Abstract
BackgroundThe structured admission form is an apparently simple measure to improve data quality. Poor motivation, lack of supervision, lack of resources and other factors are conceivably major barriers to their successful use in a Kenyan public hospital setting. Here we have examined the feasibility and acceptability of a structured paediatric admission record (PAR) for district hospitals as a means of improving documentation of illness.MethodsThe PAR was primarily based on symptoms and signs included in the Integrated Management of Childhood Illness (IMCI) diagnostic algorithms. It was introduced with a three-hour training session, repeated subsequently for those absent, aiming for complete coverage of admitting clinical staff. Data from consecutive records before (n = 163) and from a 60% random sample of dates after intervention (n = 705) were then collected to evaluate record quality. The post-intervention period was further divided into four 2-month blocks by open, feedback meetings for hospital staff on the uptake and completeness of the PAR.ResultsThe frequency of use of the PAR increased from 50% in the first 2 months to 84% in the final 2 months, although there was significant variation in use among clinicians. The quality of documentation also improved considerably over time. For example documentation of skin turgor in cases of diarrhoea improved from 2% pre-intervention to 83% in the final 2 months of observation. Even in the area of preventive care documentation of immunization status improved from 1% of children before intervention to 21% in the final 2 months.ConclusionThe PAR was well accepted by most clinicians and greatly improved documentation of features recommended by IMCI for identifying and classifying severity of common diseases. The PAR could provide a useful platform for implementing standard referral care treatment guidelines.
Highlights
The structured admission form is an apparently simple measure to improve data quality
We found that when the paediatric admission record (PAR) was used documentation for signs relevant to specific diagnoses was almost always more than 90% for key signs compared to
One of the objectives of the study was to see whether clinicians would accept the PAR since it was introduced by an external group with no specific incentives and without close supervision
Summary
The structured admission form is an apparently simple measure to improve data quality. Lack of supervision, lack of resources and other factors are conceivably major barriers to their successful use in a Kenyan public hospital setting. One of the problems identified in the survey was that data required for even crude health systems performance indicators were of poor quality and potentially misleading. Such data are likely to prevent effective health care planning for the hospital, region and nation. A structured admission form is an apparently simple measure to improve data quality, poor motivation, lack of supervision, lack of resources and other factors are conceivably major barriers to their successful use in a Kenyan public hospital setting. Data from the pre-intervention period would indicate the degree to which specific disease programmes have influenced documentation of severe illness
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
