeness of outpatient and inpatient MR was 79.12% and 51.59% respectively. On post intervention result it decreased to 57% and 41% respectively. Pre intervention total accuracy of outpatient and inpatient MR was 63.6% and 55.7% respectively. On post intervention result it increased to 80.73% and 81.67% respectively. The timelessness has improved the cards are returned to the medical recording room in 24 hours after intervention. Conclusion: The intervention has influence on improvement of Total accuracy and timeliness but decrease score of the Total completeness of medical recording in Yerer General Hospital. Recommendation: Continues trainings and follow up are required to strengthen quality department of Yerer General Hospital.
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    Improving Outpatient Medical Record Completeness in Enchini Primary Hospital, Oromia, Ethiopia
    (Addis Abeba University, 2019-06) Dereje Bokan; Mesfin Addissie; Adiam Nega
    Background: Medical records management is one of the components of health information system that documents information related to a patient generated during patient-to-health care provider encounters at a health care facility. A well-managed medical records system is critical to improve the provision of quality health care services to ensure safe medical practice, efficient and effective services and improve the patient’s experience and satisfaction with their medical encounter. Objective:-To improve outpatient medical record completion from 37% to 90% in Enchini Hospital at t he end of June 2019GC. Methods: A pre- post intervention design was used in this project to examine the completion rate of outpatient medical record. The pre-intervention assessment was conducted in the outpatient department of Enchini hospital. Base line data were collected between January and March 2019. The baseline data showed the completeness of outpatient medical records was low. Only 37% of the 50 audited patient folders were completed. A questionnaire was developed to assess knowledge gabs of all workers who were working at outpatient department such as nurses, general practitioners and medical record workers, whether supportive supervision was conducted by senior management team and availability of printing formats and materials. The root cause analysis was conducted to identify the root cause of the problem. Based on the verification, lack of awareness about outpatient medical record completeness was identified as a real root cause and a two day’s staff training on medical record completeness was conducted. Results: the outpatient medical record completion rate increased from 37% pre intervention to 89% post-intervention. Specifically, Summary sheet of all visit dates practice and International disease code practice were considerably improved by 90 and 80 percentage points respectively. Conclusion: The result of this project suggests that a simple set of intervention providing training on the awareness of medical record improves of outpatient medical record completeness. Recommendation: The hospital, the regional health bureau and FMoH need to give emphasis for the completeness of outpatient medical records as it contribute to good quality of healthcare.
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    To Assess and Improve the Low Bed Occupancy Rate in Mida Weremo Primary Hospital, Amhara, Ethiopia 2019
    (Addis Ababa University, 2019-07) Petros Anberbir ; Adiam Nega; Birhan Tassew
    Introduction: Low bed occupancy rate (BOR) is the one of the biggest problem of the hospital. As a result it brings the indication of low quality health care services, customer and staff dissatisfaction and poor revenue generation. In this study measured and improved bed occupancy rate focused on installing operation care materials and start operation care service and provided post operative care at surgical ward in Mida Weremo primary hospital in Amhara /Ethiopia. Objective: To assess and improve low bed occupancy rate from 33.2% to 75% by the end of May 2019 G.C Methodology: A pre-post intervention study design was used to improve the low bed occupancy rate in Mida Weremo Primary Hospital. Data was collect from the admission and discharge registration log books including all patients admitted pre and post intervention by using the check list from each ward by data collectors. Total of 331 admitted patients were enrolled in study. Data was analyzed by using the following formula to calculate the BOR Formula of BOR= Total number of patient days for a given period (length of stay) x 100 Available beds (bed complement) x the number of days in the period. Result: Socio-demographic section of the study most admitted patients are male (59.3%) and Christian (82.7%). The mean ± SD age was 33.7 ± 27 and 32.4 ± 24.4 in the pre intervention and post intervention respectively. During the pre intervention study the BOR was 32.3%, 32%, 36% and 30.1% on September, October, November and December respectively. Operation service was started at the month of January. In this pre-post study BOR when we see the progress of BOR in each month with in the intervention periods 55.8%, 63.3%, 74.1% and 86.6% on February, March, April and May respectively. Conclusion: The fact that the hospital hasn’t started giving operation and post operation care service was attributed for low BOR and initiating this service was the main change idea. During post intervention period BOR was increased from 33.8% to 70% in this intervention period. Recommendation: It was recommended to hospital manager to give more attention and that the departments should record and report the necessary data accurately. It was also recommended to give more emphasis and do more researches on this field.