Institutionalizing Quality in Health Care of Khyber Pakhtunkhwa: A Process of Sustaining Change Dr. Nadeem Ahmed, Dr. Shahid Yunis

Transcription

1 Institutionalizing Quality in Health Care of Khyber Pakhtunkhwa: A Process of Sustaining Change Dr. Nadeem Ahmed, Dr. Shahid Yunis 1

2 Background Increasingly complex health system and health care delivery Institutionalization of quality in the health system (HS) of Khyber Pakhtunkhwa (KP) is inevitable A Strategic Framework (SF) consisting of eight essential elements affecting HS at macro and micro level developed This SF provides a road map to create the capacity to plan, build, sustain efforts for institutionalization of quality in health system of KP Conceptual Framework for Institutionalization of QM 2

3 The Enabling Environment An environment conducive to initiating, expanding, and sustaining quality management comprising of: (a) policies that support, guide, and reinforce QM; (b) leadership that sets priorities, promotes learning, and cares about its staff; (c) core organizational values that emphasize respect, quality, and continued improvement; and (d) adequate resources allocated for the implementation of QM activities. The Enabling Environment Quality Policy defining the quality mandate Quality Strategy for setting up the provincial goals and priorities Steering & Stewardship encompassing regulation, definition and modification of roles and responsibilities, and articulation of values e.g. HSRU, HRA, IQHCS Leadership - having a vision and the ability to generate commitment to that vision - is the key to institutionalizing QM in a health system/organization at both the policy and operational levels Resources: Both allocation as well as how the organizational leaders make use of these resources 3

4 Organizing for Quality A clear delineation of roles, responsibilities, and accountability for QM in the organization, including oversight, coordination, and implementation of QM activities. e.g. Strengthening of Health Sector Reform unit Strengthening of Health Regulatory Authority Setting up of the minimum or mandatory standards and accreditation standards for health care facilities to operate in the market in consultation with all important stakeholders Quality Collaborative Forum to guide and coordinate QM activities at the provincial level Review the existing legislation, identify gaps, and coming up with a legal framework which would allow better regulation of healthcare sector. Development of a mechanism to link the financing of public health care facilities with their quality Working with Pakistan National Accreditation Council (PNAC) in adapting voluntary quality standards for the accreditation. Support Functions Several essential elements are needed to support sustained implementation of QM and improved quality of care. Three critical support functions are: (a) capacity building in QM (b) information and communication (c) rewarding and recognizing individual and team efforts 4

5 Support Functions Capacity building by ensuring knowledge and skill development in the technical implementation (standards development, process improvement, etc.) and management (leadership, planning, monitoring, etc.) of QM activities. Investment in information systems and M& E system that measure quality improvements. Recognizing and rewarding quality are one of the two most effective ways to motivate health staff and managers to continue and persevere in their efforts to meet client needs in the most effective and efficient manner in KP health system. IQHCS - Sponsored by Health Department, Government of Khyber Pakhtunkhwa - Financing Health Department ADP - Duration & Allocation 03 years ( ) Rs million - Goal To improve the quality of health care services in Khyber Pakhtunkhwa and to make health system more safe, competent, responsive and effective 5

6 Basic Approach of the Project Facilitated implementation of operational quality standards as the basis for organizing and functioning of these services that lead to predictable results at the point of service delivery Improving capacities for implementation of quality of care initiative would be structured encounter with IQHCS Coordinators to train, prepare, strengthen and reinforce the standard implementation initiative. Tied grants to health facilities for quality improvement projects/proposals Primary Care Management Committee to enable clients and communities to participate in contributing and collaborating in the quality of healthcare. Creating a critical mass of early adopters of the initiative that serve a model for potential new adopters Recognizing achievements through reward and recognition to enhance motivation 6

7 Implementation Plan Phase 1: Phase 2: Phase 3: 1st Year 2nd Year 3rd Year 08 Districts 10 Districts 06 Districts Selected Districts Phase 1 1. Peshawar 2. Charsada 3. Nowshera 4. Mardan 5. Kohat 6. Abbottabad 7. Swat 8. Haripur (10 facilities per district: Total 80 facilities) The probability that we may fail in the struggle ought not to deter us from the support of a cause we believe to be just. Abraham Lincoln 7

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