Strategies to optimise quality of care using team approach in public hospitals of Addis Ababa, Ethiopia

Abstract

Public hospitals in Ethiopia face persistent challenges, including high turnover among lead-ers and ongoing issues with the quality of healthcare services. Additionally, these hospitals often operate with limited resources and input. These factors contribute to a low level of satisfaction among both patients and health workers. Problems in healthcare delivery and patient safety are prevalent in public hospitals in Addis Ababa. While the need for action is evident, and many countries are working to integrate quality into their healthcare systems, significant obstacles to improving the quality of care remain. Achieving and maintaining high-quality health services is nearly impossible without a dedicated team approach across pri-vate, public, and civil organisations at all levels. Methodology: This study aimed to develop strategies to optimise the quality of care through a team approach in public hospitals of Addis Ababa, Ethiopia. A sequential explanatory mixed-method research design was employed. Quantitative data were collected from 412 healthcare workers (97% response rate), while the qualitative phase engaged 12 key in-formants. Descriptive and logistic regression analyses were performed using Epi Info and SPSS software. For the qualitative component, data were transcribed and analysed themat-ically using ATLAS.ti software. Findings from the quantitative and qualitative phases were integrated to inform strategy for-mulation. Five thematic domains comprising 22 sub-themes were identified: Status of team-work in hospitals, Experiences of teamwork on quality care in hospitals, Challenges in im-plementing teamwork for quality care, Facilitators in implementing teamwork for quality of care, and Monitoring and Evaluation. Interim strategies, corresponding actions, and ration-ales were developed under each domain. A purposively selected panel of 12 experts vali-dated the proposed strategies, resulting in the approval of nine final strategies aimed at optimizing quality of care through a team approach in public hospitals.