Development of Emergency Medical Services and Investment Planning Project

Transcription

1 Background Development of Emergency Medical Services and Investment Planning Project Terms of Reference for the Development of service-plans and physical standards (including international and local expertise) Reference No. DEMSIPP-A.1-CS-01 The World Bank approved to the Republic of Croatia Loan no HR for the support of Development of Emergency Medical Services and Investment Planning Projects (DEMSIPP) objectives, focused on EMS reform and on capacity building at MoHSW for developing and managing strategic plans, some of which could be financed with EU Funds depending on the results of the accession process. The Project objective is to improve the efficiency and outcomes of the emergency medical services system and to strengthen the capacity of the Ministry of Health and Social Welfare to develop and implement strategic projects. The project includes two components: (i) Development of Emergency Medical Services and (ii) Institutional Support to MoHSW for Strategic Planning. Component 1: Development of Emergency Medical Services This component would finance investments to restructure the emergency medical services in order to improve the geographical distribution of resources, responsiveness, efficiency, and quality of services. It includes four sub-components, each addressing a specific area of Emergency Service provision and monitoring. Namely, these are: (i) establishment of a Croatian Institute for Emergency Medical Services, which will guide EMS policy, set and monitor national guidelines and standards for EMS services in Croatia; (ii) reorganization of pre-hospital EMS, which will support the implementation of the national guidelines at the county level, upgrade pre-hospital EMS human, vehicle and equipment resources, and establish and integrate the EMS dispatch units with the national emergency system; (iii) integration of inhospital EMS, which will support the creation of integrated EMS departments in selected hospitals and upgrade the capacity of selected remote health centers to provide emergency services; and (iv) initiation of an emergency-related telemedicine service delivery network to improve EMS delivery on selected islands and at other remote sites through the use of telemedicine technologies. Component 2: Institutional Support to MoHSW for Strategic Planning The objective of this component is twofold: (i) to complement supply side reforms under component 1 by developing restructuring plans for health care facilities and human resources; and (ii) to strengthen the capacity of the Ministry of Health and Social Welfare to develop and manage projects, some of which could be financed through EU pre-accession and accession funds. The rationale for this component stems from two observations: (i) there are significant investments to be done to improve the efficiency of the health sector that require adequate planning and managerial capacity at the Ministry of Health and Social Welfare; and (ii) the experience in new EU member states shows that preparation of proposals and plans to make use

2 of EU structural funds should begin as early as possible. This component includes three subcomponents: (i) (ii) (iii) developing priority programs as a basis for planning the key elements of a health investment strategy. These elements would be used for advocating for the EU or other sources of funds to invest in health in such a way as to achieve a more efficient and effective health system. The elements to be supported by the Project would be focused on but not limited to the development of a health facilities masterplan, a health human resources strategy, and specific projects to harness information communication technology (ICT) to better manage the health system and deliver health services; capacity building for accessing EU funds, which would support the development of the necessary human resources and institutional capacity for accessing EU funds; project management support for successful execution of the DEMSIPP. Objectives of the consultancy The overall objective is to assist the Croatian Institute for Emergency Medical Services (CIEMS) in setting the objectives and standards for emergency medical services provision (in both prehospital EMS and integrated emergency admission departments in selected hospitals and health centres). The consultant team has to elaborate a detailed plan proposal for the development of EMS provision (for both pre-hospital EMS and in-hospital emergency admission) across the territory of the Republic of Croatia, according to the set timeframe. Concurrently, taking into account international experience and local circumstances as well as the current EMS organisation and funding in Croatia, the consultant team has to define clear standards for the provision of these services as well as for the human resources, infrastructure, vehicles and equipment needed to attain the adopted standards. And finally, the consultant team has to suggest the optimal ways of integrating all currently available emergency medical services as well as land, air and water transportation into a single Croatian EMS system. This system must also be able to ensure adequate cooperation with similar systems in other European countries, especially those in our region. Furthermore, EMS provision must be in line with the standards of relevant international bodies and a model of integrated service provision which is best suited for Croatia needs to be proposed. This model will include not only the emergency medical services, but also all other bodies and institutions providing EMS-related services, including transportation. The standards to be adopted should reflect national needs and procedures, but at the same time take into account the best international procedures, including EU standards. Available parameters will need to be used to assess the financial, but also human resources and infrastructure-related implications resulting from the implementation of these standards. Scope of Work Special tasks stemming from the consultancy objectives are specified in the following table: Tasks Conduct a situation Conduct: Activities 2

