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charset="us-ascii" Performance Improvement At Ain Shams University Hospitals

بر= ;نامج تحسين جودة الاداء
بم= ;ستشفيات جامعة عين شمس
Performance Improvement Program
At Ain Shams University <= span style=3D'font-family:Tahoma;mso-ascii-font-family:Tahoma;font-size:73%'>Hospitals
By
Prof. Mahi Al-Tehewy
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------=_NextPart_01C60754.198C24E0 Content-Location: file:///C:/EC2C4CD6/6_files/slide0028.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Performance Improvement At Ain Shams University Hospitals


Justification<= /span>
 
•<= /span>Quality of service delivery has become an important focus of attent= ion for every one employed in health care.
•<= /span>The national health reform policies in Egypt elaborated the pres= sing need and demand for a highly recognized quality = improvement.
<= span style=3D'mso-special-format:bullet;position:absolute;left:-4.1%'>•This has led Ain Shams University leaders to adopt a program to improve service delivery at Ain shams University hospitals.
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•According= ly, we reviewed the local quality initiatives and experiences and studied different qual= ity approaches available to learn lessons.
•Then we conducted situational analy= sis to formulate the basis for selecting strategic directions and  Q  policies
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Background
•ASUHs are consisted of 4 hospitals of totally 2780= beds.
•The oldest hospital had been established in 1931 a= nd has been exposed to several trials of renovation. =
<= span style=3D'font-size:81%'>•There are about half million patients attending th= e outpatients clinics annually.
•ِِِAbout 85 thousands patients admi= tted annually, most of th= em are very poor people.
<= span style=3D'font-size:81%'>•30 thousands surgical interference are done annually
<= span style=3D'font-size:81%'>•In addition, there are three specialized centers, = the first for mental healt= h, the second for oncology and the third for clinical toxicology.
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Objectives of situational analysis
•Determine QI strategies & policies at ASUHs
•Identify requirements for QI implementation.
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Method
<= span style=3D'font-size:113%;color:#CC0000'>•SWOT analysis wa= s used as a simple tool= for situational analysis of the internal and external environment of ASUHs.
•Three-day workshop was done and  attended by representatives of all = stakeholders of healthcare (provided at ASUHs)
<= span style=3D'font-size:113%'>•The works= hop was facilitated by nati= onal quality experts. 
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Results of Situational Analysis
I- Strengths
• = ;
•<= /span>Strong Leadership commitment
•<= /span>High technology&#= 13;
•<= /span>Manpower
•
 
