Situational assessment report: quality improvement and patient safety: Tellewoyan Memorial Hospital and Lofa County Health System

Tellewoyan Memorial Hospital (TMH) is a government-owned referral hospital with a 135 bed-capacity, located in Voinjama City, Lofa County, Northern Liberia. Established in the 1950s, the hospital provides primary and secondary services including paediatrics, OB/GYN, surgical services, mental health care, antenatal care and dental services, to Liberians as well as to patients from the neighbouring countries of Guinea and Sierra Leone. As part of the national mandate, services are provided free of charge to all patients. TMH operates under the authority of the Lofa County Health Team. 

This situational assessment is the first of its kind for the Twinning Partnerships for Improvement Initiative. The assessment aims to inform strategic planning of the twinning partnership for improvement between TMH and Nagasaki University Hospital, in Japan. Further, the assessment seeks to gain a deeper understanding of factors influencing quality and safety at TMH, within the context of its county health system. Quality improvement and patient safety are major areas of concern in the Liberian context and, at the request of the Liberian Ministry of Health, was the focus of this assessment. To achieve the stated objectives of the assessment, a mixed methods approach was adopted to understand quality and safety drivers and bottlenecks within TMH and the Lofa County Health System. An assessment team from WHO, along with representation from MOH/Liberia, addressed five thematic areas: quality improvement, patient safety, hand hygiene, patient and community engagement and the wider Lofa county health system. Findings from the assessment reveal several gaps needing urgent attention. Recommendations and opportunities for change are presented to address these gaps.