Improving the quality of maternity services in Nepal through accelerated implementation of essential interventions by healthcare professional associations

Abstract

The present study strengthened previous findings regarding the uptake of EIs following joint promotion by HCPAs in low-income settings.

Where Do Models for Change Management, Improvement and Implementation Meet? A Systematic Review of the Applications of Change Management Models in Healthcare

“… Sorensen 44 2016 Qualitative Semi-structured group interview Ambulatory care clinics, Minnesota, United States of America Pharmacists and medical practitioners from six health systems with a well-established medication management program Kotter’s 8-step To describe the influencing the adoption, growth and sustainability of medication management services A supportive culture and team-based collaborative care are necessary for medication management services’ sustainability. Spira 61 2017 Quantitative Surveillance data and surveys Two hospitals, Uganda Maternity Departments Accelerated Implementation Method To increase the use of intrapartum and postnatal essential interventions (EIs) in two hospitals in Uganda EIs that were regularly used had no improvement, however, seldom used EIs had a significant improvement in use due to the implementation package of activities developed Spira 62 2018 Quantitative Surveillance data Two tertiary teaching hospitals, Nepal Maternity Departments Accelerated Implementation Method To increase the use of intrapartum and postnatal essential interventions (EIs) in two hospitals in Nepal Only the timely administration of antibiotics caesarean increased, with all other EIs not showing improvement Stoller 46 2010 Mixed method Randomised control trail, observational and in-person interviews Respiratory therapy department, Cleveland clinic, Cleveland, Ohio RCT on 145 patients, 71 RTCS groups and 74 physicians. Interviews on 8 RT department leaders Kotter’s 8-step, and Silversin and Kornacki’s model - Amicus Implementing respiratory care protocols to reduce misallocation of respiratory care There were 11 desired featured to the change.…”

“…[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] Eight studies referenced their application of the Lewin 3-Stage Model of Change into a healthcare setting, [48][49][50][51][52][53][54][55] with three further studies that integrated the Lewin model with a concern-based change management approach, McKinsey 7S Model of Change, and Roger's Diffusion of Innovation Theory, respectively. [56][57][58] A further eight articles reported the use of six further models for managing and leading change: Influencer Change Model (1 study); 59 Prosci ADKAR (1 study); 60 Accelerated Implementation Methodology (AIM) (2 studies); 61,62 Advent Health Clinical Transformation Model (1 study); 63 Riches 4 stage model (1 study); 64 Youngs Nine Stage Framework (1 study), 65 and the CAP model (1 study). 66…”

“…66 System-Wide and Multi-System Change Six national or system-wide projects were identified. 42,53,55,[70][71][72] Kotter's model was employed to bring about change in one of these through the use of peerreview models in radiation oncology across 14 cancer treatment centres in Canada. 42 Over a two-year period, the proportion of radical-intent radiation therapy courses peer reviewed increased from 43.5% to 68%, with some sites reaching over 95% use of peer-review.…”

Implementation of cervical cancer prevention and screening across five tertiary hospitals in Nepal and its policy implications: A mixed-methods study

“…Moreover, ongoing sustainable training activities with long-term partnerships of public and private sectors within the health system are necessary to translate health professionals’ knowledge into practice [ 49 ]. Adapting pre-service and in-service training activities for different maternal and newborn health interventions has proven to be helpful in improving the knowledge and skills of health professionals [ 50 , 51 ]. Similar, strategies could help enable better implementation of cervical cancer prevention services and screening.…”

Health system intervention packages on improving coverage of kangaroo mother care for preterm or LBW infants: a mixed-methods systematic review

“…Design and setting. Two studies were community-based cluster randomized trials (21,22) two were reports of a national-level programmatic scale-up (23,24), one was a mixedmethods study across facility-community continuum at district/woreda level (25), three were quality-improvement studies -one facility and one community-based (26)(27)(28), and eight were uncontrolled before-after health facility-based studies (28)(29)(30)(31)(32)(33)(34)(35). Thirteen studies were conducted in lower-middle-income or low-income country settings -Bangladesh, Ethiopia, Ghana, India, Nepal, Philippines, Uganda) and three in high-income settings (USA) (Table 3).…”