The District Health Information System (DHIS) is used in South Africa to collect routine aggregated data. Analysis of hospital data in the DHIS revealed that reporting in hospitals (especially clinical data) is generally inconsistent and incomplete. The NDoH recognize these reporting and data quality challenges in hospitals and the impact they have on the ability to make informed management decisions and monitor the impact of health interventions. A data quality improvement initiative was undertaken in ten of the biggest Central and Tertiary hospitals in South Africa. The methodology to identify areas of incomplete reporting, findings of the onsite visits and interventions implemented to improve reporting rates in these hospitals are all discussed. This initiative demonstrated that well-designed and targeted interventions tested an refined in a few health facilities can easily be replicated in other facilities, making data quality intervention more cost effective in resource constrained settings.
When suicide occurs, it is regarded as an adverse event. Often, little attention is given to the nurses who cared for the patients prior to the adverse event. Instead the affected nurses are expected to write statements and incident reports about the adverse event. The aim was to explore the experiences of nurses who cared for patients who successfully committed suicide whilst admitted at a specific general hospital in Gauteng Province, South Africa. A qualitative exploratory research was conducted. Data were collected through in-depth interviews with a purposive sample of six nurses and content analysis was done. Nurses experienced feelings of shock; blame and condemnation; inadequacy and feared reprisal. This study suggests a basis for development of support strategies to assist the nurses to deal with their emotions following experience of adverse events.
The Enhanced Anesthesia Recovery Program (EARP) is a unique patient-centered, Anesthesiologist-led quality improvement initiative designed to reduce postoperative anesthesia-related complications and to accelerate recovery. Anesthesia-related complications are known to be associated with poor patient outcomes and higher morbidity/mortality. This project was designed to develop protocols to improve anesthesia recovery and thereby the quality of patient outcomes. A detailed review of national & international guidelines was carried out and EARP pathways were designed to incorporate changes in perioperative management, as per recent clinical research findings, to improve the patient surgery experience, ensuring better postoperative cognitive function and a reduction in postoperative morbidity. Following project implementation, a remarkable improvement was seen in Anesthesia Related patient care outcomes, benefitting around 6233 patients. The median Length of Stay in PACU was reduced from 26 minutes to 18 minutes. Early Return of Cognitive Functions (Early Recovery) was evident by a reduction in the time for a post-operative return of cognitive functions, from 10 minutes to 3 minutes. The percentage of people requiring oxygen supplementation was reduced from 20% to 5%. The unplanned tracheal re-intubation Rate was reduced from 0.05 to 0.02. The percentage of patients experiencing postoperative nausea and vomiting was reduced from 8% to 3%. This initiative also resulted in about a 50% reduction in spending on anesthetic agents for patients.
Tata Memorial Hospital (TMH) is a Comprehensive Care Centre for Cancer located in Mumbai, India. Patients from all over India and some from neighboring countries choose to travel to Mumbai (Bombay) to receive treatment at our centre. Given the geographical constraints, TMH has adopted Information Technology to reach out to patients in distant communities. TMH has a home-grown Electronic Medical Record System, the contents of which are shared with patients and providers over the hospital- wide Intranet, and globally through our website. TMH has been carrying out paperless and filmless operations since 2013, enabling the real time exchange of information and ensuring a continuum of care. Paper Records preceding this year are scanned, archived and made available as part of the EMR. Prior to Smart Card implementation, it was not uncommon to find patient or their relatives queuing up for services or payments. This had resulted in delays in providing services, and hardship for patients and their relatives. Overcrowding meant staff being stressed with a propensity for mistakes in data entry, resulting in a faulty service. This would compromise patients if unnoticed, or result in a repetition of service it noticed. In addition, hospital management was concerned about lengthy transaction times and deficiency of service. It was in this context that in the year 2011, the Hospital Management took an initiative to integrate Smart Card Technology with the existing Electronic Medical Record (EMR) and Electronic Financial Record (EFR), to improve interaction between patients and the Institution. The strategy was to use Smart Card (SC), containing an embedded IC chip for patient identification, to carry out all transactions involving patient care, in order to minimize transcription errors and enhance patient safety. The implementation of this strategy involved process re-engineering and training of all staff members. The results of the past 4 years 2013-16 have been analyzed to determine the efficacy of this initiative.
In its quest to improve service delivery and reduce congestion, the busy R. K. Khan Hospital Pharmacy has embarked on a unique partnership with community organizations whereby 13 community facilities including community halls, temples and churches, are being used as venues for issuing chronic medicines to patients. Patients receive their initial supply at the hospital and are then referred to a facility mos convenient to them to collect their repeat medicine. They only return to hospital after six months on their review dates. Almost 24000 patients per month are currently utilizing this service. Medicines are pre-dispensed, transported and controlled by pharmacy staff. It has resulted in a win-win situation for both patients and the hospital. Patients benefit by receiving their medicines quickly and conveniently from centres close to their homes instead of queueing for hours at the pharmacy. The hospital benefits since congestion is significantly reduced.
