MEDA WELABU PRIMARY HOSPITAL

EMERGENCY OUTPATIENT HEALTH CARE SRVICE QUALITY

IMPROVEMENT PLAN 2016

FEBRUARY 2016

BIDIRE

PROJECT TITTLE
Improving pediatric Emergency Care Service Quality Score at MEDA
WELABU PRIMARY HOSPITAL

PARTICIPANTS
S,n QI TEAM MEMBERS RESPONSIBILITY

1 Dr. Habtamu Lemma QI team leader

2 Mr. Gezu Gemmachisa QU head
3 Sr. Derartu EOPD head
4 Dr. Tarecha EOPD physician
5 Mr. Tagane melake QU officer

Background:
 Meda welabu primary Hospital was established in 2008 and has been serving the community as
the only primary hospital for about eight years in Meda welabu woreda east borena zone Oromia
regional state.
Hospital based Emergency care is part of the patient flow in a hospital setting and includes the
processes and procedures needed to ensure the efficient flow of patients between services. As
stated in the national hospital transformation guideline, properly designed and implemented
hospital based emergency medical care services will reduce patient emergency triage and
treatment times, increase provider efficiency and staff and client satisfaction as well as improve
overall quality of care.
PROBLEM STATEMENTS
Clinical audit was done in emergency department by quality improvement team reveals that the quality
of care in was found to have major gaps related to the provision of an appropriate triage service, providing
comprehensive clinical evaluation, outlining a correct management. Such gaps in quality of care provision
had definitely contributed to the poor child health outcomes following each child health service in our
hospital.
RATIONALE OF QI PROJECT
Emergency care includes a well-designed Patient triage, proper Case management, and providing basic
and timely Laboratory, pharmacy and diagnostic service. The rationale of this project is improving the ER
service score which is defined by
 Appropriately triaged / triage paper is filled and attached,
 Appropriate triage classification as per standards and management of emergency condition
as per the ETAT guideline.
 Justifiable diagnosis following a comprehensive evaluation (pertinent history, pertinent
physical examination and justifiable investigations all documented.
 Appropriate management was outlined with correct good dispensing practice
 Appropriate nursing care and monitoring the progress of the patients as per standards.
PROJECT GOALS OR AIM:
 We Meda Welabu Primary Hospital QI Team Plan
To Improve Pediatric Emergency Care Service
Score From Baseline Score 29% To More Than
90% At Meda Welabu Primary Hospital At The End
Of September 2017 E.C.
SPECIFIC OBJECTIVES
Improving ETAT implementation >90 %
Provision of comprehensive clinical evaluation by
the right clinician >90%
Appropriate outlining of management plan >90%
METHODOLOGY
A multidisciplinary QI team will formed to design, implement
and monitor the project.
The team consisted of a pediatric nurse, the case leader
physician, the head nurse and two quality officers.
Root-cause analysis will do using the driver diagram and fish
bone diagram and the change ideas were proposed for
improvement by the quality improvement team.
Then interventions were prioritized using ease of
implementation of the interventions and importance of the
interventions.
 ROOT CAUSE ANALYSIS

DRIVEN DIAGRAM FOR ROOT CAUSE ANALYSIS AND POSSIBLE SOLUTION

driven

Data collection and analysis plan

· Charts will be selected using simple random sampling
· Chart audit checklist will used to fill the audit findings for each case; Audit findings will fed to an
excel data base (1 if standards of interest are met and 0 for any missing component from a
particular standard), a hard copy of the audit finding will be also maintained for each chart
· Weekly, the outcome measures of interest will calculated and fed to a summary sheet
· When adequate data points are there, run chart rules of interpretation will used to look for

evidence of improvement.

IMPACT MONITORING AND EVALUATION PLAN

· Outcome measures
Proportion of patients received minimum standard pediatric emergency care

· Process measures
Proportion of weekly cases in the week who are triaged appropriately and
correct triage classification given
Proportion of weekly cases with a justifiable diagnosis following a

comprehensive evaluation (pertinent history, pertinent physical examination

and justifiable investigations)

Proportion of weekly cases for who appropriate management was outlined
with correct good dispensing practice.
 · Balancing measures
 Average emergency waiting time at pediatrics ER

IMPLEMENTATION / WORK PLAN

s.n Key activities Responsible Startin Ending Remark

g date date
1
2
3
4
5
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 BUDGET PLAN
s.no Key activities need resources Unit price Total price Source of
budget

6
QI TEAM OF MEDA WELABU PRIMARY HOSPITAL