ArticleBMJ open2026
E-Patient Quality Improvement and Standardisation (EQIS) platform for improving maternal and paediatric clinical care in Bangladesh: study protocol for a prospective open cohort study.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionInappropriate healthcare practices are major contributors to poor outcomes of maternal and paediatric patients. Where resources are scarce, provider-level targeted interventions, such as implementation of standardised, evidence-based protocols and quality improvement initiatives, are particularly needed to address these gaps in care. Simulation-based tools have been shown to have a promising effect on improving clinical care management. This study aims to evaluate the effectiveness of a simulation-based platform called E-Patient Quality improvement and Standardisation (EQIS) in improving maternal and paediatric healthcare in Bangladesh. METHODS AND ANALYSIS: The study employs a prospective, open-cohort design and will be conducted across five tertiary-level hospitals in Dhaka, Bangladesh. All physicians engaged in providing maternal or paediatric care will be recruited. The EQIS platform will facilitate the development of online simulated cases, aiming to enhance physician practice and patient outcomes through involvement and immediate personalised feedback. The development of cases will consist of several stages of review by expert clinicians, ensuring that the cases align with national and local practice guidelines. Each participant physician will work on three cases per round, completing one of six rounds every 4 months for 2 years. The primary outcome will be the change in mean EQIS clinical performance score among participating physicians across evaluation rounds. Descriptive and inferential analysis will be done to assess trends in clinical performance and pinpoint areas for improvement. In addition, patient-level pre-impact and post-impact data will be collected. These data will evaluate the impact of the EQIS platform on physician performance, as measured by changes in patient satisfaction, treatment costs, referrals and facility utilisation. ETHICS AND DISSEMINATION: The study protocol was approved by the National Research Ethics Committee of the Bangladesh Medical Research Council (registration number: 59524062024). Dissemination of the study findings will be through meetings with stakeholders, conference presentations and publications in peer-reviewed journals.
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