Quality Improvement-Integrated Kangaroo Mother Care (QIiKMC) – combining quality improvement (QI) and clinical education enhances implementation.
Research Team: Khalid Aziz, Nalini Singhal, Stella Kyoyagala, Milly Nassejje, Elias Kumbakumba, Majeeda Kamaluddeen, Susan Niermeyer, Julieth Kabirigi, William Keenan, Ashish KC, Douglas McMillan.
KMC improves outcomes for small newborns. QIiKMC is KMC education combined with Evidence-based Practice for Improving Quality (EPIQ). We hypothesize that integrating clinical and QI tools enhances implementation.
QIiKMC was developed by clinicians with global health and QI experience. It’s “learning by sharing” methodology encourages healthcare providers (HCP) to engage one-another and parents. The (6 x 2 hour) modules are available in digital format for remote facilitation or can be printed for face-to-face learning with local teams of 3-8 persons. Evaluation tools include facility surveys, simulation-based scenarios, and knowledge assessments.
We evaluated 33 physicians and nurses in Uganda, Tanzania and Nepal: knowledge scores increased from 79% to 88% post-workshop, 77% indicated it was useful or very useful. Supportive comments included “The link between EPIQ and KMC in identification and solving problems” and “Usefulness of family involvement in caring for the newborn in the hospital and home”. Participants suggested a preference for face-to-face learning and more time for hands-on practice. KMC implementation increased from 0 to 65% of preterm babies (by October 2022). Staff reported increased job satisfaction with QI involvement. Length of stay fell by 5 days. Government financing increased KMC beds from 4 to 8. Families helped families learn KMC. One father indicated “When my baby grows up, I will let him know that it was my warmth which kept him alive”.
CONCLUSIONS: Integrating clinical and QI education is feasible, empowering, and impactful.
Dr. Khalid Aziz is Professor Emeritus of Pediatrics in the Faculty of Medicine and Dentistry and Medical Director (Quality Improvement) in the Office of Lifelong Learning at University of Alberta, Edmonton Alberta. He is also a staff neonatologist in the Edmonton Neonatal Program and Stollery Children’s Hospital, Edmonton since 2007.