BEST PRACTICES IN HEALTHCARE SERVICE DELIVERY FETHI AS
BEST PRACTICES IN HEALTHCARE SERVICE DELIVERY: FETHI AS A CASE STUDY PRESENTATION BY DR JIMOH AK SERVICOM NODAL OFFICER, FEDERAL TEACHING HOSPITAL, IDO-EKITI, EKITI STATE
INTRODUCTION � People-centred and integrated health services are critical for reaching universal health coverage. � Universal health coverage is defined as ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user to financial hardship.
INTRODUCTION � � � People-centred care is care focused and organized around the health needs and expectations of people and communities, rather than on diseases Patient-centred care focuses on individual seeking care (the patient). People-centred care encompasses individual care and also includes attention to the health of people in their communities and their crucial role in shaping health policy and health services
INTRODUCTION � Integrated health services encompasses the management and delivery of quality and safe health services so that people receive a continuum of health promotion, disease prevention, diagnosis, treatment, diseasemanagement, rehabilitation and palliative care services, through the different levels and sites of care within the health system, and according to their needs throughout the life course.
HEALTH SYSTEM � � � A health system/health care system/healthcare system, is the organization of people, institutions, and resources that deliver healthcare services to meet the health needs of target populations Modern health care systems have many interrelated components. Most healthcare interactions involve � Consumers who seek healthcare, � Professionals � Facilitating who provide the care organizations who provide administrative, regulatory and financing functions to support or control these healthcare encounters
HEALTH SYSTEM � All sustainable and effective healthcare systems work to balance 3 goals: � 1) Appropriate access to necessary healthcare services � 2) Assurance of quality workforce, services and institutions � 3) Acceptable cost to society
Challenges Facing the Delivery of Health Services � Health systems � raises and channel resources � create and manage the service delivery mechanisms � bring effective health-improving technologies to the people � Service delivery is a critical link in this chain—the locus at which money and technology are transformed into health-improving interventions � However, the funds and technologies that are available are often not being used effectively
Challenges Facing the Delivery of Health Services � Fully equip health facilities with shockingly few patients � Communities with low levels of coverage in life-saving services even where capacity exists to provide that coverage � Trained workers missing from their assigned posts: a study in six countries of the presence of health workers in their assigned posts found that 35 percent of workers were absent at the time of an unannounced visit during official working hours � Empty shelves for drugs and supplies when workers have been paid and supplies purchased
Challenges Facing the Delivery of Health Services � Clearly, having money and technology are not sufficient conditions for impact � Even with more money and better technologies, a major challenge remains: improving the delivery of health services
SERVICOM and the Health Sector � � � Total Quality Management (TQM) concept refers to a systematic attempt to achieve continuous improvement in the quality of an organisation’s products and/or services Quality management has become an important issue in healthcare organizations (hospitals) The increased attention to quality is due to governmental regulations, influence of customers, and hospital management initiatives The role of government as the main provider of healthcare (HC) services has changed. SERVICOM initiative appears to be built around TQM.
SERVICOM and the Health Sector � Objectives of SERVICOM in the health sector � Delivery of quality health service that is accessible, equitable and affordable through inpatient, outpatients and community service � Training of qualified health professionals as appropriate to sustained the needed workforce in the health sector � Conducting of quality research activities that uplift the standard of living of our citizens
SERVICOM and the Health Sector � The SERVICOM charter serves to enlighten numerous clients about � The nature of services rendered by the hospital � The quality of such services � The obligations to them for the quality service delivery � How they can make their complaints in event of service failure and be sure to get their complaint properly addressed and solved.