Hong Kong is proud of its population's long life expectancy, but rapid population ageing is one of its greatest challenges. The Hospital Authority (HA) is the largest healthcare organization in Hong Kong. To cope with the challenges, HA has formulated the "Strategic Service Framework for Elderly Patients", emphasizing the development of multidisciplinary integrated elderly services, patients and caregivers; engagement, and enhancing collaboration with community partners. Over the past few years. HA has innovated and re-engineered various service models to provide appropriate care based on the stratified needs of individual elderly patients. We have adopted an integrated case management approach to cater for the multi-faceted needs of high risk elderly, enhanced chronic disease management and improved support for self-care. Information technology has played a significant role in transforming the service model. Evaluation of the new programmers showed encouraging results in reduction of unnecessary hospitalizations, improvements in health outcomes and patient empowerment.
This paper describes Tan Tock Seng Hospital's (TTSH) Journey in delivering value to both staff and patients, anchored on an Engaging Leadership framework. As the healthcare landscape becomes increasingly complex and TTSH continues o strive for organizational excellence, we focused on organizational health in tandem - delivering value to our staff so that they can deliver value to our patients. We built an Engaging Leadership Framework anchored on staff and patient values. Leadership builds both human capital and social capital in people through engagement. Better care begins with better people. People are best engaged and equipped to do their jobs well, learning each day to do their jobs better and innovating to do their jobs differently. The leader's role evolves from a management perspective to a leadership perspective, from control to engagement and from hierarchy to collectively. We envision to build leaders at all levels, through the concept of "Collective Leadership", built on engagement.
Blood products are essential components of effective healthcare management. However, they are expensive and scarce in many developing countries. In South Africa, several factors are likely to escalate this problem in the future. The "Saving Blood, Saving Lives" Project is an innovative healthcare system that promotes the rational utilization of blood products, improved decision-making, accountability, and quality improvement. It requires no budget and no additional staff. Once implemented, it simply takes a few hours a month to run. The inclusion of the innovative "accountability form" has contributed to its success. The project has significantly reduced the unnecessary administration of blood products, expenditure, and improved the efficient delivery of blood products to those patients who need them most. The project has been adopted and successfully replicated in several other South African hospitals, and is ideally suited to the developing world.
In 2012 the Manila Doctors Hospital became the first hospital in the Philippines to launch and commit to a Social Vision. Since then, this Social Vision has served as a guide for good governance and a blueprint for its Corporate Social Responsibility (CSR) programs focusing on health, environment and gender. The goal of the Manila Doctors comprehensive CSR health program is to render the fundamental right to health care available to marginalized patients. Through our CSR programs, more than 20,000 financially challenged patients gain access to quality medical services annually. This directly contributed to the country's health development agenda 2016-2020 of achieving the health related SDG Targets of Financial Risk Protection, Better Health Outcomes and Responsiveness.
According to World Health Organization (WHO)reports, MERS patient of the last five years mostly occurred in Saudi Arabia, but uniquely, over 180 patients appeared in Korea in 2015. The reason is in the nature of the Korean medical, characterized by high medical accessibility. MERS has rapidly expanded to infect large numbers of people in Korea in a short period of time through nosocomial infection. Under the circumstances, Myong Ji Hospital had accepted MERS patients and did not cause any nosocomial infection because the hospital had prepared, trained and formed a response team for emerging infectious diseases, a year before MERS occurred in Korea. However, Myong Ji Hospital has under-estimated the communication problem; inadequate communication during the MERS period caused a lot of confusion among people. Myong Ji Hospital learned two important lessons in responding to emerging infectious diseases; the first was to prepare a form of workforce, facility, manual and drills; the second was to prepare proper communication methods.
This article is about health insurance-related and Third Par!y Administrator services in India. Health Insurance in India is still at an early stage: only about 14% of the entire population has taken out insurance. There is a large chunk of the population without any insurance coverage. Third Party Administrators (TPA's) are intermediary between Insurance companies. Hospitals (Providers) and Insured Parties (Corporate or Individual). Indian Health Insurance is growing at the rate of almost 30% per year. The government of India is launching a lot of schemes to cover the population, especially in rural parts of the country. Current market size is almost Rs 22000 Crores.
