Implementation of the WHO Standards to assess the quality of paediatric care using health workers as source of data: findings of a multicentre study (CHOICE) in Italy

被引:6
|
作者
Liguoro, Ilaria [1 ]
Mariani, Ilaria [2 ]
Iuorio, Andrea [3 ]
Tirelli, Francesca [4 ]
Massarotto, Marcella [5 ]
Cardinale, Fabio [6 ]
Parrino, Roberta [7 ]
Dal Bo, Sara [8 ]
Rivellini, Sara [1 ]
Trobia, Gian Luca [9 ]
Valentino, Kevin [10 ]
Sordelli, Silvia [11 ]
Lubrano, Riccardo [12 ]
De Rosa, Giuseppina [7 ]
Pandullo, Michela [1 ]
Di Stefano, Vita Antonella [9 ]
Martucci, Vanessa [12 ]
Baltag, Valentina [13 ]
Barbi, Egidio [14 ,15 ]
Lazzerini, Marzia [2 ,16 ]
机构
[1] Univ Udine, Acad Hosp Santa Maria Misericordia, Dept Med DMED, Div Paediat, Udine, Italy
[2] Inst Maternal & Child Hlth IRCCS Burlo Garofolo, WHO Collaborating Ctr Maternal & Child Hlth, Trieste, Italy
[3] IRCCS Meyer Childrens Univ Hosp, Dept Pediat Emergency Med, Florence, Italy
[4] Univ Padua, Dept Womens & Childrens Hlth, Padua, Italy
[5] Treviso Hosp, Dept Pediat, Treviso, Italy
[6] Univ Bari, Pediat Hosp Giovanni XXIII, Dept Pediat, Bari, Italy
[7] Childrens Hosp G Cristina, ARNAS Civ Cristina Benfratelli, Pediat Emergency Unit, Dept Pediat, Palermo, Italy
[8] Santa Maria Croci Hosp, Dept Pediat, Ravenna, Italy
[9] Cannizzaro Emergency Hosp, CA Pediat & Pediat Emergency Room Unit, Catania, Italy
[10] AO SS Antonio & Biagio & Cesare Arrigo, Children Hosp, Pediat & Pediat Emergency Unit, Alessandria, Italy
[11] Carlo Poma Hosp, Dept Pediat, Mantua, Italy
[12] Sapienza Univ Rome, Santa Maria Goretti Hosp, Dept Pediat, Latina, Italy
[13] WHO, Dept Maternal Newborn Child & Adolescent Hlth & Ag, Geneva, Switzerland
[14] Inst Maternal & Child Hlth IRCCS Burlo Garofolo, Dept Paediat, Trieste, Italy
[15] Univ Trieste, Trieste, Italy
[16] London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, Maternal Adolescent Reprod & Child Hlth Care Ctr, London, England
关键词
Child Health; Infant; INTENSIVE-CARE; CHILD HEALTH; VOLUME;
D O I
10.1136/bmjpo-2024-002612
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objectives There is little experience in implementing the WHO Standards for improving the quality of care (QOC) for children. We describe the use of 75 WHO-Standard based Quality Measures to assess paediatric QOC, using health workers (HWs) as data sources.Design Cross-sectional study.Setting 12 Italian hospitals.Participants The minimum target of 75% of HWs was reached in all facilities; answers from 598 HWs were analysed.Primary and secondary outcome measures 75 prioritised WHO Quality Measures were collected using a validated, and Italian-language questionnaire exploring views of HWs providing care to children. A QOC index was also calculated based on the assessed Quality Measures.Results In both the domain of resources and work organisation, most Quality Measures showed a high overall frequency of reported 'need for improvement', with high variability across hospitals. Key needs for improvement included: availability of clear and complete protocols (eg, on paediatric emergencies: 44.6%; range 10.6%-92.6%); clear hospitalisation criteria for diarrhoea (50.5%; range 30.3%-71.7%); number of hand-washing stations (13.2%; range 3.4%-37.0%); equipped working rooms with computers for HWs (66.1%; range: 32.1%-97.0%); training (eg, on pain management: 43.5%; range 17.9%-76.7%), periodic discussion of clinical cases (43.5%; range 8.1%-83.7%) audits (48.8%; range 29.7%-76.7%); and all indicators related to system to improve QOC. Factors significantly associated with a lower QOC Index included HWs working in facilities in Southern Italy (p=0.001) and absence of a paediatric emergency department (p=0.011).Conclusions The use of the 75 prioritised Quality Measures, specific to HWs provide valuable data on paediatric QOC, which can be used to drive a quality improvement process.
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页数:10
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