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Table 1 Key components of the multifaceted intervention to improve adoption of new pneumonia policy

From: Effect of enhancing audit and feedback on uptake of childhood pneumonia treatment policy in hospitals that are part of a clinical network: a cluster randomized trial

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
  1. *Specific goals included attaining at least 80% compliance with classification and treatment for childhood pneumonia admissions