3 analysis of EMS standards currently used in Croatia Prepare an overview of internationally recognised approches to EMS development Prepare an overview of the desired level of EMS for Croatia 1. an individual analysis of the existing emergency medicine services for each Croatian region 2. an analysis of the current physical, human and technical resources in the provision of (pre-hospital and in-hospital) services in Croatia, focusing particularly on the participation of health centres and primary care physicians in the pre-hospital EMS and on the participation of specific hospital departments in hospital emergency admission 3. an analysis of the emergency medical services currently forseen in case of mass accidents and disasters, focusing particularly on some of the potential accidents and disasters (fires, explosions, terrorist attacks, floods, sea accidents, plane accidents, industrial accidents, etc.) 4. an analysis of the current pre-hospital EMS transportation system (land, water, sea) for each of the Croatian regions 5. an analysis of the current dispatch system and of the management of EMS processes (for all regions, for both pre-hospital and in-hospital services) 6. an analysis of the current legal framework for the EMS provision in the Republic of Croatia 7. an analysis of the existing ways of funding EMS in the Republic of Croatia Prepare: 1. an overview of organisation structures for (pre-hospital and in-hospital) EMS provision in several EU member states 2. an overview of different types of legislative arrangements for the EMS system in at least three countries including those that having similar traditional organisational arrangements for the health care system 3. an overview of different models of financing the EMS system in the EU member states (at least three) including those countries having similar traditional organisational arrangements for the health care system 4. an overview of different models of ICT and telemedicine system development (as support to the EMS system) in the EU member states 5. an overview of different models of transportation system development in EU member states (at least three), focusing particularly on the countries having a similar territorial and infrastructure distribution 6. an overview of models of other state and public institutions and associations' participation in EMS provision (ICRC, The Croatian Mountain Rescue Service, 112 service, The Croatian Automobile Club, etc.) Elaborate: 1. a proposal of the best suited model of (pre-hospital and in-hospital) EMS organisational structure for Croatia, taking into account regional specificities and the need to have an integrated system 2. a proposal of the desired level of physical, human and technical resources (technical resources in terms of equipment) in the pre-hospital 3

4 and in-hospital services system in the Republic of Croatia ensuring a full independence of the EMS system from the primary care system (general/family medicine, paediatrics and gynaecology) 3. a proposal of the desired level of standards in EMS provision in case of mass accidents and disasters, focusing particularly on some of the potential accidents and disasters (fires, explosions, terrorist attacks, floods, sea accidents, plane accidents, industrial accidents,etc.) 4. a proposal of the optimal organisation of the (land, water, air) transportation system for pre-hospital EMS for each of the Croatian regions 5. a proposal of the optimal dispatch system and of the management of EMS processes (for all regions, for both pre-hospital and in-hospital service) 6. a proposal of the optimal quality control system for the EMS system Prepare an overview of expected costs and timeframe for the implementation of selected EMS standards in the Republic of Croatia Elaborate: 1. a plan proposal for the introduction of the new model of pre-hospital and in-hospital EMS in Croatia, bearing in mind regional specificities as well specificities pertaining to the way the system is financed in the Republic of Croatia 2. a plan proposal for attaining the desired level of physical, human and technical resources in pre-hospital and in-hospital services system in the Republic of Croatia for all regions 3. a plan proposal for attaining the desired level of EMS provision standards in case of mass accidents and disasters, focusing particularly on some of the potential accidents and disasters (fires, explosions, terrorist attacks, floods, sea accidents, plane accidents, industrial accidents, etc.) 4. a plan proposal for attaining the optimal organisation of the (land, water, air) transportation system for pre-hospital EMS for each of the Croatian regions 5. a plan proposal for urgent implementation of the optimal dispatch system and of the management of EMS processes (for all regions, for both pre-hospital and in-hospital service) 6. a detailed cost estimate of the implementation of the aforementioned plans 7. a detailed overview of legislative activities and the timeframe for the adoption of certain legislative texts which would allow for a timely and full implementation of all plans 8. an overview of all of the bodies responsible for specific activities in each of the stages of moving from the current to the desired EMS system for all regions of the Republic of Croatia 9. an overview and a detailed calendar of the activities to be taken on gradually by the Croatian Institute for Emergency Medical Services so that it could assume all of its responsibilities and tasks stipulated by the law as soon as possible 4

