Table 1 Key components of the multifaceted intervention to improve adoption of new pneumonia policy
Intervention | Description | Treatment arm involved |
|---|---|---|
Network strategy | o Sensitization of hospital pediatric care teams on quality healthcare service by coordinating team o Initiative to improve quality of pediatric data through providing minimal ICT infrastructure (desktop computer), introduction of standardized pediatric admission record form, and recruitment of data clerk at each hospital o Establishment of clinical information network bringing together Ministry of Health, pediatric professional organization, hospital team leaders, and senior peers from a local University and a research organization o External facilitation of quality improvement efforts by network coordinating team through 6 monthly face-to-face network meetings and communication with pediatricians (via phone, email, social media) and a total of 2 or 3 hospital visits in 2014 and early 2015 | Both intervention and control |
Standard audit and feedback | o Developing and implementing tools for monitoring indicators of quality of general pediatric care o Two to three-monthly feedback reports of performance assessed against national guidelines for pediatric care o Each hospital’s performance compared to its own performance in the preceding period and also compared anonymously to other network hospitals o General encouragement offered to improve all aspects of care by coordinator to team leaders by 2-monthly phone/email communication | Both intervention and control |
Enhanced audit and feedback | o Definition of goals for adoption of new pneumonia* policy o Monthly feedback in text of: ▪Hospital performance in comparison with goals for indicators of correct pneumonia classification and treatment as contained in new policy ▪Hospital performance in comparison with anonymized performance information of other hospitals o Graphical representation of each hospital’s performance trend by month from the start of the intervention o Specific follow up on pneumonia indicator performance by coordinator with team leaders by monthly phone/email communication | Intervention only |