Association between health worker motivation and healthcare quality efforts in Ghana
Association between health worker motivation and healthcare quality efforts in Ghana
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DOI：
10.1186/1478-4491-11-37
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发表时间：
2013-08-14
影响因子：
4.5
通讯作者：
de Wit, Tobias F. Rinke
中科院分区：
文献类型：
--
作者：
Alhassan, Robert Kaba;Spieker, Nicole;de Wit, Tobias F. Rinke
背景：加纳是撒哈拉以南非洲国家之一，在普及优质医疗保健方面取得了重大进展。然而，它仍然是一个挑战，以实现2015年的目标，与健康有关的千年发展目标（MDGs），部分原因是卫生部门的人力资源的挑战，包括低员工motivation.Purpose：本文涉及卫生工作者的动机和评估协会在加纳的高质量护理和病人安全的指标。目的是确定有助于提高医疗机构质量的卫生工作者层面的干预措施。方法：该研究是对加纳两个地区64个初级医疗机构的卫生工作者（n = 324）进行的基线调查。数据收集涉及使用SafeCare Essentials工具进行的质量护理评估，国家健康保险局（NHIA）的认证数据和工作场所激励因素的结构化员工访谈。进行了斯皮尔曼相关性检验的假设，即卫生工作者的动机水平与努力水平，由初级医疗机构，以提高质量的护理和病人safety.Results：在卫生设施的质量护理情况普遍较低，由SafeCare Essentials工具和NHIA数据确定。大多数被评估的机构没有记录在案的持续质量改进和患者安全过程的证据。总体而言，工作人员的积极性似乎较低，虽然工人在私营设施比工人在公共设施的工作条件更好（P < 0.05）。工作人员对工作条件的满意度与诊所对质量改进和患者安全的努力之间存在显著的正相关（P < 0.05）。结论：作为加纳实现与卫生有关的千年发展目标努力的一部分，应将更全面的工作人员激励措施纳入质量改进战略，特别是在政府中，工作条件被认为是最差的医疗机构。
Background: Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation.Purpose: This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities.Methods: The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety.Results: The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P < 0.05). Significant positive associations were found between staff satisfaction levels with working conditions and the clinic's effort towards quality improvement and patient safety (P < 0.05).Conclusion: As part of efforts towards attainment of the health related MDGs in Ghana, more comprehensive staff motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where working conditions are perceived to be the worst.