| The difficulty of questioning clinical practice: experience of facility-based case reviews in Ouagadougou, Burkina Faso. | |
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MedLine Citation:
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PMID: 18503575 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To describe the implementation of facility-based case reviews (medical audits) in a maternity unit and their effect on the staff involved. DESIGN: Cross-sectional descriptive study. SETTING: A 26-bed obstetric unit in a district hospital in Ouagadougou, Burkina Faso. SAMPLE: Sixteen audit sessions conducted between February 2004 and June 2005. Thirty-five staff members were interviewed. METHODS: An analysis of all the tools used in the management of the audit was performed: attendance lists, case summary cards and register of recommendations. The perceptions of the staff about the audits were collected through a questionnaire administrated by an external investigator from 10 June 2005 to 16 June 2005. MAIN OUTCOME MEASURES: Session participation, types of problems identified, recommendations proposed and implemented and staff reaction to the audits. RESULTS: Only 7 midwives from a total of 15 regularly attended the sessions. Eighty-two percent of the recommendations made during the audits have been implemented, but sometimes after a delay of several months. Interviewed personnel had a good understanding of the audit goals and viewed audit as a factor in changing their practice. However, midwives highlighted problems of bad interpersonal communication and lack of anonymity during the audit sessions, and pointed out the difficulty of practising self-criticism. CONCLUSIONS: A lack of staff commitment and the resistance of maternity personnel to being evaluated by their peers or service users are reducing acceptance of routine audits. The World Health Organization must take all these factors into account when promoting the institutionalisation of medical audits in obstetrics. |
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Authors:
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F Richard; C Ouédraogo; V Zongo; F Ouattara; S Zongo; M E Gruénais; V De Brouwere |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-05-22 |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 116 ISSN: 1471-0528 ISO Abbreviation: BJOG Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2008-12-17 Completed Date: 2009-03-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 38-44 Citation Subset: AIM; IM |
Affiliation:
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Quality and Human Resources Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. frichard@itg.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Attitude of Health Personnel Burkina Faso Confidentiality Cross-Sectional Studies Female Hospitals, District / standards* Hospitals, Maternity / standards* Humans Interprofessional Relations Medical Audit / methods, standards* Midwifery / standards Obstetrics / standards* Pregnancy |
| Comments/Corrections | |
Comment In:
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BJOG. 2009 Jan;116(1):7-10
[PMID:
19087075
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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