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1. Affiliate respondents (n = 5)
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- Existence of treatment protocols
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- Staffing- related issues: shortage, underperformance and poor attitude
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- Procure essential resources for patient care
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- Quality control and assurance measures are in place
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- Scarcity of resources
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- Use resources efficiently
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- Improved patient care practicies
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- Patient care
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- Enhance team work with supporting departments
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(Additional file 1: Appendix 1, Section 1.1)
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- Lack of some patients taking responsibility for their own care
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(Additional file 1: Appendix 1, Section 1.3)
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(Additional file 1: Appendix 1, Section 1.2)
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2. Patient respondents (n = 4)
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In-patients described their overall satisfaction of the care they receive as
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- Poor amenities and services in the department
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- Strengthen staff attitude and performance
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• 'very good’ (1 view)
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- Weak adherence to treatment protocol
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- Involve patients in their treatment and management
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• 'good’ (2 views)
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- Patients not involved in their own care
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- Improve amenities in the department
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• 'poor’ (1 view)
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(Additional file 1: Appendix 1, Section 2.2)
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(Additional file 1: Appendix 1, Section 2.3)
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(Additional file 1: Appendix 1, Section 2.1)
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3. Staff respondents (n = 4)
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- Staff attitude and performance is good
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- Workload
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- Provide supervision and training
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- Existence of treatment protocols
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- Poor patient care
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- Encourage patient-centred care
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- Availability of some logistics like the computer for e-learning
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- Lack of adherence to treatment protocol by some staff
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- Ensure accountability of and by staff
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(Additional file 1: Appendix 1, Section 3.1)
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- Staff-related issues: inadequate training and supportive supervision, low incentives for work
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- Encourage effective communication among staff
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(Additional file 1: Appendix 1, Section 3.2)
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4. Management respondents
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1. Effort to maintain quality
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• The medical department is perceived to be the weakest department in KCH for quality of health care delivery(Additional file 1: Appendix 1, Section 4.1)
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1. Civil society should be involved in sensitizing patients and holding health staffs accountable to patients
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4.1 Current state of quality of healthcare
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(Additional file 1: Appendix 1, Section 4.1)
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• Inadequate human resource
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• Lack of some essential diagnostic tools
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• Limitation in the use of the few available diagnostic tools
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4.2 Patient care and patient focus
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1. Patients appreciate staffs when satisfied with service given
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1. Patients complaint about wrong prescription or delayed treatment
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2. Weak patient involvement in their treatment plan
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3. Self referrals and weak patient referral system among referring facilities
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4.3 Treatment protocols
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• Treatment protocols are available and accessible to all staffs
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1. Non-compliance due to personal preferences among prescribers; ignorance on the relevance of protocol use; lack of drugs to prescribe
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• There is a planned review of the current protocols
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4.4 Change management
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1. Emergency cases are attended to in the MSS ward before transferring to intensive care
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3. No defined human resource plan to cater for staff who leave
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2. Team system for focused patient care and ward rounds
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4.5 Management-related issues
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• Shortage of staff
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• Lack of training and proper orientation for staff
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• Poor staff attitude (Additional file 1: Appendix 1, Section 4.5.1)
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• Weak accountability by staff (Additional file 1: Appendix 1, Section 4.5.2)
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• Weak leadership structures
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(Additional file 1: Appendix 1, Section 4.5.3)
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• KCH as a tertiary hospital wastes resources by attending to many primary level cases
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(Additional file 1: Appendix 1, Section 4.5.4)
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• Disintegrated data management system in the hospital
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• No strategic plan for the hospital (Additional file 1: Appendix 1, Section 4.5.5)
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