wow-inequalities/02-data/intermediate/wos_sample/bb9df8f1d37016719fc02897ba333d71-aveling-emma-louise/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Background: Access to safe surgical care represents a critical gap in
healthcare delivery and development in many low-and middle-income
countries, including Ethiopia. Quality improvement (QI) initiatives at
hospital level may contribute to closing this gap. Many such quality
improvement initiatives are carried out through international health
partnerships. Better understanding of how to optimise quality
improvement in low-income settings is needed, including through
partnership-based approaches. Drawing on a process evaluation of an
intervention to improve surgical services in an Ethiopian hospital, this
paper offers lessons to help meet this need.
Methods: We conducted a qualitative process evaluation of a quality
improvement project which aimed to improve access to surgical services
in an Ethiopian referral hospital through better management. Data was
collected longitudinally and included: 66 in-depth interviews with
surgical staff and project team members; observation (135 h) in the
surgery department and of project meetings; project-related
documentation. Thematic analysis, guided by theoretical constructs,
focused on identifying obstacles to implementation.
Results: The project largely failed to achieve its goals. Key barriers
related to project design, partnership working and the implementation
context, and included: confusion over project objectives and project and
partner roles and responsibilities; logistical challenges concerning
overseas visits; difficulties in communication; gaps between the time
and authority team members had and that needed to implement and engage
other staff; limited strategies for addressing adaptive-as opposed to
technical-challenges; effects of hierarchy and resource scarcity on QI
efforts. While many of the obstacles identified are common to diverse
settings, our findings highlight ways in which some features of
low-income country contexts amplify these common challenges.
Conclusion: We identify lessons for optimising the design and planning
of quality improvement interventions within such challenging healthcare
contexts, with specific reference to international partnership-based
approaches. These include: the need for a funded lead-in phase to
clarify and agree goals, roles, mutual expectations and communication
strategies; explicitly incorporating adaptive, as well as technical,
solutions; transparent management of resources and opportunities;
leadership which takes account of both formal and informal power
structures; and articulating links between project goals and wider
organisational interests.'
affiliation: 'Aveling, EL (Corresponding Author), Univ Cambridge, Inst Publ Hlth,
Cambridge Ctr Hlth Serv Res, Forvie Site,Robinson Way, Cambridge CB2 0SR, England.
Aveling, EL (Corresponding Author), Harvard TH Chan Sch Publ Hlth, Dept Hlth Policy
\& Management, Boston, MA 02115 USA.
Aveling, Emma-Louise, Univ Cambridge, Inst Publ Hlth, Cambridge Ctr Hlth Serv Res,
Forvie Site,Robinson Way, Cambridge CB2 0SR, England.
Aveling, Emma-Louise, Harvard TH Chan Sch Publ Hlth, Dept Hlth Policy \& Management,
Boston, MA 02115 USA.
Zegeye, Desalegn Tegabu, Fed Minist Hlth, POB 1234, Addis Ababa, Ethiopia.
Silverman, Michael, Univ Leicester, Dept Infect Inflammat \& Immun, Univ Rd, Leicester
LE1 7RH, Leics, England.'
article-number: '393'
author: Aveling, Emma-Louise and Zegeye, Desalegn Tegabu and Silverman, Michael
author-email: eaveling@hsph.harvard.edu
author_list:
- family: Aveling
given: Emma-Louise
- family: Zegeye
given: Desalegn Tegabu
- family: Silverman
given: Michael
da: '2023-09-28'
doi: 10.1186/s12913-016-1639-4
files: []
issn: 1472-6963
journal: BMC HEALTH SERVICES RESEARCH
keywords: Quality improvement; Surgery; Patient safety; Partnership; Ethiopia
keywords-plus: PATIENT SAFETY; COMMUNITY-DEVELOPMENT; CARE; INFRASTRUCTURE; UNIVERSITY
language: English
month: AUG 17
number-of-cited-references: '36'
orcid-numbers: Zegeye, Desalegn Tegabu/0000-0002-5231-9967
papis_id: d878e9e2d53e8f84b031f111e7ddb672
ref: Aveling2016obstaclesimplementat
times-cited: '17'
title: 'Obstacles to implementation of an intervention to improve surgical services
in an Ethiopian hospital: a qualitative study of an international health partnership
project'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000381463200002
usage-count-last-180-days: '0'
usage-count-since-2013: '9'
volume: '16'
web-of-science-categories: Health Care Sciences \& Services
year: '2016'