RCPCH ETAT+ Project - Kenya

Partnering with the Royal college of Paediatrics & Child Health (UK) and Ministry of Health

Title of Project: Working in partnership to achieve MDG4 in East Africa: Improving the quality and safety of hospital care for sick infants and children through ETAT+ Executive summary

Aim: This project aims to reduce the mortality rate for children less than five years thereby, contributing to MDG4 through improved quality of emergency care for infants and children in Kenya, Rwanda and Uganda

Description: The partnership was started in 2012.between the Royal college of Paediatrics & Child Health, Kenya Paediatric Association and Ministry of Health. This involved the implementation of an 18 month ETAT+ intervention package in East Africa with six hospitals being targeted in Kenya.
For each included hospital, this included:

  • A baseline survey of hospital practice, including mortality statistics
  • ETAT+ training for 30 doctors, nurses and clinical officers during a five day course
  • Provision of guidelines, job aides, equipment and some hospital refurbishment to create an appropriate triage area / room
  • Identification of a hospital-based etat+ champion to drive quality improvement
  • Supervision by an in-country etat+ clinical lead visiting every three months
  • Quality assurance visits every six months by an identified UK consultant paediatrician with assessments of hospital practice
  • Assessment of impact through 6 monthly and an end of project survey of hospital practice and mortality rates for comparison with baseline

Achievements

  • Pre Training Surveys performed in all selected hospitals prior to their respective ETAT+ Trainings
  • 6 Hospitals Trained; Summary as follows:
Hospital Dates Number Enrolled Number
Completed the Course
Total Number
Certified
Doctors
Trained
Clinical Officers
Trained
Nurses
Trained
Muranga District Hospital 5 -9th Nov 2012 31 30 22 2 2 24
Makueni District Hospital 19 -23rd Nov 2012 31 28 24 5 5 20
Nanyuki District Hospital 14 – 18th Jan 2013 31 31 22 4 3 24
Mama Lucy Hospital 28th Jan – 1st Feb 2013 31 31 30 6 9 16
PCEA Chogoria Mission Hospital 18th -22nd  Mar 2013 32 31 28 3 7 21
Narok District Hospital 1 -5th Apr 2013 34 27 24 4 8 15
TOTAL   189 178 159 24 34 120
  • All hospitals developed an implementation plan amongst hospital administration and UK Visiting consultants to prioritize areas for improvement in care in the hospitals
  • ETAT+ Country clinical lead continued to provide mentorship and guidance to the hospitals by telephone on a monthly basis and by visit on a 3 monthly basis
  • Monthly reports reflecting improvements , challenges and opportunities for change have been compiled by the hospital champions along with the collection of monthly mortality figures
  • 6 monthly hospital surveys have been carried out for comparison to the baseline surveys
  • 6 monthly quality assurance meetings have been held bring together various hospital paediatricians; hospital champions and the visiting UK Consultants as well as the country clinical lead and overall project manager.
    These meetings have provided a basis for experience sharing, creating a community of practice and ensuring quality assurance of collected data across all hospitals
  • Equipment has been purchased for the refurbishment of the six hospitals according to the hospital needs using funds allocated for hospital improvement
  • Knowledge and Skills of healthcare workers continue to be improved by running of regular CME Sessions and Drills in the various hospitals.
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