Title: Chile: reaping the rewards of investments in quality.

POPLINE Document Number: 102029

Author(s):

Brown LD
Gnecco G

Source citation:

QA Brief, 1994 Winter;3(3):28-31.

Abstract:

During the first 2 years of a quality assurance program/Ministry of Health collaboration in Chile, training, organization, and planning were emphasized. During the third year, a significant number of small teams were achieving quality improvements at the local level. Currently, 50 projects on different aspects of maternal and child health care are in various stages of completion, covering between 1 and 10 health centers each. In Santiago, health center staff improved breast feeding support and achieved 60% exclusive breast feeding at 4 months (33% at 6 months) as well as an improvement in health professionals' knowledge from 4.25 to 6.43 on a scale of 1 to 7. A regional effort undertaken by a group of midwives improved the collection, dissemination, and analysis of information about the incidence of low birth weight infants so that this information could provide the high-quality data necessary to influence planning and programming decisions. In Santiago, which has the highest rate of adolescent pregnancies in Chile, a midwives group improved the way in which information on prenatal care was given to these young women during their prenatal orientation. By including all of the relevant information on one card, the midwives improved significantly the likelihood that the adolescents would make and keep the necessary appointments and that they would have important information at their fingertips. The teens all saved the cards as keepsakes of their first pregnancies. Also in Santiago, a team of physicians assessed the quality of care in treating acute respiratory infections. They found that over 80% of providers did not have time to record the necessary information which would insure appropriate care as the patient moved through the health system. An initial effort to improve this situation was only partially successful, so the physicians are developing a more detailed plan. In the final example, a physician evaluated the quality of record-keeping across 7 specialties in his hospital and found it lacking. The initial response to the findings was not positive, but as providers received more training in quality evaluation and improvement, attitudes changed. The hospital formed a medical records committee to develop ways to improve record-keeping and, thus, patient care. This indicates that a move from evaluation to improvement requires broad-based awareness of the merits of quality control.

Keywords:

Chile
Quality Control
Quality of Health Care
Delivery of Health Care
Maternal-Child Health Services
Breastfeeding
Promotion
Low Birth Weight
Adolescent Pregnancy
Antenatal Care
Respiratory Infections
Records
South America, Southern
South America
Latin America
Americas
Developing Countries
Organization and Administration
Health Services Evaluation
Program Evaluation
Programs
Health
Primary Health Care
Health Services
Infant Nutrition
Nutrition
Marketing
Economic Factors
Birth Weight
Body Weight
Physiology
Biology
Reproductive Behavior
Fertility
Population Dynamics
Demographic Factors
Population
Maternal Health Services
Infections
Diseases
Information Processing
Information