Improving the Quality of Paediatric Hospital Care in the Kyrgyz Republic

NCT02001116 | Completed Phase 2 DMC

• 1 other identifier: WHOCCT-001
• Study Type: interventional
• Target: 4,626
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Quality of Hospital Care for Children

Keywords

Quality of care; Hospital; Children; WHO guideline

Outcome Measures

Primary Outcomes (2)

• Quality of Care

  Quality of Care will be measured using 10 pre-defined indicators 1. Inappropriate hospitalisation (i.e. versus WHO standards) 2. Increased risk of iatrogenic adverse effects (i.e unnecessary poly-therapy, compared to WHO standards) 3. Unnecessary pain (i.e. unnecessary injections or other invasive procedures, as compared to WHO standards) 4. Incorrect Diagnosis (i.e. versus WHO standards) 5. Incorrect Treatment (i.e. versus WHO standards) 6. Inconsistency between diagnosis and treatment (i.e. versus WHO standards) 7. Inadequate Monitoring: (i.e. versus WHO standards) 8. Lack of nutritional evaluation (i.e. versus WHO standards) 9. 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 Outcomes (1)

• Outcomes of QoC

  12 months

Study Arms (2)

Pilot Hospitals

EXPERIMENTAL

Other: Quality Improvement intervention

Control Hospitals

NO INTERVENTION

Interventions

Quality Improvement intervention OTHER

1. Training for local trainers and medical staff on the National Adaptation of the WHO guidelines "Pocket Book of Hospital Care for Children". 2. Regular supporting supervision and monitoring at hospital level aimed at a sustainable improvement of the quality of the paediatric hospital care

Pilot Hospitals

Eligibility Criteria

• Age: 2 Months - 59 Months
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• 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.

You may not qualify if:

• Children not included in the above criteria.

Sponsors & Collaborators

• WHO Collaborating Centre for Maternal and Child Health, Trieste: lead
• World Health Organization: collaborator
• Scientific Center of Children RAMS: collaborator
• Post Graduate Institute of Medical Education and Research, Chandigarh: collaborator

Study Sites (1)

Thalas, Chiu and Issik-Kul Regions

Thalas, Chiu, Issik-Kul, Kyrgyzstan

Location

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD

Study Record Dates

• First Submitted: November 27, 2013
• First Posted: December 4, 2013
• Study Start: October 1, 2013
• Primary Completion: December 1, 2014
• Study Completion: December 1, 2014
• Last Updated: August 25, 2015

Record last verified: 2015-08

Locations

KY (1)