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Table 4 Results from Participant Survey Pre and Post Learning Collaborativea, b

From: Successful implementation of a combined learning collaborative and mentoring intervention to improve neonatal quality of care in rural Rwanda

 

Pre-ABC LC

Post-ABC LC

P-value

Number participants

71

67

 

Percent rating QI Knowledge and Confidence 4 or 5 scale 1 (little/none) to 5 (very/extremely)

 QI Knowledge

24/65 (37%)

58/65 (89%)

<  0.001

 Confidence in helping to improve quality at your clinic or department/district

30/64 (47%)

58/65 (89%)

< 0.001

 Confidence in leading QI at your clinic

34/58 (59%)

61/67 (91%)

< 0.001

Percent rating Leadership as very Interested in QI (scale 1 (not at all) to 3 (very interested)).

 Facility management interest in measuring and improving quality for neonatal patients

43/68 (63%)

63/66 (95%)

< 0.001

 Facility management interest in hearing ideas from you and other staff for QI?

38/67 (57%)

43/64 (67%)

0.2

Participant motivation at work (percent always or often) (scale never, sometimes, often always)

 My work is rewarding

17/63 (29%)

18/63 (27%)

0.84

 My work is stressful

4/65 (6%)

3/63 (5%)

1.0

 I feel emotionally drained by my work

53/63 (84%)

43/60 (72%)

0.09

 I feel isolated in my work

4/66 (6%)

0/64 (0%)

1.0

 I can help my clients

62/65 (97%)

65/67 (98%)

0.62

 I have confidence in my skills

63/64 (98%)

61/63 (97%)

0.62

 I am motivated to perform well in my job

42/67 (63%)

35/63 (55%)

0.35

Working Environment (percent very good or Excellent) (scale poor, fair, good, very good, excellent)

 Maternity/neonatal services at my clinic/hospital are excellent

31/59 (53%)

23/64 (36%)

0.06

 I have enough basic clinical equipment and supplies to provide good care and services to patients

41/62 (66%)

51/61 (84%)

0.03

 I have adequate support and information to help make clinical decisions

53/67 (79%)

41/57 (72%)

0.35

 There is enough space for me to be able to provide care for the patients and ensure privacy

45/66 (68%)

44/61 (72%)

0.42

 The clinic has a very good environment (friendliness, teamwork, respect, lack of chaos)

44/63 (70%)

47/63 (75%)

0.79

Peer to Peer learning

N (% yes)

N (% yes)

 

 Since the last LS, have you heard any ideas or asked for help from the other participating HC/hospitals?

17/47 (36%)

40/60 (66%)

0.024

Team work

 Have you been involved in activities that look at the quality of neonatal care and work to improve problems at your site?

36/64 (56%)

55/63 (87%)

< 0.001

 Do staff members work together to improve quality of care for neonatal patients?

59/63 (93%)

61/64 (95%)

0.72

 Have you been asked for your input how to improve neonatal care?

43/67 (64%)

59/63 (93%)

< 0.001

Data Utilization

 Have you seen or used any routine reports for measuring the quality of care?

32/63 (50%)

37/62 (59%)

0.32

Identified barriers to delivery of quality care at their site (Yes/No)

n = 71

N = 67

 

 High number of patients

29 (40%)

34 (50%)

0.24

 Number of staff

30 (42%)

27 (40%)

0.32

 Social or economic problems in patients’ lives (getting to clinic, food, etc)

30 (42%)

21 (31%)

0.18

 Training of staff

28 (39%)

14 (20%)

0.018

 Communication between providers and patients

15 (21%)

9 (13%)

0.23

 The staff does not work together as a team

14 (19%)

5 (7%)

0.03

 Complexity of care (severity of illness, complicated pregnancy, etc)

8 (11%)

5 (7%)

0.56

 Clinic flow

7 (9%)

6 (8%)

0.86

  1. a “Pre” data obtained at the start of the first learning session. “Post” data obtained at the start of the “Harvest Session”
  2. b Missing data for a specific question were excluded