Improving the quality of COVID-19 care in Sierra Leone: A modified Delphi process and serial nationwide assessments of quality of COVID-19 care in Sierra Leone.
<h4>Introduction</h4>Improving the quality of care that patients receive is paramount to improving patient outcomes and engendering trust during infectious disease outbreaks. Whilst Quality Improvement (QI) is well established to drive improvement in routine care and in health systems, t...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
|
| Series: | PLOS Global Public Health |
| Online Access: | https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002670&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850128400792944640 |
|---|---|
| author | Daniel Youkee Michael Lahai Abdul R Mansaray Sorie Samura James Bunn Sulaiman Lakoh Stephen Sevalie |
| author_facet | Daniel Youkee Michael Lahai Abdul R Mansaray Sorie Samura James Bunn Sulaiman Lakoh Stephen Sevalie |
| author_sort | Daniel Youkee |
| collection | DOAJ |
| description | <h4>Introduction</h4>Improving the quality of care that patients receive is paramount to improving patient outcomes and engendering trust during infectious disease outbreaks. Whilst Quality Improvement (QI) is well established to drive improvement in routine care and in health systems, there are fewer reports of its use during infectious disease outbreaks.<h4>Methods</h4>A modified Delphi process was undertaken to create a standardized assessment tool for the quality of COVID-19 care in Sierra Leone. Four rounds of assessment were undertaken between July 2020 and July 2021. To assess change across the four assessment periods compared to baseline we used a mixed effects model and report coefficients and p values.<h4>Results</h4>During the Delphi process, 12/14 participants selected the domains to be assessed within the tool. The final 50 questions included 13 outcome questions, 17 process questions and 20 input questions. A total of 94 assessments were undertaken over four assessment periods at 27 facilities. An increase of 8.75 (p = <0.01) in total score was seen in round 2, 10.67 (p = <0.01) in round 3 and 2.17 (p = 0.43) in round 4 compared to baseline. Mean cumulative scores for COVID-19 Treatment Centres were higher than Hospital Isolation Units (p<0.02) at all four timepoints. Significant improvements were reported in coordination, diagnostics, staffing, infection prevention and control (IPC), nutrition, and vulnerable populations domains, but not in the oxygen, care processes, infrastructure and drugs domains.<h4>Conclusion</h4>We demonstrate the feasibility of creating a quality of care assessment tool and conducting sequential nationwide assessments during an infectious disease outbreak. We report significant improvements in quality-of-care scores in round 2 and round 3 compared to baseline, however, these improvements were not sustained. We recommend the use of QI and the creation of standardised assessment tools to improve quality of care during outbreak responses. |
| format | Article |
| id | doaj-art-ef475b97aabd46fdafa8e9aa7359b23b |
| institution | OA Journals |
| issn | 2767-3375 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj-art-ef475b97aabd46fdafa8e9aa7359b23b2025-08-20T02:33:19ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-01312e000267010.1371/journal.pgph.0002670Improving the quality of COVID-19 care in Sierra Leone: A modified Delphi process and serial nationwide assessments of quality of COVID-19 care in Sierra Leone.Daniel YoukeeMichael LahaiAbdul R MansaraySorie SamuraJames BunnSulaiman LakohStephen Sevalie<h4>Introduction</h4>Improving the quality of care that patients receive is paramount to improving patient outcomes and engendering trust during infectious disease outbreaks. Whilst Quality Improvement (QI) is well established to drive improvement in routine care and in health systems, there are fewer reports of its use during infectious disease outbreaks.<h4>Methods</h4>A modified Delphi process was undertaken to create a standardized assessment tool for the quality of COVID-19 care in Sierra Leone. Four rounds of assessment were undertaken between July 2020 and July 2021. To assess change across the four assessment periods compared to baseline we used a mixed effects model and report coefficients and p values.<h4>Results</h4>During the Delphi process, 12/14 participants selected the domains to be assessed within the tool. The final 50 questions included 13 outcome questions, 17 process questions and 20 input questions. A total of 94 assessments were undertaken over four assessment periods at 27 facilities. An increase of 8.75 (p = <0.01) in total score was seen in round 2, 10.67 (p = <0.01) in round 3 and 2.17 (p = 0.43) in round 4 compared to baseline. Mean cumulative scores for COVID-19 Treatment Centres were higher than Hospital Isolation Units (p<0.02) at all four timepoints. Significant improvements were reported in coordination, diagnostics, staffing, infection prevention and control (IPC), nutrition, and vulnerable populations domains, but not in the oxygen, care processes, infrastructure and drugs domains.<h4>Conclusion</h4>We demonstrate the feasibility of creating a quality of care assessment tool and conducting sequential nationwide assessments during an infectious disease outbreak. We report significant improvements in quality-of-care scores in round 2 and round 3 compared to baseline, however, these improvements were not sustained. We recommend the use of QI and the creation of standardised assessment tools to improve quality of care during outbreak responses.https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002670&type=printable |
| spellingShingle | Daniel Youkee Michael Lahai Abdul R Mansaray Sorie Samura James Bunn Sulaiman Lakoh Stephen Sevalie Improving the quality of COVID-19 care in Sierra Leone: A modified Delphi process and serial nationwide assessments of quality of COVID-19 care in Sierra Leone. PLOS Global Public Health |
| title | Improving the quality of COVID-19 care in Sierra Leone: A modified Delphi process and serial nationwide assessments of quality of COVID-19 care in Sierra Leone. |
| title_full | Improving the quality of COVID-19 care in Sierra Leone: A modified Delphi process and serial nationwide assessments of quality of COVID-19 care in Sierra Leone. |
| title_fullStr | Improving the quality of COVID-19 care in Sierra Leone: A modified Delphi process and serial nationwide assessments of quality of COVID-19 care in Sierra Leone. |
| title_full_unstemmed | Improving the quality of COVID-19 care in Sierra Leone: A modified Delphi process and serial nationwide assessments of quality of COVID-19 care in Sierra Leone. |
| title_short | Improving the quality of COVID-19 care in Sierra Leone: A modified Delphi process and serial nationwide assessments of quality of COVID-19 care in Sierra Leone. |
| title_sort | improving the quality of covid 19 care in sierra leone a modified delphi process and serial nationwide assessments of quality of covid 19 care in sierra leone |
| url | https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002670&type=printable |
| work_keys_str_mv | AT danielyoukee improvingthequalityofcovid19careinsierraleoneamodifieddelphiprocessandserialnationwideassessmentsofqualityofcovid19careinsierraleone AT michaellahai improvingthequalityofcovid19careinsierraleoneamodifieddelphiprocessandserialnationwideassessmentsofqualityofcovid19careinsierraleone AT abdulrmansaray improvingthequalityofcovid19careinsierraleoneamodifieddelphiprocessandserialnationwideassessmentsofqualityofcovid19careinsierraleone AT soriesamura improvingthequalityofcovid19careinsierraleoneamodifieddelphiprocessandserialnationwideassessmentsofqualityofcovid19careinsierraleone AT jamesbunn improvingthequalityofcovid19careinsierraleoneamodifieddelphiprocessandserialnationwideassessmentsofqualityofcovid19careinsierraleone AT sulaimanlakoh improvingthequalityofcovid19careinsierraleoneamodifieddelphiprocessandserialnationwideassessmentsofqualityofcovid19careinsierraleone AT stephensevalie improvingthequalityofcovid19careinsierraleoneamodifieddelphiprocessandserialnationwideassessmentsofqualityofcovid19careinsierraleone |