Improving the Quality of Paediatric Hospital Care in the Kyrgyz Republic

Improving the Quality of Paediatric Hospital Care in the Kyrgyz Republic: Evaluation of the Impact of the Intervention

A cooperation agreement between the Ministry of Health (MOH) of Kyrgyz Republic and WHO-EURO was established, for the implementation of a WHO Project to improve the quality of pediatric care in the referral hospitals. The pilot regions selected for this intervention are the three northern regions of Thalas, Chiu and Issik-Kul Region in Kyrgyz Republic. The MOH project will be implemented at a first stage in a group of 10 pilot hospitals, randomly selected among the existing hospitals in the above cited regions. Pilot Hospitals will be compared to "control hospitals", which are the hospitals in the region not receiving the intervention, using a pre-defined set of indicators of quality of care. The results of the present evaluation on the pilot hospitals will provide data that will inform the MOH on how better to scale up this project at a national scale.

Study Overview

• Status: Completed
• Conditions: Quality of Hospital Care for Children
• Intervention / Treatment: Other: Quality Improvement intervention

• Study Type: Interventional
• Enrollment (Actual): 4626
• Phase: Phase 2; Phase 3

Contacts and Locations

Study Locations

• Kyrgyzstan
  • Thalas, Chiu, Issik-Kul, Kyrgyzstan
    • Thalas, Chiu and Issik-Kul Regions

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 2 months to 4 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• The study will evaluate Quality of Care delivered to children at hospital level. This will be assessed by a direct review of patients' charts, in comparison with pre-defined standard. At the hospital level children's charts will be randomly chosen among children 2 months to 59 months, hospitalized with common diseases, such as acute respiratory diseases, diarrhoea, and fever.

Exclusion Criteria:

• Children not included in the above criteria.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Pilot Hospitals	Other: Quality Improvement intervention; Training for local trainers and medical staff on the National Adaptation of the WHO guidelines "Pocket Book of Hospital Care for Children".; Regular supporting supervision and monitoring at hospital level aimed at a sustainable improvement of the quality of the paediatric hospital care
No Intervention: Control Hospitals

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality of Care	Quality of Care will be measured using 10 pre-defined indicators; Inappropriate hospitalisation (i.e. versus WHO standards); Increased risk of iatrogenic adverse effects (i.e unnecessary poly-therapy, compared to WHO standards); Unnecessary pain (i.e. unnecessary injections or other invasive procedures, as compared to WHO standards); Incorrect Diagnosis (i.e. versus WHO standards); Incorrect Treatment (i.e. versus WHO standards); Inconsistency between diagnosis and treatment (i.e. versus WHO standards); Inadequate Monitoring: (i.e. versus WHO standards); Lack of nutritional evaluation (i.e. versus WHO standards); Incorrect use of IV fluids (i.e. versus WHO standards)	12 months
Primary outcome	Children with concomitant presence of all the following three indicators of case management: 1) unnecessary hospitalization; 2) increased risk of iatrogenic adverse effects; 3) unnecessary painful procedures	12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Outcomes of QoC	Summary scores according to the WHO Quality Asessment Tool	12 months

Collaborators and Investigators

• Sponsor: WHO Collaborating Centre for Maternal and Child Health, Trieste
• Collaborators: World Health Organization; Postgraduate Institute of Medical Education and Research; Scientific Center of Children RAMS

Study record dates

Study Major Dates

• Study Start: October 1, 2013
• Primary Completion (Actual): December 1, 2014
• Study Completion (Actual): December 1, 2014

Study Registration Dates

• First Submitted: November 27, 2013
• First Submitted That Met QC Criteria: November 27, 2013
• First Posted (Estimate): December 4, 2013

Study Record Updates

• Last Update Posted (Estimate): August 25, 2015
• Last Update Submitted That Met QC Criteria: August 24, 2015
• Last Verified: August 1, 2015

More Information

Terms related to this study

• Keywords: Children; Hospital; Quality of care; WHO guideline
• Other Study ID Numbers: WHOCCT-001