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The development of non-web based maternity database as a quality improvement tool at Ridge Regional Hospital, Ghana
Abstract Number: F 73
Abstract Type: Case Report/Case Series
Introduction: Kybele®’s partnership with Ghana health service towards improving maternal care is ongoing. Numbers of deliveries have grown from 1900 deliveries in 2004 to over 11,000 in 2012, a five - fold increase at Ridge Hospital. Staffing numbers have only doubled. Monthly paper-based data generated by the midwives was unsustainable and labor-intensive. Quality improvement (QI)metrics to assess progress of system change implementations (referral patterns, case fatality ratios, stillbirths from referral centers and within Ridge system, cesarean section delays, reduction in NICU admissions, maternal death) is required. As internet access is often unreliable, a non-web database was created.
Methods: Monthly maternal demographic summary and QI metrics are collected from patient folders and log books in maternity wards, operating rooms, and NICU. New wide-screen 23” computer, fan and semi-private room is created to improve working condition for data entry personnel. The database was developed on Microsoft Access 2010 platform. Intermittent internet connection allowed distance access to database and improvement made with minimal disruption to daily data acquisition. Authors C. Petermann and P Herlihy, both Microsoft access experts, contributed pro bono to database revisions. The database is backed-up daily on a usb drive.
Results: A comprehensive locally-applicable maternity application was created that has incorporated government-required data and the continual QI metrics. Changes to database due to new metrics identified are undertaken while the database is not in use, due to the time zone differences. Midwives can now concentrate on midwifery responsibilities. Currently, government and hospital auditors and departmental researchers utilize the database as a reliable generator of useful summary data.
Conclusions: Non web-based locally-generated database allows customized relevant data acquisition. Fluctuating internet availability means web-based database entry is unavailable. Internet can be reserved for long-distance remote improvement of software. Universal knowledge and availability of Microsoft Access allows easier internet-based support. Non Microsoft Access based platforms may have restricted customization and higher financial costs that are too burdensome to small low resource hospitals. A non web based local database can be easily installed in small local maternity units within the same area where the same type of data is collected.