Ethiopian Healthcare Quality and Safety

• Healthcare quality concerns are significant in Ethiopia.

Ethiopian Hospital Alliance for Quality (EHAQ) 4th Cycle Audit Tool

• Purpose is to assess hospitals against quality standards and drive improvement.
• Growing needs of hospital customers coupled with disease dynamism require continuous improvement.
• Hospitals' infrastructure and quality service are in early stages in most regions.

National Patient Safety Guideline

• Healthcare quality and patient safety concerns and reports of medico-legal issues have grown.
• 10% of patients are exposed to hazards in health facilities.
• 2% of patients die due to harm sustained in health facilities.
• 50% of healthcare harm is preventable, yet it claims over 3 million lives a year globally.

Specific Healthcare Quality Concerns

• Medication administration errors: most patients were not informed about medication dosage, frequency, and potential side effects, and drug order forms lacked allergy, height, and weight prompts.
• Surgical site infections: Prevalence among women who had caesarean sections was 9.8% to 12.4%.
• Healthcare-associated infections (HCAIs): Pooled prevalence of 7–17%, higher in intensive care units, pediatric wards, and surgical wards, and common HCAIs include surgical site infections, urinary tract infections, bloodstream infections, and respiratory tract infections.
• Significant percentage of samples from patients with HCAIs showed anti-microbial-resistant bacteria.
• Other critical patient safety concerns include: diagnostic errors, fall accidents, patient misidentification, unsafe blood transfusions, and venous thrombosis.

Health System Challenges

• Gaps exist in the availability and readiness of health infrastructure, like infection prevention and control, lab equipment, and personal protective equipment.
• There is low adherence to practice standards and guidelines.
• Lack of an institutionalized patient safety culture: healthcare staff would not report errors due to fear of embarrassment or punishment, and staff was blamed for mistakes instead of focusing on learning.
• Gaps in using data for decision-making.
• Staff training on patient safety is inadequate.
• Lack of national guidelines was identified as a critical impediment.
• Shortages of care providers and staff overburdening were also reported.

System Bottleneck Focused Reform (SBFR) Initiative

• Aims to improve hospitals' clinical care outcomes and client satisfaction.
• Issues include "No habits for evidence use," "Enormous wastages," and "Huge disparities: Plan vs. Commitments."

Initiatives Underway

• Development and implementation of EHAQ audit tool to systematically assess and improve quality.
• Creation of the National Patient Safety Guideline to provide a framework for structuring and coordinating healthcare safety practices.
• SBFR initiative represents another major effort to address systemic issues and improve the overall quality of hospital services.