–
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Situational Analysis
I- Strengths
–Highly qualified and competent staff <= /span>
–Increasing interest in quality improvement among  hospital leaders and some members of the medical staff
–Presence of qualified persons capable of leading quality improvement = programs
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Situational Analysis
II- Weakness
–Poor culture of quality
–Some health leaders underestimate the value of quality and are skeptical about <= /span>feasibility and effectiveness of its approaches in improving health services
–Poor spirit of team work
–High resistance to change
–Few qualified human resources in quality<= /div>
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Situational Analysis
II- Weakness
•Undergraduate and postgraduate medical studies are lacking components about healthcare quality concepts and approaches
•Training needs in healthcare quality are not clearly identified
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Situational Analysis
II- Weakness (c= ont.)
–Deeply rooted bureaucratic administrative approaches
–Poor inter and intra-sectoral coordination =
–Dual role: being educational and service institutions (unclear organization)
–Lack of managerial skills at all levels
–Job descriptions are not available for= all members of health teams. Moreover, what are available are not properly communicated between health team
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Situational Analysis
II- Weakness (c= ont.)
•Supply and Financ= e
<= span style=3D'font-size:88%'>•Rules and regulation of incentives do not support quality improvement activities.
•Bureaucrac= y of financing and methods of dispensing
<= span style=3D'font-size:88%'>•Poor salar= ies of physicians and other members of health team
•Preparing = budget is not depending on real needs
•Mal distri= bution of some resources
•Scanty fund posts for quality
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Situational Analysis
II- Weakness (c= ont.)
•<= /span>
•Poor maintenance&= #13;
•Poor monitoring s= ystem = ;
•Poor information system
•Poor infrastructure
<= span style=3D'font-size:125%;color:#660066;mso-color-index:6'>•The problem of sustainability of activities
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Situational Analysis
III Opportuniti= es
•Political commitment
•National standards for general hospi= tals are available now
<= span style=3D'font-size:113%'>•Establish= ment of HSQ unit at Faculty of Medicine in 1999
<= span style=3D'font-size:113%'>•Starting establishment of the Center of Educational Quality and Accreditation at  Ain Shams University
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Situational Analysis
III Opportuniti= es (cont.)
•Many parti= es are interested in qual= ity (national and international)
•Availabil= ity of evidence based pract= ice guidelines at no cost
<= span style=3D'font-size:125%'>•Availabil= ity of quality measures and q= uality improvement projects at n= o cost
•<= /span>
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Situational Analysis
IV Threats
<= nobr>•Global Layer =
•Unstable exchange rate for foreign currency
•Globalization of the health sector by January 2005 will develop free market of healthcar= e, new competitive providers, firms or organizations for accreditation, unstu= died rush of local facilities to be accredited by international organization= 3;
•
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•TRIPS (Trade related aspects of intellectual property rights) will affect, drug market and medical supplies =
•The current legislations, or policies are un-sufficient= to protect the local healthcare market.
•Vision of the authorities regarding how to = face current and future threats is poorly communi= cated.
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Situational Analysis
IV Threats (cont.)
•Lack = of quality culture
•Lack = of data culture
•Low expectation = of clients is considered as a threat to achieve optimum level of quality
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Situational Analysis
IV Threats (cont.)
<= span style=3D'mso-special-format:nobullet;display:none'>•   Adjacent Layer= 3;
• - Powerful highly skilled professional international competitors are starting invading healthcare market in Egypt
• - Potential competitors are expected from everywhere for the big Egyptian market
• - Monopoly in the field of medical supplies and drugs especially after application of TRIPS
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Strategic Goals
•Ensure quality of healthcare delivered in ASUHs
•Building up capacities for quality at all levels
•Creat= e and communicate culture of quality in ASUHs
• Satisfy the needs and expectations= of healthcare providers and consumers
•Intra= -sectoral coordination between different departments
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Strategic Directi= on
•<= /span>Intensive strategies
–Service development
–Market development
•<= /span>Defensive strategies
–Joining with others
–Right sizing and down sizing 
•<= /span>Decentralization =
•<= /span>Diversification (low cost providers= )
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سياسة الجودة ب= 605;ستشفيات جامعة عين شمس
•التأسيس الهيكلى للجودة Institutionalization of quality
•تمكين لجان الجودة من تنفيذ خططها وأنشطتها = ودعمها بكافة الصلاحيات للوصول إلى أهدافها
•بناء الكوادر البشرية فى مجال إدارة الجودة
•دعم المستشفيات للتطابق مع المعايير
•نشر ثقافة الجودة وخلق إحتياج لتحسسين الج= 608;دة   بين مقدمى ومستخدمى الخدمة
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سياسة الجودة ب= 605;ستشفيات جامعة عين شمس
•= التنسيق بين القطاعا= 578; داخل الأدار= 577; المركزية للمستشفي&#= 1575;ت
•= الاتجاه التدرييجى المدروس <= span lang=3DAR-SA style=3D'font-family:"Times New Roman";mso-bidi-font-family:"= Times New Roman"; font-size:106%'>نحو اللامركزية فى &= #1575;لأدارة
•= تضميين المناهج الدراسية بكلية الطب والتمريض لمفاهيم الجودة
•= تقوية وتدعيم  نظام قياس أومتابعة ذا= 578;ية وخارجية مستمر
•= مكافاءة وتحفيز الأداء المتميز=
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Come to the challenge
•= End of
•The First and Easy part