IMPROVING HEALTHCARE SERVICE DELIVERY IN FEDERAL TEACHING HOSPITAL, IDO-EKITI (FETHI), EKITI STATE INPUT ACTIVITIES OUTPUT
SERVICOM UNIT IN FETHI � � First created in 2007 under the office of then Medical Director Present Unit inaugurated in 2017 � SERVICOM Committee/Officers SERVICOM data officers � SERVICOM Departmental Officers Office located at Room 20, Administrative Building, FETHI � � Medical Doctor (Consultant) Pharmacist (Chief Pharmacist) Office, Room 20, Physiotherapist (Principal Physiotherapist) SERVICOM Administrative Building FETHI Nursing officer (Assistant Director Nursing) Administrative officer (Chief Administrative Officer) Engineer (Senior Engineer) Social Welfare (Senior Administrative Officer)
SERVICOM ACTIVITIES IN FETHI � � � SERVICOM Hospital Round � Impromptu visit to service points/windows, clinics, wards, departments, various receptions etc � Collect information on staff duty roster and daily attendance/time-book register � Collect information on challenges facing quality service delivery � Encouraging supervisors, heads of department/unit to reveal to us what they fear to tell the management directly � Interact with patients/clients on quality of service, their grievances, and other issues Immediate response to Grievances and complaints either from phone calls, verbal notification or direct observations Implementation of various government circulars or directive e. g. Executive orders, patient’s bill of right SERVICOM Committee/unit meeting on a monthly basis, SERVICOM Reports � Detailing our observations for each Hospital Round; directly send to the CMD � Monthly reports on our activities
SERVICOM ACTIVITIES IN FETHI
Improving Healthcare Service Delivery in Federal Teaching Hospital, Ido-Ekiti (FETHI), Ekiti State � Background History: � Located at Ido-Ekiti in Ido/Osi LGA of Ekiti State � Established as general hospital in then old Western Region in 1954 � Renamed Federal Medical Centre in 1999 by the Federal Government � Residency Training Programme in eight departments � Accredited School of Nursing Programme � Full bed capacity of two hundred and ninety � Upgraded to Federal Teaching Hospital in 2014 after an MOU signed between Afe Babalola University, Ado-Ekiti and the FGN to serve as training hospital for the medical students and other allied health professional students
REPOSITIONING OF FETHI BY PROF AJAYI LED MANAGEMENT TEAM
COMMUNICATION BETWEEN FETHI MANAGEMENT AND STAFF ØESTABLISHMENT OF COMMON USER GROUP (CUG) MOBILE PHONE ØESTABLISHMENT OF FETHI REBRANDED TELEGRAM GROUP ØREGULAR MEETINGS WITH VARIOUS UNION EXECUTIVES ØOPEN FORUM MEETINGS ØMONTHLY MORNING PRAYER SESSION IN THE CONFERENCE HALL
REPOSITIONING OF FETHI BY PROF AJAYI LED MANAGEMENT TEAM � Aimed at improvement of service delivery in FETHI in line with the federal government objectives for the health sector through: � Physical infrastructure � Equipments � Making health services available directly to the people in the communities � Health Professional and their capacity development
PHYSICAL INFRASTRUCTURES
TUNDE ALADESANMI THEATER COMPLEX
NEWLY RECONSTRUCTED THEATER EXTERIOR Four separate entrances to theater instead of just one in the past New Offices for Theater Personnel • Pharmacy unit • Pay point window • Patients relative arena Patient’s relative toilet New Theater Corridor
NEWLY RECONSTRUCTED THEATER INTERIOR Nurses station, Entrance for patients and Endoscopy room Entrance corridor for Perioperative Nurses in customized theater gown theater personnel Exit corridor for waste Scrub station with infrared sensor water tap and pedal control water tap
NEWLY RECONSTRUCTED THEATER INTERIOR Operating theater suite 1 with connecting camera to the seminar room Operating theater suite 2 Four Bedded Recovery Room
NEWLY RECONSTRUCTED THEATER INTERIOR Mini-conference room with seating capacity of about 20 with monitor linked to theater suite 1
Redesigning of the Male Medical and Surgical wards
RECONSTRUCTED LABOUR WARD IN MATERNITY COMPLEX • THREE MOTORIZED DELIVERY BEDS • CARDIOTOCOGRAPHY MACHINE • HANDHELD DOPPLER MACHINE • WITH THE NEW LABOUR ROOM AND EQUIPMENT, OUR PATIENTS NOW ENJOY A BETTER DELIVERY EXPERIENCE • AWARDED THE NEATEST PROCEDURE AREA • DELIVERY RATE INCREASED ABOVE 300
