Hospital quality improvement in Ethiopia: a partnership-mentoring model.
OBJECTIVE
Quality improvement efforts are increasingly common in the United States; however, their use in developing countries is limited. We sought to evaluate the impact of a large-scale intervention on several key management indicators through hospital quality improvement efforts.


METHODS
Pre-post-descriptive study of 14 hospitals in Ethiopia.


METHODS
Six regions and two city administrations in Ethiopia.


METHODS
Hospital leaders and management mentors in participating hospitals.


METHODS
In collaboration with the Ministry of Health and the Clinton HIV/AIDS Initiative, we implemented a countrywide quality improvement initiative in which 24 mentors with hospital administration experience were placed for 1 year in Ethiopia to work side-by-side with hospital management teams. We also provided a professional development course to enhance quality improvement skills.


METHODS
s) Presence of 75 key management indicators; reported management skills of hospital leaders by the mentors.


RESULTS
In pre-post analysis, we found improvement in 45 of the 75 (60%) key management indicators between August 2006 and May 2007. The changes reflected a total of 105 management indicators improved across the 14 hospitals, which equates to a per-hospital mean of 7.5 (standard deviation 5.9) improvements. Reported management skills of hospital leaders improved in several management domains, although their reported confidence in these skills remained largely unchanged.


CONCLUSIONS
Our findings indicate that quality improvement efforts can be effective in improving hospital management in developing countries. Longer follow-up is required to assess the sustainability of the hospital improvements accomplished.
Bradley
Elizabeth
E
School of Public Health, Yale University, 60 College Street, New Heaven, CT 06520, USA.
Hartwig
Kari A
KA
Rowe
Laura A
LA
Cherlin
Emily J
EJ
Pashman
Josh
J
Wong
Rex
R
Dentry
Tim
T
Wood
W Edward
WE
Abebe
Yigeremu
Y
D005002:Ethiopia; D006740:Hospital Administrators / Q000193:education / Q000592:standards*; D006779:Hospitals, Public / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D008330:Management Audit / Q000379:methods; D008611:Mentors; D010865:Pilot Projects; D011785:Quality Assurance, Health Care / Q000379:methods*; D013192:Staff Development / Q000379:methods