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Policy and Guidelines for
National Hospitals
– 1st
Discussion Document
Consensus Building Workshop
19th - 20th October 200...
19th Oct 20092 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Workshop Objective
Discuss...
19th Oct 20093 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Workshop Outcome
 Definiti...
19th Oct 20094 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Challenges of Hospital Sect...
19th Oct 20095 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Need for Tertiary Care and ...
19th Oct 20096 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Definition and Role
I. Be C...
19th Oct 20097 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Autonomy
 Legal framework ...
19th Oct 20098 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Recommending Guidelines for...
19th Oct 20099 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Guidelines and Minimum Requ...
19th Oct 200910 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Guidelines and Minimum Req...
19th Oct 200911 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Guidelines and Minimum Req...
19th Oct 200912 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
ToR for National Hospitals...
19th Oct 200913 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Recommended Hospitals
 Ge...
19th Oct 200914 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Recommended Hospitals
 Ho...
19th Oct 200915 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Guidelines for the Establi...
19th Oct 200916 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Guidelines for the Establi...
Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
THANK YOU!
19th Oct 200918 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy
Progress Milestones
 June...
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Afghanistan National Hospitals Policy_Workshop_19 Oct 09

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  • Dear Desmukh, as we cooperate with hospitals in Kabul this is a valuable insight into hospital development policy. Could you, please, send your ppt-slides to albrecht.kasper@albertinen.de? with regards - Albrecht Kasper
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  • Dear Desmukh, could you please send these slides to email address?

    Thank you
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Transcript of "Afghanistan National Hospitals Policy_Workshop_19 Oct 09"

