Herawati Dewi Marhaeni Diah, Sunjaya Deni Kurniadi, Gumilang Lani, Adistie Fanny, Dewi Judistiani Raden Tina, Yuniati Tetty, Handono Budi
Departement of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
Departement of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia.
J Multidiscip Healthc. 2022 Aug 31;15:1887-1899. doi: 10.2147/JMDH.S374905. eCollection 2022.
The quality of infant healthcare service is one of the essential factors in preventing infant mortality. The purpose of the study was to analyze the quality performance in primary healthcare centers (PHC) and hospitals before and after the point of care quality improvement (POCQI) training for Infant Healthcare Services (IHS).
This is a mixed-method study design with convergence triangulation strategy, conducted at six public PHCs and four hospitals in two districts of West Java Province, Indonesia. One hundred health care workers (HCWs) were involved for quantitative study at baseline and end of intervention. An additional 40 patients participated as informants for qualitative study. Quantitative data analysis was performed by Rasch modeling and independent -test for all variables, followed by content analysis for qualitative data.
There were significant changes in the variables of POCQI skill (mean diff: 5.14, p=0.001), quality improvement (QI) understanding (mean diff: 1.2; p=0.001), and QI engagement (mean diff: 1.7; p=0.001) in the PHC group. Although there was an increase in process and outcome variables, the changes were not significant. There was a significant change in all variables in the hospital group which were outcome (mean diff: 2.32 (p=0.19); POCQI skill (mean diff: 2.80, p=0.001); process (mean diff: 1.48, p= 0.01); QI understanding (mean diff: 1.01; p=0.01), and QI engagement (mean diff: 1.52; p=0.03). Patient perception in the qualitative study showed that PHCs and Hospitals' services improved. Moreover, health care workers found they have a better understanding of service quality and created quality changes and improved POCQI steps.
Implementation of POCQI in PHC and hospitals improved the performance of the quality of his, therefore assuring that POCQI is an appropriate approach and tool to be adopted in the policy for strengthening the health system.
婴儿医疗服务质量是预防婴儿死亡的关键因素之一。本研究旨在分析婴儿医疗服务（IHS）的即时护理质量改进（POCQI）培训前后，初级卫生保健中心（PHC）和医院的质量表现。
这是一项采用汇聚三角测量策略的混合方法研究设计，在印度尼西亚西爪哇省两个地区的6家公立初级卫生保健中心和4家医院开展。100名医护人员参与了基线和干预结束时的定量研究。另外40名患者作为定性研究的 informant 参与。对所有变量进行Rasch建模和独立检验进行定量数据分析，随后对定性数据进行内容分析。
初级卫生保健中心组在POCQI技能（平均差异：5.14，p = 0.001）、质量改进（QI）理解（平均差异：1.2；p = 0.001）和QI参与度（平均差异：1.7；p = 0.001）变量上有显著变化。虽然过程和结果变量有所增加，但变化不显著。医院组所有变量均有显著变化，包括结果（平均差异：2.32（p = 0.19）；POCQI技能（平均差异：2.80，p = 0.001）；过程（平均差异：1.48，p = 0.01）；QI理解（平均差异：1.01；p = 0.01）和QI参与度（平均差异：1.52；p = 0.03）。定性研究中的患者认知表明，初级卫生保健中心和医院的服务有所改善。此外，医护人员发现他们对服务质量有了更好的理解，并创造了质量变化，改进了POCQI步骤。
在初级卫生保健中心和医院实施POCQI提高了婴儿医疗服务质量的表现，因此确保POCQI是加强卫生系统政策中应采用的适当方法和工具。
