Evaluation of quality of care at the orthopedic surgery Unit at Central Hospital in Yaounde

Abstract

Context: Increasing incidence of trauma injuries in orthopedics and the rarety of care quality evaluation in Cameroon due to the bias opinion of their main aim in health providers mind makes it important to evaluate the quality of care delivered so as to help the health professional make the best diagnostic and therapeutic choice for the patient thus increasing their chances of survival. Objectives: Evaluate care quality in the Orthopedic Unit at Central Hospital, describe the pathologic profile, evaluate the ressources, assses the procedures. Methodology: To attain this objective, an observational evaluative situational analysis design study was conducted in the Orthopedic Surgery Unit at Central Hospital of Yaounde in the from November 2021- June 2022. The pathologic profil was assessd by file review and data collected using a questionnaire, human resources data were collected using an interview guide, also material resources were assessed using an observation grid, furthermore processes were analysed using an evaluation grid. Data collected was analysed using the statistical package for social sciences SSPS version 26. The mean and median were used for quantitative variables and the Likert scale was used to establish a qualitative value to each patient interm of continuity, safety, and efficacy. These values were then used inturn to obtain the care quality value of each medical file included and thus the overall care quality. Results: Following data collection, 200 medical records and 40 medical staff members were included in the study. For the former The median age was 39 years, with an interquartile range of 30 to 53 years and extremes ranged from 6 to 87 years. A sex ratio of 1:1.63. Secondly the most common cause of traumatic injury was RTA with 79%. In addition to this fractures were the commonest type of trauma with closed fracture constituting 54.41% and open fracture 41.5% of cases of which 95% happened through a direct mechanism. Further more the lower limb was the predominant body part affected for 70.76% followed by 14.41% for the superior limb. For the latter, during the first week of data collection in the Orthopedic Surgery Unit we had 3 surgeons, 14 residents, 7 registerd nurses, 13 assistant nurses, 3 medical student for a total of 40 medical staff members to which the 13 admission rooms (containing 50 beds) were divided accordingly. The median age of the experienced number of years of the medical staff was 2.5 years with the extremities being 3 months and 16 years. The sex ratio was 1:1. Also concerning the material resources the study objectivated that 71.4% of the technical equipment was functional and in good state, adequate at 97.2% but accessible at 37.5%. Moreover most of the procedures in power were regularly implemented but only two were found be lagging behind as they were oftenly enacted. The last but not the least the care quality was adequate in 98% of cases with efficacy being at its best in 93.5% of cases, continuity being at its best in 98% of cases and safety was at its best in 71% of cases. Conclusion: The care quality at the Orthopedic Surgery Unit at Central Hospital of Yaounde meet up the recommended standard in term of continuity and efficacy but more effort has tobe done in the improvement of safety which is lower due to the less adequate health environment and the passivity in the application of certain procedures.