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Multicenter Study
. 2024 Aug 30;8(Suppl 7):e002612.
doi: 10.1136/bmjpo-2024-002612.

Implementation of the WHO Standards to assess the quality of paediatric care using health workers as source of data: findings of a multicentre study (CHOICE) in Italy

Ilaria Liguoro  1 , Ilaria Mariani  2 , Andrea Iuorio  3 , Francesca Tirelli  4 , Marcella Massarotto  5 , Fabio Cardinale  6 , Roberta Parrino  7 , Sara Dal Bo  8 , Sara Rivellini  1 , Gian Luca Trobia  9 , Kevin Valentino  10 , Silvia Sordelli  11 , Riccardo Lubrano  12 , Giuseppina De Rosa  7 , Michela Pandullo  1 , Vita Antonella Di Stefano  9 , Vanessa Martucci  12 , Valentina Baltag  13 , Egidio Barbi  14   15 , Marzia Lazzerini  16   17 ; CHOICE Study Group
Collaborators, Affiliations
Multicenter Study

Implementation of the WHO Standards to assess the quality of paediatric care using health workers as source of data: findings of a multicentre study (CHOICE) in Italy

Ilaria Liguoro et al. BMJ Paediatr Open. .

Abstract

Objectives: There is little experience in implementing the WHO Standards for improving the quality of care (QOC) for children. We describe the use of 75 WHO-Standard based Quality Measures to assess paediatric QOC, using health workers (HWs) as data sources.

Design: Cross-sectional study.

Setting: 12 Italian hospitals.

Participants: The minimum target of 75% of HWs was reached in all facilities; answers from 598 HWs were analysed.

Primary and secondary outcome measures: 75 prioritised WHO Quality Measures were collected using a validated, and Italian-language questionnaire exploring views of HWs providing care to children. A QOC index was also calculated based on the assessed Quality Measures.

Results: In both the domain of resources and work organisation, most Quality Measures showed a high overall frequency of reported 'need for improvement', with high variability across hospitals. Key needs for improvement included: availability of clear and complete protocols (eg, on paediatric emergencies: 44.6%; range 10.6%-92.6%); clear hospitalisation criteria for diarrhoea (50.5%; range 30.3%-71.7%); number of hand-washing stations (13.2%; range 3.4%-37.0%); equipped working rooms with computers for HWs (66.1%; range: 32.1%-97.0%); training (eg, on pain management: 43.5%; range 17.9%-76.7%), periodic discussion of clinical cases (43.5%; range 8.1%-83.7%) audits (48.8%; range 29.7%-76.7%); and all indicators related to system to improve QOC. Factors significantly associated with a lower QOC Index included HWs working in facilities in Southern Italy (p=0.001) and absence of a paediatric emergency department (p=0.011).

Conclusions: The use of the 75 prioritised Quality Measures, specific to HWs provide valuable data on paediatric QOC, which can be used to drive a quality improvement process.

Keywords: Child Health; Infant.

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Conflict of interest statement

Competing interests: No, there are no competing interests.

Figures

Figure 1
Figure 1. Flow diagram. 1Missing information on all close-ended questions including sociodemographic questions; 2suspected duplicates identified as cases with same answers to close-ended questions including sociodemographic questions and, when available, same date of questionnaire completion.
Figure 2
Figure 2. QOC index by hospital (n=514). QOC, quality of care.
See this image and copyright information in PMC

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