Good practices to optimise the performance of maternal and neonatal quality improvement teams: Results from a longitudinal qualitative evaluation in South Africa, before, and during COVID-19
Many maternal and neonatal deaths can be avoided if quality healthcare is provided. To this end, the South African National Department of Health implemented a quality improvement (QI) programme (2018-2022) to improve maternal and neonatal health services in 21 public health facilities. This study so...
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Published in | PloS one Vol. 19; no. 11; p. e0314024 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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Public Library of Science
19.11.2024
Public Library of Science (PLoS) |
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Abstract | Many maternal and neonatal deaths can be avoided if quality healthcare is provided. To this end, the South African National Department of Health implemented a quality improvement (QI) programme (2018-2022) to improve maternal and neonatal health services in 21 public health facilities. This study sought to identify good practices aimed at improving QI teams' performance by identifying optimal facility-level contextual factors and implementation processes. We purposively selected 14 facilities of the 21 facilities for a longitudinal qualitative process evaluation. We interviewed 17 team leaders, 47 members, and five QI advisors who provided technical support to the teams. The data were analysed using framework analysis. We choose the Consolidated Framework for Implementation Research as framework given that it explicates contexts and processes that shape programme implementation. Six quality improvement teams were assessed as well-performing, and eight as less well-performing. This research conceptualises a 'life course lens' for setting up and managing a QI team. We identified eight good practices, six related to implementation processes, and two contextual variables that will optimise team performance. The two most impactful practices to improve the performance of a QI team were (i) selecting healthcare workers with quality improvement-specific characteristics, and (ii) appointing advisors whose interpersonal skills match their technical quality improvement competencies. |
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AbstractList | Many maternal and neonatal deaths can be avoided if quality healthcare is provided. To this end, the South African National Department of Health implemented a quality improvement (QI) programme (2018-2022) to improve maternal and neonatal health services in 21 public health facilities. This study sought to identify good practices aimed at improving QI teams' performance by identifying optimal facility-level contextual factors and implementation processes. We purposively selected 14 facilities of the 21 facilities for a longitudinal qualitative process evaluation. We interviewed 17 team leaders, 47 members, and five QI advisors who provided technical support to the teams. The data were analysed using framework analysis. We choose the Consolidated Framework for Implementation Research as framework given that it explicates contexts and processes that shape programme implementation. Six quality improvement teams were assessed as well-performing, and eight as less well-performing. This research conceptualises a 'life course lens' for setting up and managing a QI team. We identified eight good practices, six related to implementation processes, and two contextual variables that will optimise team performance. The two most impactful practices to improve the performance of a QI team were (i) selecting healthcare workers with quality improvement-specific characteristics, and (ii) appointing advisors whose interpersonal skills match their technical quality improvement competencies. Many maternal and neonatal deaths can be avoided if quality healthcare is provided. To this end, the South African National Department of Health implemented a quality improvement (QI) programme (2018-2022) to improve maternal and neonatal health services in 21 public health facilities. This study sought to identify good practices aimed at improving QI teams' performance by identifying optimal facility-level contextual factors and implementation processes. We purposively selected 14 facilities of the 21 facilities for a longitudinal qualitative process evaluation. We interviewed 17 team leaders, 47 members, and five QI advisors who provided technical support to the teams. The data were analysed using framework analysis. We choose the Consolidated Framework for Implementation Research as framework given that it explicates contexts and processes that shape programme implementation. Six quality improvement teams were assessed as well-performing, and eight as less well-performing. This research conceptualises a 'life course lens' for setting up and managing a QI team. We identified eight good practices, six related to implementation processes, and two contextual variables that will optimise team performance. The two most impactful practices to improve the performance of a QI team were (i) selecting healthcare workers with quality improvement-specific characteristics, and (ii) appointing advisors whose interpersonal skills match their technical quality improvement competencies.Many maternal and neonatal deaths can be avoided if quality healthcare is provided. To this end, the South African National Department of Health implemented a quality improvement (QI) programme (2018-2022) to improve maternal and neonatal health services in 21 public health facilities. This study sought to identify good practices aimed at improving QI teams' performance by identifying optimal facility-level contextual factors and implementation processes. We purposively selected 14 facilities of the 21 facilities for a longitudinal qualitative process evaluation. We interviewed 17 team leaders, 47 members, and five QI advisors who provided technical support to the teams. The data were analysed using framework analysis. We choose the Consolidated Framework for Implementation Research as framework given that it explicates contexts and processes that shape programme implementation. Six quality improvement teams were assessed as well-performing, and eight as less well-performing. This research conceptualises a 'life course lens' for setting up and managing a QI team. We identified eight good practices, six related to implementation processes, and two contextual variables that will optimise team performance. The two most impactful practices to improve the performance of a QI team were (i) selecting healthcare workers with quality improvement-specific characteristics, and (ii) appointing advisors whose interpersonal skills match their technical quality improvement competencies. |
