AN ASSESSMENT OF SAFETY AND QUALITY MANAGEMENT IN TWO PRIMARY CARE HOSPITALS IN THE UPPER WEST REGION OF GHANA

Abstract

Safety and quality management run through every aspect of the health system including clinical care, where concerns are to the effect that, service utilisation has quadrupled after the introduction of the National Health Insurance Scheme (NHIS) without any knowledge of the corresponding rise in the safety and quality, especially that the Upper West Region houses the country's poorest people. The study assessed the state of safety and quality of healthcare in two primary hospitals focusing on four main areas: management systems, clinical practices, patients' safety, and client-centred care. A cross sectional observational and descriptive study design was adopted using both qualitative and quantitative research methods. A two-stage Multi-stage sampling was used in which two hospitals, 43 service areas, and 44 respondents were assessed. Data were collected using record reviews, direct observation and interviews. Data analysis was done manually and electronically (using computer software Microsoft excel), described and interpreted. Safety and quality management was found to be low (38.4%; 99/258) in hospitals because: the management systems (36.3%; 371102) were observed to be of poor quality, highly centralised, with little initiatives at the base; clinical practices were below safety standards (33.3%; 24/72) wholly influenced by professional negligence; and health care was found not to be client-centred (26.7%; 8/30) as no efforts were made to get the inputs of client communities. However, there was equity in the distribution of healthcare, whilst patient safety was measured up to standard (55.6%; 30/54). It is recommended that healthcare authorities adopt a bottom-up management approach to strengthen and decentralise leadership, develop professionals to improve their competence and initiatives, and re-focus health care to be more client-centred to produce more satisfied clients both at health facilities and beyond.