JMIR Publications

ABSTRACT

Background:

Quality of care for tuberculosis (TB) is deficient in high burden countries and urgently needs improvements. However, identifying those improvements comprehensively is challenging. Providing high-quality TB care is an important step toward improving patients’ quality of life and decreasing TB morbidity and mortality. Developing effective tools for assessing a quality of provided service using international standards and guidelines, helps to identify the existing gaps and give opportunity to ensure access to high-quality services in health facilities. This study was aimed to develop evaluation instruments for defining quality of provided care and proposing further quality improvement programs for TB inpatient treatment services in Armenia.

Methods:

We are assessing the largest TB inpatient facility in Armenia to evaluate its compliance with the Joint Commission International Accreditation Standards for Hospitals, International Standards for TB Care, and WHO framework for conducting TB program reviews. Data was collected utilizing a mixed methods approach through 24 in-depth interviews and eight standardized checklists to explore practices of healthcare professionals, assess inpatient treatment experience of patients and their family members, evaluate the facility environmental conditions and define the level of policies applied. It was analyzed using scoring system converted to percentages for both patient-centered and organization-management functions. The SWOT (strengths, weaknesses, opportunities, and treats) analysis was applied to describe details of the assessment results, including the direct quotes from the in-depth interviews. Discussion: Going in-line with the notion of healthcare quality and patient safety will strengthen tuberculosis control and help to prevent TB epidemics. Effective assessment of inpatient care facility using the developed instruments and methods in this study, will support implementation of similar assessment mechanisms in other counties’ national tuberculosis programs. It also may become a platform for developing a similar approach in assessing ambulatory TB services of the national tuberculosis programs in resource-limited countries.