Improving the Quality of Paediatric Hospital Care in the Kyrgyz Republic

Study Overview
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Brief Summary
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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.

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

Conditions
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Quality of Hospital Care for Children

Intervention / Treatment
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* Other: Quality Improvement intervention


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 2 Months
Maximum Age: 59 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Pilot Hospitals<br> | Other: Quality Improvement intervention<br>* 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<br>|
| No Intervention: Control Hospitals<br> | |

What is the study measuring?
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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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Quality of care, Hospital, Children, WHO guideline