5 Timeframe and scope of work This assignment is expected to require twenty (20) weeks of work of the consultant team (the international consultant team and two local consultants), covering a period of four months between January 2010 and April During this timeframe, estimated 20 weeks of work include 12 weeks of international expertise and 8 weeks of local expertise). The expected outputs include the prepared analyses, guidelines/service development plans as well as the system of their adoption in line with the tasks/activities specified in the above table. A detailed work plan for the consultant team will be presented within tree (3) weeks after signing the contract. The total effective time of work will be spread within the abovementioned timeframe. Deliverables and required reports The consultant team will prepare the following reports in Croatian and English: 1. A short inception report confirming the expected deadlines and outputs for each task and specifying any issues that should be brought to the Management's attention in order for the consultants to be able to complete their assignment. Deadline: tree (3) weeks after signing the contract 2. A detailed report on the analysis of the EMS standards currently used in Croatia, in line with the task described in the table. Deadline: six (6) weeks after the adoption of the inception report. 3. A report containing an overview of the internationally recognised approaches to EMS development, in line with the tasks described in the table. Deadline: tree (3) weeks after the adoption of the report under item A report containing an overview of the desired level of emergency medical services for Croatia, in line with the tasks specified in the table. Deadline: four (4) weeks after the adoption of the report under item A report containing an overview of the expectes costs and timeframe for the implementation of the selected EMS standards in the Republic of Croatia. Deadline: tree (3) weeks after the adoption of the report 6. A comprehensive final report encompassing the reports mentioned under items 1. to 5. within twenty (20) weeks after the adoption of the inception report. While preparing this final report, the consultant team has to submit an executive summary of the final report, stressing the key results of the report and summarizing the main recommendations for implementation. 5

6 The consultant team needs to submit all deliverables (reports) in the electronic version, but also in 2 hardcopies. All the data provided to the consultant team by the client in the course of their work as well as all the information provided by the consultant team should be regarded as client's business secret. The documents and reports prepared and submitted by the consultant team as direct outputs of this contract are exclusively owned by the client and none of the consultant team members are allowed to use them without an explicit written authorisation of the client. Institutional arrangements In the implementation of the Terms of Reference the consultants will work under the supervision of the Working Group for Emergency Medical Services of the MoHSW which is directly involved in the Development of Emergency Medical Services and Investment Planning Project- DEMSIPP (Component 1) headed by the Component 1 Working Group Leader and the Project Leader. Qualification requirements The organization contracted will have: Experience in health sector reform, preferably in the area of EMS services; Prior experience in working with two or more transition countries in the area of health reform, preferably in EU accession countries; Preferably have experience in working with a EU member state in the area of health reform; and Demonstrated experience in at least 3 assignments of similar size and scope in the last 3 years. The team would have one or more individuals with the following credentials: Systematic formal education in medicine, economics, administration or similar fields and at least five (5) years of experience of working in the area of emergency medical services organisation and management. The team leader needs to have at least ten (10) years of similar work experience; Experience of working and collaborating with the stakeholders in defining emergency medical services organisation and standards; Experience and good practical understanding of EMS standards, as well as the organisation and management of pre-hospital and in-hospital EMS, especially in the EU and North America; Experience from countries having a similar health care system as Croatia, the experience from East European countries is an advantage; Consultant's understanding of the Croatian health care system and reform objectives is an advantage; Well developed oral and written communication skills and text processing skills as well as organisation and presentation skills; Ability to work in a team and experience from similar projects is an advantage; Good command of the English language in oral and written communication, with the ability to present one's results in a clear and succint manner is a must. 6

7 The team would also have one or more individuals with the following credentials: Good understanding of the pre-hospital and in-hospital EMS system as well as the health care and health insurance system in Croatia in terms of the related legislation and funding as well as in terms of the way the system really functions in practice. Good understanding of the pre-hospital and in-hospital (integrated emergency admission departments) EMS system in the Republic of Croatia, of educational and training programmes for physicians and medical nurses and of the way these are locally delivered. Experience in the development of guidelines/protocols/algorhytms in this area of medicine. Fluent in Croatian and English. Able to present their results in a clear and succint manner. The designated Project Team Leader must have previous leadership experience in an assignment of similar size and scope which have included team members with international as well as local expertise. Conditions provided by the Contracting Authority 1. Responsible body The consultants will work under the supervision of the Working Group for Emergency Medical Services of the MoHSW which is directly involved in the Development of Emergency Medical Services and Investment Planning Project- DEMSIPP (Component 1) headed by the Component 1 Working Group Leader and the Project Leader. The Contracting Authority is obligated to provide all relevant documents to consultants (laws, regulations, reports and studies prepared in the framework of other projects), enable access to the necessary data (in all of the institutions and at all levels responsible for record keeping) and ensure regular comminication with all system stakeholders who can assist the consultant team in completing their contracted assignment. The Contracting Authority is obligated to facilitate access to reports and data from relevant studies conducted for the Croatian government. Meetings with relevant institutions and individuals will be organised. Visits to key areas specified in plans will be facilitated. 2. Work premises Given the duration of the assignment and limited availability of office space and adequate office equipment at the Ministry of Health and Social Welfare, the consultants are expected to arrange their office premises by themselves or work from their hotel rooms when they are not at meetings. Computers, Internet connection and office materials are to be taken care of by the consultant. 7