  1. 1. Policy and Guidelines for National Hospitals – 1st Discussion Document Consensus Building Workshop 19th - 20th October 2009 - Dr. Michael Niechzial and Dr. Amol Deshmukh Support to Institutional Development Project Islamic Republic of Afghanistan, MOPH / EU
  2. 2. 19th Oct 20092 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Workshop Objective Discuss, debate and recommend content Resulting in ‘Policy on National Hospitals’ ‘Strategic and Operational Plan for National Hospitals’ ‘Minimum Requirements for National Hospitals’
  3. 3. 19th Oct 20093 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Workshop Outcome  Definition and Role  Policy  Guidelines for Strategic and Operational plans  Guidelines for Minimum Requirements  Recommend Hospitals - prioritisation and phasing if required  Establishing ‘National Hospitals Responsibility Team’and their ToR / Work Plan
  4. 4. 19th Oct 20094 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Challenges of Hospital Sector in Afghanistan  General Hospital Sector  Resource variation, utilisation, dependence and role of donors  Medical Supplies  Management – General, Financial and HR  Nursing  Potential National Hospitals / Tertiary Care Sector  Unorganised sector and unequal access for patients  Trained Human Resources  Quality of Care  Others  Categorisation of Kabul Hospitals  Bed requirement in Kabul
  5. 5. 19th Oct 20095 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Need for Tertiary Care and National Hospitals  Balance between primary, secondary and tertiary  Requirement as per HNSS: Strategy 2.1  Emergency Medical Services  Resource optimisation  Training healthcare professionals
  6. 6. 19th Oct 20096 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Definition and Role I. Be Centres of Excellence in the respective speciality/specialities II. Provide Evidence Based Medicine and guide other hospitals III. Capacity building of healthcare professionals IV. Support MOPH in National Health Programs V. Establish International linkages for academic and clinical excellence
  7. 7. 19th Oct 20097 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Autonomy  Legal framework to establish independent hospital entity e.g. trust  Establishment of Hospital Boards  Memorandum of Understandings with reputed international hospitals or hospital groups for supporting the National Hospitals  Establishing organisation for centrally directing and monitoring the professional training courses  Study the process of transfer of human resources from the Government rolls to the autonomous bodies.  Study and recommend accounting and finance systems to be adopted and implemented by autonomus bodies/hospitals  Option of MOPH establishing a autonomy unit and task force to mange the whole process.
  8. 8. 19th Oct 20098 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Recommending Guidelines for developing Min. Standards  To be developed speciality wise  To include essential requirements for each speciality  In line with the guidelines which are of high priority  Proposed general structure:  Emergency Medical Services and Ambulance  Staffing and Staff Performance  Financial Performance Requirements  Audits - Internal and External Financial  Infrastructure Requirements • PG Training centre • Bed Strength  Equipment Requirements (Speciality wise)  Drugs and consumables  Quality of care  Professional Education and Training requirements
  9. 9. 19th Oct 20099 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Guidelines and Minimum Requirement (Standards) No. Guidelines Prioritisation Component I: Licensing, Registration and Accreditation 1. Licensing, Registration and Accreditation of National Hospitals High Component II: Governance and Hospital Management 2 Governance and Autonomy to National Hospitals High 3 Annual Hospital Plans and conformity to the plan Low 4 Effective and efficient utilisation of resources like staff, budgets, beds and equipments 5 Cross utilisation of services between hospitals Medium 6 Donors supporting National Hospitals High 7 Involvement of communities Low 8 Availability of essential supplies and medicines High 9 Essential committees to be functional in Hospitals High 10 Selection of Medical Director, Nursing Director & Director admin High 11 Qualifications required and selection of Medical, Nursing and Administration Directors High
  10. 10. 19th Oct 200910 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Guidelines and Minimum Requirement (Standards) No. Guidelines Prioritisation Component III: Professional Training and Education 12 Professional Training & Education for Medical, Nursing, Technicians & Management Staff High Component IV: HR Management 13 Minimum Requirements for Hospital Management Staff Medium 14 Minimum staffing requirements Medium 15 Planning annual hospital HR plan and conformity to the plan Medium Component V: Financial Management 16 Financial management of National Hospitals High 17 Regulatory framework for financing, revenue generation and expenditure High 18 Cash management, accounting standards, & financial audits Medium 19 Developing budgets & conformity to planned budgets Medium
  11. 11. 19th Oct 200911 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Guidelines and Minimum Requirement (Standards) No. Guidelines Prioritisation Component VI: Quality of Clinical and Support Services 20 Essential patient safety norms High 21 Infection Control & environmental hygiene High 22 Clinical guidelines & protocols Medium 23 Diagnostic Services High 24 Nursing Administration & Management; provision of uniform Nursing care; and Nursing care SOPs’ High 25 Medical Record & HMIS Medium 26 Essential Equipments, Supplies, and Drugs & Consumables High Component VII: Integration into referral system 27 Integration of National Hospitals into a national / regional referral system Medium
  12. 12. 19th Oct 200912 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy ToR for National Hospitals Responsibility Team  Study recommended National Hospitals  Study on Autonomy  Develop drafts for submission  ‘Policy for National Hospitals’  ‘Strategic and Operational Plan for National Hospitals’  ‘Minimum Requirements for National Hospitals’  Other work as required
  13. 13. 19th Oct 200913 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Recommended Hospitals  General National Hospitals Eastern Region / Kabul: Jumhoriat Hospital Western Region / Herat: Northern Region / Mazar-e-Sharif: Southern Region / Kandahar: Mirwais Hospital Central Region / Chagcharan: ?(Provincial Hospital)  Specialised National Hospitals For Emergency Health Services: Ibn Sina Emergency Hospital For Trauma & Orthopaedics: Wazir Akbar Khan Hospital For Paediatrics: Indira Gandhi Institute of Child Health For Obstetrics & Gynaecology: Malalai Hospital For Ophthalmology: NOOR Eye Hospital For Pulmonology and Cardiac Sciences: Ibn-Sina Chest Hospital For Psychiatry: Mental Hospital For Dentistry and Maxillofacial Surgery: Stomatology Hospital For Burns and Plastic Surgery: Esteqlal Hospital For Infectious Diseases: Antoni Hospital
  14. 14. 19th Oct 200914 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Recommended Hospitals  Hospitals suggested for status of secondary level care (EPHS): Ataturk Hospital Ehayi Mo Jadad Hospital Kair Khana Hospital Rabia Balkhi Hospital The above shortlisted hospitals should further undergo prioritisation and phasing in view of sound allocation of resources in phased manner to develop the National Hospitals.
  15. 15. 19th Oct 200915 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Guidelines for the Establishment and Operation of National Hospitals  The National Hospitals of Afghanistan will provide tertiary care services as part of the comprehensive referral network of the health system.  The role of National Hospitals, as part of a unified national health system, will be:  To develop as Centres of Excellence in the respective specialities  To provide Evidence Based Medicine and guide other hospitals  To provide professional training for healthcare professionals  To support MOPH in National Health Programs  To establish international linkages for academic and clinical excellence  The National Hospitals must be rationally distributed so their services are accessible on an equitable basis for the entire population. The National Hospitals should collectively provide services in all specialities as per the disease prevalence and load.  The MOPH will carry out a detailed analysis and recommend Hospitals in Kabul, Regional Hospitals, and others for conferring status of National Hospital. The recommendation should include the resource planning for the hospitals including its recommendation on granting autonomy. The Draft Policy Statement
  16. 16. 19th Oct 200916 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Guidelines for the Establishment and Operation of National Hospitals  Emergency medical services for life threatening diseases should be provided as per need. The MOPH will recommend services which will be subsidised (completely or partially) by the government and those which will be paid for by the patients.  The MOPH will develop licensing and registration requirements for National Hospitals which will include minimum requirements (standards). Private hospitals and hospitals not under the MOPH can also be conferred the National Hospital status provided they satisfy the licensing and registration requirements.  The National Hospitals must undergo national accreditation within one year and international hospital within three years of acquiring National Hospital status. The accreditation standards should ensure financial, administrative and clinical efficiency and effectiveness so as to provide quality care to all patients.  The MOPH will develop and implement strategies, strategic plans and operational plans to achieve the desired outputs of the above mentioned policies. These should include the following areas:  Licensing, Registration and Accreditation  Governance and Hospital Management  Professional Training and Education  HR Management  Financial Management  Quality of Clinical and Support Services  Integration into the national referral system
  17. 17. Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy THANK YOU!
  18. 18. 19th Oct 200918 Dr Michael Niechzial & Dr Amol R Deshmukh Afghanistan National Hospitals Policy Progress Milestones  June 2008 - Theme for Policy Presented  August 2008 - Guidelines for Policy Presented  3rd August 2009 - First draft of document Presented  Now Oct 2009 - Finalise Recommendations  End Oct 2009 - Submit second / final draft

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