Assessment of Quality of Care at the Accident Centre, Korle Bu Teaching Hospital

Abstract

Health care settings both in developed and developing countries are bedevilled with quality problems, which may be defined, as gap between what is and what is expected. Quality is how good or bad something is. The thing may be a product or a service. People will only patronise health care services that meet expectations. Quality of care Assessment is the measurement of the quality of healthcare services. It measures the difference between expected and actual performance to identify opportunities for improvement and where standards have been established, a quality assessment measures the level of compliance with standards. The study was retrospective as well as a cross-sectional descriptive, using both qualitative and quantitative designs. It described the causes and possible solutions to the problem of poor quality of care at the Accident Centre of the Korle Bu Teaching Hospital. Despite the call for health care institutions to deliver quality services to clients, it appeared that quality of care was being compromised in the Accident Centre of the Korle Bu Teaching Hospital. This is because in the 2005, 2006 and 2007 Performance Reviews and Annual Reports of the hospital, it appeared consecutively that quality of care was poor at the Accident Centre due to factors such as: Lack of or inadequate basic but essential equipment, congestion and long waiting time, acute shortage of staff of all grades, inadequate consumables, heavy work load among others. This prompted the researcher to undertake the study. Secondary data was mostly employed to describe the quality of health care at the Accident Centre looking at some inputs/structure, process/care provider performance and outcome variables. Availability of equipment, staff strength in relation to requirements and work load and medicine and non medicine consumables were measured as inputs/structural variables while waiting time and interpersonal relationships of care providers towards clients was measured as process or provider performance variable. Case Fatality Rate (CFR) was used as outcome measure. Findings were that the A/C lacked basic but essential equipment, essential staff such as traumatologist and anaesthetists. The resuscitation room and the ICU did not have medicine and non medicine consumables such as, antibiotics, pethidine, diagnostic sets and splints. The average waiting time was also found to be long. The interpersonal relationships of some care providers toward clients were not good enough. Finally, the study made some recommendations, which could be used to solve the problems found and a conclusion was drawn. It was recommended that the KBTH management increases the equipment supply, engages more staff of all grades, opens a pharmacy unit at the A/C, shortens waiting time for the clients, organises regular trainings and workshops for its care providers on effective communication and human relation skills.