ABSTRACT
Background: The Ministry of Health and Social Protection (MOHSP) of the Moroccan Kingdom acknowledges the crucial need to improve the quality and safety of care provided to patients. As a result, they have launched a process that involves, developing a conceptual framework and implementing national health policies aimed to enhance services offered to hospital users. Objective: The aim of this study is to identify all the approaches developed by the MOHSP since 1990 to enhance the quality and safety of care. Materials and Methods: This study is a descriptive qualitative analysis. The data was collected over a six-month period, through semi-structured interviews with professionals reporting to the MOHSP, and through a document analysis. Results: The results provide a comprehensive description of approaches to quality and safety of care in the Moroccan health system, the findings reveal that these approaches are based on three complementary strategies: continuous quality improvement, standardization, and safety of care. Conclusions: The Moroccan health system has implemented various strategies to improve the quality and safety of care. However, these strategies have not been sustained due to several factors. To ensure sustainability, the system needs to invest in capital and resources, involve quality experts in hospitals, use processbased approaches, strengthen legislation and regulations related to quality of care, and translate them into implementing decrees.
ABSTRACT
Context: The process of caring for patients requiring surgery exposes them to a high risk of COVID-19 infection during the pre-operative, operative, and post-operative phases, as these procedures are known to be modes of transmission for the virus. Objective: We conducted this study to prevent the risk of COVID-19 infection by identifying potential failure modes during the patient care process, determining critical activities, and defining mitigation measures to reduce transmission. Materials and methods: Through a quality and a priori risk management method, which is Healthcare Failure Mode and Effect Analysis (HFMEA), applied in the patient care process in the Central Operating Room of Mohammed VI University Hospital in Morocco. Results: We identified 38 potential failure modes in the patient care process during the three phases (preoperative, operative, and postoperative) that could increase the risk of COVID-19 infection. Of these, 61% are classified as critical, and we have identified all their possible causes. To reduce the risk of transmission, we have proposed 16 mitigation actions. Conclusion: The use of HFMEA has been effective in the new pandemic context, improving patient safety during the care process in the operating room and reducing the risk of COVID-19 infection.
