The first step is to understand the problem. Walimu works with hospital staff to conduct a facility assessment of the quality of emergency and severe illness care, and then conducts focus groups and interviews with staff to understand the barriers and gaps in care.
|Hospital assessment: Walimu uses a standardized tool to understand care processes and resources for triage, diagnosis and treatment of patients.|
|Focus groups: Walimu conducts focus groups and interviews to understand what is contributing to the barriers to high quality care and develop potential solutions.|
Walimu provides hands-on training using the World Health Organization's IMAI Quick Check+ training curriculum to a group from each hospital. Training is team based, with each hospital sending clinical officers or doctors, nurses, auxiliaries and facility managers. The training gives hospital teams the skills and knowledge to manage the severely ill.
Walimu then recruits a quality improvement team at each hospital. The team develops a hospital quality improvement plan based on the findings from Walimu's assessment and launches a bi-weekly Plan-Do-Check-Act (PDCA) cycle. Walimu provides a set of interventions to establish and support the team:
|Mentoring: Walimu mentors provide training on change management, run clinical drills, and track progress of the PDCA cycle.|
|Life-saving equipment: Walimu provides cheap, essential equipment and funds small capital improvements, such as basic urgent care units.|
|Guidelines: Walimu provides access to clinical guidelines to manage patients as well as change management guidelines and tools.|
Walimu captures data on the quality of care given to patients who are severely ill. This data udit provides a running snapshot of quality of care at the facility, allowing both the hospital staff to track progress and Walimu to understand if the program is working.
Walimu works closely with the hospital team, Ministry of Health, and District Health Officer to embed the gains made by the project. Walimu works throughout the course of the project to equip the facility to maintain the plan-do-check-act cycle and data audit and feedback system.
|Objective progress measures: Walimu trains hospital staff to collect data on a sample of care encounters at the facility, to enable objective analysis of improvements.|
|Appropriate reporting: Walimu reports quality data back to hospital staff and other stakeholders through web, mobile and printed reports.|