PEADIATRIC DEPARTMENT
NEW BUILDINGS COMPLETED PHYSIOTHERAPY DEPARTMENT NEW ACCIDENT AND EMERGENCY UNDER CONSTRUCTION
PATIENT’S RELATIVE PAVILLION AND PATIENT’S SEATS AT VARIOUS OUTPATIENT CLINICS
NEW CAFETERIA FOR BOTH STAFF AND PATIENTS WITH A SEATING CAPACITY FOR 30 PEOPLE
NEW EQUIPMENTS
NEW OPHTHALMOLOGY EQUIPMENTS AUTOREFRACTION MACHINE TRIAL LENS SET Efficiency has improved, Result more precise, Increase patients load
NEW DENTAL LABORATORY
NEW LABORATORY EQUIPMENTS • Turn around time has reduced significantly • Quality of service and value added unquantifiable • Increased IGR
COMMUNITY OUTREACH PROGRAMME
OUTREACH PROGRAMME � � Twice weekly visit of health personnel to communities in the sixteen local government area of the state on rotational basis; with extension to some communities in Kwara State Examples of services during visitation � Immunizations � Environmental health and sanitation � Collection of health statistics and records � Health education � Clinics for health care and prevention � Referral opportunity � Information on services available in FETHI
COMMUNITY OUTREACH PROGRAMME
COMMUNITY OUTREACH PROGRAMME IGOGO-EKITI
HUMAN CAPACITY DEVELOPMENT
HUMAN CAPACITY DEVELOPMENT � � � Successful reaccreditation of various residency training programme and nursing programme. In house workshop and seminar on discipline, customer/staff relationship, professionalism, attitudinal change, health and safety, and work ethics both for Junior and Senior staff Sponsorship of staff to ASCON, IHSAN, CMD, SERVICOM Institute to acquire more professional skills Study leave for both academic and professional development Improving seminar rooms in the hospital for better training of all personnel and medical student
THREE-DAY SEMINAR BY SERVICOM FETHI FOR TMC, SMC AND MAC MEMBERS
TRAINING OF CLINICAL INFORMATION DESK OFFICERS
CAPACITY TRAINING ON HEALTH AND SAFETY
IN-HOUSE CAPACITY TRAINING ON WORK ETHICS AND ATTITUDE
THE OUTCOMES
ADMISSIONS 4500 4000 3500 3000 2500 2000 1500 1000 500 0 2016 2017 2018 Source: Health Information Management Department, FETHI. 2019
DISCHARGES 4500 4000 3500 3000 2500 2000 1500 1000 500 0 2016 2017 2018 Source: Health Information Management Department, FETHI. 2019
LABORATORY INVESTIGATIONS 140000 120000 100000 80000 60000 40000 20000 0 2016 2017 2018 Source: Health Information Management Department, FETHI. 2019
SURGICAL OPERATIONS 1200 1000 800 600 400 200 0 2016 2017 2018 Source: Health Information Management Department, FETHI. 2019
OUTPATIENT CLINICS 30000 25000 2016 2017 15000 2018 2019 10000 5000 0 GOPD CHOP NHIS MOPD Source: Health Information Management Department, FETHI. SOPD
RADIOLOGY (XRAY) 6000 5000 4000 3000 2000 1000 0 2016 2017 2018 Source: Health Information Management Department, FETHI. 2019
ULTRASOUND SCAN 4000 3500 3000 2500 2000 1500 1000 500 0 2016 2017 2018 Source: Health Information Management Department, FETHI. 2019
DELIVERIES 450 400 350 300 250 200 150 100 50 0 2016 2017 2018 Source: Health Information Management Department, FETHI. 2019
INTERNALLY GENERATED REVENUE 40000000 IGR EXCLUDING SCHOOLS 35000000 30000000 25000000 20000000 15000000 10000000 5000000 0 Jan Feb Mar Apr May Jun 2017 2018 Jul Aug Sep Oct Nov Dec 2019 Source: Office of the Chief Medical Director, FETHI
QUOTABLE QUOTES � "Without SERVICOM, we probably would not have been where we are today in Federal Teaching Hospital, Ido. Ekiti (FETHI) in terms of improved service delivery. The activities of the unit under the able leadership of Dr Kayode Jimoh have been driving us in terms of quality services, ” CMD, FETHI, Prof. Adekunle Ajayi � “We are happier, our patients are happier and comfortable, better services with improved turnaround time. We can now talk at conferences when our contemporaries are talking” HOU, Optometry, Ophthalmology, Department, FETHI � “Quality of service and value added are unquantifiable” HOD Haematology Department, FETHI
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