Assessment of the level of continuous quality improvement implementation and associated factors in public hospitals of Addis Ababa, Ethiopia

Abstract

Problem Statement: Continuous quality improvement has become an important aspect of healthcare organizations as they are forced to change and improve. Ethiopian National Health Care Quality Strategy was crafted as a call to action to improve quality across the entire Ethiopian health system. Objective: To assess the level of implementation of continuous quality improvement and to assess factors affecting implementation of continuous quality improvement in government hospitals, in Addis Ababa. Method: Institutional based cross-sectional study has been conducted in government hospitals in Addis Ababa. 368 Health professionals from 5 hospitals was included in this study. Data was collected using a structured questionnaire. Epi info version 7.2 was used for data entry and SPSS versions 25 for analysis. Association between independent variables with implementation of continuous quality improvement was checked using multivariable linear regression. In performing the statistical analyses p value of 0.05 and confidence interval (CI) of 95% was considered as statistically significant. Result: The overall quality result outcome is 65%. Of the six dimensions information and analysis achieved the highest score (3.34±0.86) followed by Leadership (3.25±0.90). Human resource utilization dimension was the lowest score (3.14±0.94). Strategic quality planning, human resource utilization, quality process management and customer satisfaction monitoring were positively associated with increased quality results. Conclusion: The findings indicated that CQI implementation was less successful in Addis Ababa health sector due to lower human resource management like low employees’ participation in quality management activities, low quality process management, and low customer satisfaction assessment practices. The findings revealed that the most important contributing factors to successful CQI implementation in the study hospitals were information use and analysis, strategic quality planning, good human resource management, customer satisfaction and quality process management. Based on this finding it is recommended investments on continuous quality improvement should be geared towards improving the overall performance of the hospitals.

Thesis available at ACIPH Library