Healthcare Service Auditing and Intervention in an Emergency Paediatric Unit.

Abstract

A pre- and post-intevention randomized cross-sectional study was carried out from January to February and April to May 2001, respectively, to audit and intervene in the timeliness of health services delivery in an Emergency Paediatric Unit (EPU) of Jos University Teaching Hospital. A structured questionnaire was used to observe and follow up 86 and 101 patients (in the pre-and post-intervention periods respectively) from the time of arrival to the time of being seen by the doctor. Also a cause and effect diagram and countermeasure matrix were used to identify and solve the problems of poor timeliness of health service delivery. There were no significant differences in the ages, weights and heights of the pre-and post-intervention children studied (p>0.05). The overall mean excess (wasted) time from arrival to actually being seen by the doctor was 133121.8 minutes. Sixty-three percent of this excess time was the time between retrieving the patients' folders and actually being seen by the doctor, which was significantly reduced from 89 minutes to eight minutes (p<0.001) following intervention. There was a general reduction in the mean excess time at various points of health care delivery, and on the number of cold cases seen in EPU. However, there was no difference (p>0.05) in the mortality rate between the two periods. Timely health care service is very important in the provision of quality care which in turn, will most likely improve the utilization of health services.

Nigerian Journal of Paediatrics 2002 ; 29 :71-74.