142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Using quality improvement tools to improve emergency care for children under-five years in 4 hospitals in Northern Region of Ghana

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 10:30 AM - 10:42 AM

Alexander Suuk Laar, Mr , Department of Health, National Catholic Health Service, Department of Health, c/o Christian Village, KS-99, Kumasi, Ghana, Ghana, Ghana

Hospitals in Ghana are critically overcrowded due to increasing demand for hospital care. Overcrowding cause serious delays in the care pathway for children especially the critically ill Under-five children as their care is not prioritized. This lead to early hospitalization and mortality. The aim of this Quality Improvement (QI) work was to improve emergency care for the critically ill under-five children in 4 hospitals.


The QI teams used Process Map to analyze both Out Patient Department (OPD) and admission cases in their hospitals.  The results showed that under-five children spend between 270 and 390 minutes between the records unit and the desk where vital signs are checked. Underlying this was the observation that children including the critically ill and adults joined the same queue to see prescribers at the OPD. Measures were put in place to reduce delay in provision of care.


There has been a reduction in Under-5 mortality in 3 out of the four hospitals ranging from 16.6% to 58.2% between January 2009 and December 2013.  Major reduction in mortality occurred in Tamale Central hospital from a mean of 65 to 27 per 1000 admissions representing 58.2% between May 2011 and December 2013.  There was no reduction in Under-five mortality in Tamale Teaching hospital. 


Action is needed to improve the quality of care for the critically ill children under-five in hospitals in Ghana and beyond by introducing QI methods in health care.

Keywords: emergency care, triage, critically ill children, Ghana

Learning Areas:

Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify how Quality Improvement work can improve emergency care for the critically ill under-five children in hospitals Demonstrate how Quality improvement tools can be used to improve health outcomes for children in hospitals

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract Author on the content I am responsible for because I work as a Project Officer with the organisation from which the data used in writing this abstracted was generated from. I hold a master of Public Health(Health Economics) from the University of Cape Town, South Africa.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.