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The Performance Measurement of the Quality Health Care: Standpoint Perspectives the Staff Practicing in the Primary Health Care Establishments in Morocco

Zaadoud B, Chbab Y, El Ghaza S, Chaouch A

Object: The subject of our research concerns the measurement of the performance in Primary Health Care Establishments (PHCE). How to evaluate the impact of qualitative approaches on the perception of the actors of the PHCE and the level of performance in these establishments.

Method: The data collection was made through a questionnaire for the staff who exercises in the PHCE. This questionnaire contains three parts adapted according to the model of Donabedian (Structure, processes and results), understanding seven domains. The first part concerns the Structure dedicated to the Quality Planning, the Leadership and the Human Resources Management. The second part concerns the processes dedicated to the Process Management, the Monitoring and the analysis. The third part handles the Results of the quality and the user’s satisfaction. Every domain contains 4 to 9 questions handling an aspect with 46 questions. The questionnaire was sent to the concerned in an individual way either directly or through emails, assuring the guarantors.

Result: We note significant differences in the perception of the quality of the care of the health workers general. The steps of ACQ remain a good tool to improve the quality of the care. The satisfaction of the population remains high with a performance of (74%), the steps of ACQ are effective tools of the organizational change, the impact on the change of professional practices for our case (68%) have this image, which varies, enters average and low on the CQ. Continuity and integration of the care are assured only in 34% of the cases. The fragmentation of the services, the ineffective use of the suppliers of care, the bad quality of the collection and the management of the information, the lack of coordination, the lack of importance given to the prevention, as well as the deficits in the access to healthcare stand out as the main problems.

Conclusion: Even if the links are not established within the framework of a scientific research, quality approaches are generally recognized as an essential tool to help establishments to improve the quality and the safety of the patients. Tools proposed in quality approaches remain an essential lever for the promotion of quality approaches. They demonstrated positive effects on the quality of the care, but some constraints slow down their evolution. It is not still common to make evaluations of the quality of the care in the PHCE to obtain the relevant information on the benefit. The necessity of having measurement tools for performance which puts in coherence the piloting of the operational level with the strategy, to integrate the organizational objectives into the measures of operational performances and make estimate its structures towards a real management by the quality.