BACKGROUND:Hospital bed utilization is influenced by various factors which can be divided into patient, physician and administration related. These factors should be seen from the eyes of healthcare providers so that any improvement initiative taken by the administration is matched with the health worker's perception which ultimately affect the hospital efficiency and quality of care.AIM AND OBJECTIVE:To ascertain the factors influencing hospital bed utilization from the perspective of healthcare providers.METHODS:This cross sectional study was conducted in an apex tertiary care public institution in northern region of India. All the resident doctors and nurses in the 18 wards of 7 specialties and 7 super specialties were interviewed using a structured validated self-administered questionnaire.RESULTS:A total of 279 participants (117 doctors and 162 nurses) were enrolled in the study. The factors significantly influencing bed utilization with regard to doctors are patients (2.34, 0.36), physician (2.47, 0.32), administrative (2.61, 0.29) and with regard to nurses are patient (1.97, 0.40), physician (1.97, 0.46), administrative (2.39, 0.40).CONCLUSION:Changing healthcare trends in the recent past (innovations in policy decisions, technological advances, business sustainability aspect, quality initiatives etc.), gave an insight to policy makers (administrators) to consider the perception of healthcare providers (human resource) regarding bed utilization as an important component of healthcare delivery system.
Patient safety improvements demand a complex system-wide effort, involving a wide range of actions in performance improvement, environmental safety and risk management, including infection control, safe use of medicines, equipment safety, safe clinical practice and safe environment of care. Healthcare accreditation is one of the major steps towards improving quality and patient safety. Amongst the several accrediting agencies across the world, the Joint Commission International, (JCI) stands out as the gold standard in healthcare accreditation. The patient safety journey for hospitals like the Apollo Group, formally started with Apollo Hospitals, Delhi becoming the first JCI accredited Hospital in India, in 2005. In the years to come, eight hospitals of the Group also became JCI accredited; taking the number of hospitals accredited by JCI to twenty-three in the country. The National Accreditation Board for Hospitals and Healthcare providers (NABH) was formed thereafter and today nearly three hundred hospitals are accredited by NABH across the country. There is more to patient safety and healthcare quality beyond just accreditation. With a view to further improve patient safety; Apollo Hospitals have taken several initiatives.
In this article, we describe how we spread safety culture of correct site surgery from Major Operating Theatre to Day Surgery. We discuss how we integrated the High 5s Project Correct Site Surgery protocol into the Day Surgery Operating Theatre (DSOT) workflow and monitored compliance through audit and feedback. We also reflect on how human factors analysis (HFACS) helps in bridging the gaps by providing a tool for recognizing possible causes of non-compliance. Background: The High 5s Project, established by World Health Organization (WHO), in 2007, is an international collaboration carried out in seven countries - Australia, Germany, France, the Netherlands, Singapore, Trinidad & Tobago and the United States of America - and coordinated by the WHO Collaborating Centre on Patient Safety, The Joint Commission. Its mission is to facilitate implementation and evaluation of standardized patient safety solutions within a global learning community, to achieve measurable, significant and sustainable reductions in high-risk patient safety problems.
In this article, we describe our project to initiate an online learning course, using real-world scenarios to help nurses enhance their communication skills with patients so as to improve the patient experience. The philosophy behind our project is 'a complaint is a gift'. We discuss how patient's complaints are incorporated into our curriculum and the use of HEART language to provide patients a better hospital experience. The 'HEART' acronym refers to five attributes which we believe all nurses should embody: Be HUMBLE, be EMPATHETIC, use APPEALING statements, be RESPONSIBLE and TELL the facts when interacting with patients. The communication modules are hosted online as an alternative to classroom teaching, as this offers increased learning flexibility.
Service excellence Training is an important continuing priority in Lorma Medical Center. Its design and contents are modified as needed to respond to patients' comments on the quality of service by Lorma staff. Noted inadequacies in customer satisfaction were bared in the Patient Surveys of Lorma in 2013. Floating of Satisfaction Assessments is done monthly by the Patient Relations Officer and summaries of the same are submitted by the Executive Secretary to the Department Heads concerned for immediate action, monitoring and reporting on improvements made. The premise is that process improvements should be based on data (1).
China's biggest population size is the foremost intriguing factor in the country's wellness tourism opportunity. Preventative medicine and health prevention is one of the most growing healthcare sectors due to state-of-the-art advanced medical diagnostics and technology. However, wellness tourism in China is still in its infancy, it offers massively new opportunities for the outbound wellness tourism industry. Several reports reveal that environmental assets, including fresh air, clean water and natural features, are considered the most important attributes for the development of wellness tourism for the Chinese. Phuket Island is one of the best tourism destinations with a great reputation for environmental leisure and beach activities. Additionally, advanced medical facilities and specialist physicians at hospital providers in Phuket Island provide the opportunity to serve a proven outcome-based preventative medicine and wellness intervention for clients or patients who are seeking wellness tourism and healthy longevity.