Audience | Academic |
Author | Pillay, Yogan Chetty, Terusha Odendaal, Willem Singh, Yages Goga, Ameena Marshall, Carol Makua, Manala Kauchali, Shuaib Hunt, Xanthe Tomlinson, Mark |
AuthorAffiliation | 2 Department of Psychiatry, Stellenbosch University, Cape Town, Western Cape, South Africa 4 Institute for Life Course Health Research, Stellenbosch University, Cape Town, Western Cape, South Africa 8 South African National Department of Health, Pretoria, Gauteng, South Africa 11 University of South Africa, Pretoria, Gauteng, South Africa 3 Health Systems Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa 5 School of Nursing and Midwifery, Queens University, Belfast, United Kingdom 12 Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa 9 Clinton Health Access Initiative, Pretoria, Gauteng, South Africa (formerly) LSTM: Liverpool School of Tropical Medicine, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND 6 Department of Paediatrics and Child Health, University of Pretoria, Pretoria, Gauteng, South Africa 10 Division of Public Health and Health Systems, Department |
AuthorAffiliation_xml | – name: 8 South African National Department of Health, Pretoria, Gauteng, South Africa – name: 7 Division of Community Paediatrics, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa – name: 4 Institute for Life Course Health Research, Stellenbosch University, Cape Town, Western Cape, South Africa – name: 5 School of Nursing and Midwifery, Queens University, Belfast, United Kingdom – name: 11 University of South Africa, Pretoria, Gauteng, South Africa – name: 13 Africa Health Research Institute, Somkhele, KwaZulu Natal, South Africa – name: 1 HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa – name: 9 Clinton Health Access Initiative, Pretoria, Gauteng, South Africa (formerly) – name: 2 Department of Psychiatry, Stellenbosch University, Cape Town, Western Cape, South Africa – name: LSTM: Liverpool School of Tropical Medicine, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND – name: 10 Division of Public Health and Health Systems, Department of Global Health, Stellenbosch University, Cape Town, Western Cape, South Africa – name: 3 Health Systems Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa – name: 6 Department of Paediatrics and Child Health, University of Pretoria, Pretoria, Gauteng, South Africa – name: 12 Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa |
Author_xml | – sequence: 1 givenname: Willem orcidid: 0000-0002-3295-7283 surname: Odendaal fullname: Odendaal, Willem organization: Health Systems Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa – sequence: 2 givenname: Mark surname: Tomlinson fullname: Tomlinson, Mark organization: School of Nursing and Midwifery, Queens University, Belfast, United Kingdom – sequence: 3 givenname: Ameena surname: Goga fullname: Goga, Ameena organization: Department of Paediatrics and Child Health, University of Pretoria, Pretoria, Gauteng, South Africa – sequence: 4 givenname: Yages surname: Singh fullname: Singh, Yages organization: HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa – sequence: 5 givenname: Shuaib surname: Kauchali fullname: Kauchali, Shuaib organization: Division of Community Paediatrics, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa – sequence: 6 givenname: Carol surname: Marshall fullname: Marshall, Carol organization: South African National Department of Health, Pretoria, Gauteng, South Africa – sequence: 7 givenname: Yogan surname: Pillay fullname: Pillay, Yogan organization: Division of Public Health and Health Systems, Department of Global Health, Stellenbosch University, Cape Town, Western Cape, South Africa – sequence: 8 givenname: Manala surname: Makua fullname: Makua, Manala organization: University of South Africa, Pretoria, Gauteng, South Africa – sequence: 9 givenname: Terusha surname: Chetty fullname: Chetty, Terusha organization: Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa – sequence: 10 givenname: Xanthe surname: Hunt fullname: Hunt, Xanthe organization: Africa Health Research Institute, Somkhele, KwaZulu Natal, South Africa |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/39561133$$D View this record in MEDLINE/PubMed |
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Copyright | Copyright: © 2024 Odendaal et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. COPYRIGHT 2024 Public Library of Science 2024 Odendaal et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2024 Odendaal et al 2024 Odendaal et al 2024 Odendaal et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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Snippet | Many maternal and neonatal deaths can be avoided if quality healthcare is provided. To this end, the South African National Department of Health implemented a... |
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SubjectTerms | Advisors Analysis Biology and Life Sciences COVID-19 COVID-19 - epidemiology Female Health care Health care facilities Health care reform Health services HIV Hospitals Human immunodeficiency virus Humans Infant mortality Infant, Newborn Infants Infants (Newborn) Longitudinal Studies Maternal health services Maternal Health Services - organization & administration Maternal Health Services - standards Medical care Medical personnel Medical research Medicine and Health Sciences Mothers Neonates Neonatology Optimization Participation Patient outcomes People and Places Performance enhancement Performance evaluation Pregnancy Public health Qualitative analysis Qualitative Research Quality control Quality Improvement Quality management SARS-CoV-2 Social Sciences South Africa - epidemiology Stillbirth Team leaders Teams Work groups |
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Title | Good practices to optimise the performance of maternal and neonatal quality improvement teams: Results from a longitudinal qualitative evaluation in South Africa, before, and during COVID-19 |
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