Table 3. Average score per technical quality care proxy (n = 64).
| Risk assessment areas (technical quality proxies) | Statistics | |||
|---|---|---|---|---|
| Leadership process and accountability | Mean f | Std. Dev. | Min. | Max. |
| 1.Leadership and accountability responsibilities are defined | 1.91 | 0.39 | 0 | 3 |
| 2.Leadership for quality and patient safety | 1.67 | 0.47 | 1 | 2 |
| 3.Day to day planning is collaborative | 1.42 | 0.64 | 0 | 2 |
| 4.Clinical and managerial contracts are effectively managed | 1.53 | 0.67 | 0 | 2 |
| 5.Compliance with all laws and regulations related to the clinic | 0.88 | 0.63 | 0 | 2 |
| 6.Clear commitment to patient and family rights | 1.89 | 0.31 | 1 | 2 |
| 7.Policies and procedures for high-risk procedures and patients | 0.50 | 0.82 | 0 | 3 |
| Competent and capable workforce | ||||
| 8.All staff have personal files and job descriptions | 1.70 | 0.49 | 1 | 3 |
| 9.The credentials for physicians are reviewed | 1.28 | 0.45 | 1 | 2 |
| 10.The credentials for nurses and other health professionals are reviewed | 1.39 | 0.61 | 0 | 2 |
| 11.Staff members are oriented to their jobs | 0.94 | 0.43 | 0 | 2 |
| 12.Patient care staff are trained in resuscitative techniques | 1.20 | 0.41 | 1 | 2 |
| 13.Staff are educated on infection prevention and control | 1.23 | 0.43 | 1 | 2 |
| 14.Communication among those caring for the patients | 0.39 | 0.73 | 0 | 2 |
| Safe environment for staff and patients | ||||
| 15.Regular maintenance for buildings | 0.81 | 0.50 | 0 | 2 |
| 16.Control of hazardous materials | 0.91 | 0.39 | 0 | 2 |
| 17.There is a fire safety programme | 0.47 | 0.50 | 0 | 1 |
| 18.Biomedical equipment is maintained in a safe condition | 1.52 | 0.62 | 0 | 2 |
| 19.Stable water and electricity sources are available | 0.80 | 0.69 | 0 | 2 |
| 20.Reduction of health care-associated infections through proper hand hygiene | 1.00 | 0.78 | 0 | 3 |
| 21.Barrier techniques are used | 1.61 | 0.52 | 0 | 2 |
| 22.Proper disposal of sharps and needles | 1.30 | 0.52 | 0 | 2 |
| 23.Proper disposal of infectious waste | 1.91 | 0.40 | 0 | 2 |
| 24.Appropriate sterilization and cleaning procedures are used | 0.73 | 0.57 | 0 | 2 |
| Clinical care of patients | ||||
| 25.Correct patient identification | 0.19 | 0.59 | 0 | 3 |
| 26.Patient education about high risk procedures and informed consent | 1.41 | 0.68 | 0 | 2 |
| 27.Medical and nursing assessments for all patients | 0.61 | 0.70 | 0 | 2 |
| 28.Laboratory services are available and reliable | 1.53 | 0.50 | 1 | 2 |
| 29.Diagnostic imaging services available, safe and reliable | 1.39 | 0.52 | 0 | 2 |
| 30.Anesthesia and sedation are used appropriately | 1.22 | 0.52 | 0 | 2 |
| 31.Surgical services are appropriate to patients needs | 0.53 | 0.69 | 0 | 2 |
| 32.Medication use is safely managed | 1.06 | 0.66 | 0 | 2 |
| 33.Patients are educated to participate in their care | 1.06 | 0.43 | 0 | 2 |
| 34.Care that is planned and provided is written down in a patient record | 1.41 | 0.64 | 0 | 3 |
| Improvement of quality and safety | ||||
| 35.There is a process for collecting and reviewing events that are unexpected and/potentially harmful to patients | 1.05 | 0.33 | 0 | 2 |
| 36.High-risk processes are high-risk patients are monitored | 1.19 | 0.43 | 0 | 2 |
| 37.Patient experience is monitored | 1.09 | 0.46 | 0 | 2 |
| 38.There is a complaint process | 1.02 | 0.42 | 0 | 2 |
| 39.Clinical guidelines and pathways are available and used | 0.23 | 0.56 | 0 | 2 |
| 40.Staff understand how to improve processes | 1.00 | 0.71 | 0 | 2 |
| 41.Clinical outcomes are monitored | 0.08 | 0.27 | 0 | 1 |
| Overall average technical quality care e | 1.07 | 0.22 | 0.63 | 1.58 |
Source: WOTRO-COHEiSION Project Household and Health Facility Surveys (March, 2012)
eOverall average technical quality care score computed by summing quality scores of all 64 facilities divided by the 41 quality care criteria.
fMean scores depict the levels of effort demonstrated by health facilities per each risk area from 0–3 where high values suggest better performance towards patient safety and risk reduction and vice versa. Zero (0) is scored when the desired quality improvement activity in a clinic is absent or there is mostly ad hoc activity related to risk reduction. One (1) is scored when the structure of more uniform risk-reduction activity begins to emerge in a clinic. Two (2) is scored when there are processes in place for consistent and effective risk-reduction. Three (3) is scored when there are data to confirm successful risk-reduction strategies and continuous improvement.