Online Collaborative Interactive Learning Among Hospitals in the Philippines

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ROJoson's Lecture during the 31ST ANNUAL NATIONAL CONVENTION AND EXHIBITION, Private Hospitals Association of the Philippines, November 22, 2010 …

ROJoson's Lecture during the 31ST ANNUAL NATIONAL CONVENTION AND EXHIBITION, Private Hospitals Association of the Philippines, November 22, 2010
Manila Hotel

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  • 1. Online Collaborative and Interactive Learning Among Hospitals in the Philippines REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg Designer and Facilitator, Online Collaborative and Interactive Learning in Hospital Services Administration 31ST ANNUAL NATIONAL CONVENTION AND EXHIBITION Private Hospitals Association of the Philippines November 22, 2010 Manila Hotel
  • 2. Online Collaborative and Interactive Learning Among Hospitals in the Philippines “Online” Methodology being done through Internet (group emails and websites) “Collaborative and Interactive Learning” Objectives group of people contributing their abilities, experiences, and insights and interacting with each other for learning “Among Hospitals in the Philippines” Contents implies problems, issues and concerns in Philippine hospitals being brought forth for collaborative and interactive learning OCIL Project (started in June, 2010)
  • 3. Online Collaborative and Interactive Learning Among Hospitals in the Philippines Objectives of Talk: • To share by describing my two ongoing OCIL projects on hospital services administration, namely, OCIL on Admitting Service and OCIL on Breast Wellness Center, with focus on the mechanics. • To send out an open invitation to members of PHAP and to anybody in the audience who would find the OCIL beneficial to their hospital services to join my current and future OCILs.
  • 4. Online Collaborative and Interactive Learning (OCIL) Objective 1: • To share with you by describing my two ongoing OCIL projects on hospital services administration, namely, OCIL on Admitting Service and OCIL on Breast Wellness Center, with focus on the mechanics.
  • 5. Online Collaborative and Interactive Learning (OCIL) Two ongoing OCIL projects on hospital services administration: OCIL on Admitting Service (OCIL_AdmS) OCIL on Breast Wellness Center (OCIL_BreastWC) *Part of mother OCIL on Health Care Service Administration, Hospital Service Administration, and Hospital Administration (OCIL_HCSA_HSA_HA) ** Other OCILs to be put up: OCIL on Operating Room, OCIL on Department of Surgery; OCIL on Infection Management Center; etc.
  • 6. Online Collaborative and Interactive Learning (OCIL) Objectives and End-points Development of: Primer (Administrative Design and Development Program) Business and Operational Plan Template Operations Manual Template Manager-leaders Mentors Admitting Service Breast Wellness Center √ √ √ √ √ √ √ √ √ √ Clinical Practice Guidelines Education on Breast Wellness
  • 7. Online Collaborative and Interactive Learning (OCIL) “Who,” “How,” and “Fee” of Joining OCILs *People with interest to improve the health care services in the Philippines and in their health care organizations through "administration" are invited or can be referred to the OCILs *Know how to use emails and open them at least once a week! NO FEE is charged for joining and participating in the OCILs!
  • 8. Online Collaborative and Interactive Learning (OCIL) Categorization of Online Participants Categorized by their declared and requested roles in OCIL: Facilitators Mentees (with manifestation of desire to get a formal certification of completion = actively participating) Anecdotalists (intermittent commenters / sharers) Bystanders (do not interact and collaborate = read emails, observe online interactions)
  • 9. Online Collaborative and Interactive Learning (OCIL) Certification of Mentees: Minimum Requirements for Certification: • Active online collaboration and interaction (at least once a week) for minimum of 48 weeks (out of 52 weeks in a year) on all questions and issues posted by facilitator (guided by contents of learning) • Case study of an existing Admitting Service / Breast Wellness Center of a hospital with at least a proposed improvement design and development program or a design and development plan for a new Service
  • 10. Online Collaborative and Interactive Learning (OCIL) Certification of Mentees: Issuance of Certificate: • Upon complete fulfillment of requirements for certification • Issued by the facilitator
  • 11. Online Collaborative and Interactive Learning (OCIL) Learning Methods using primarily emails and electronic discussion group
  • 12. Online Collaborative and Interactive Learning (OCIL) Online Tools Emails Group Emails Websites Admitting Service Breast Wellness Center Individual emails of participants Individual emails of participants Yahoo Groups Yahoo Groups Yahoo Groups Yahoo Groups Wordpress.com Wordpress.com Google.com Google.com
  • 13. ocil_admitting_service@yahoogroups.com http://health.groups.yahoo.com/group/ocil_admitting_service
  • 14. ocil_admitting_service@yahoogroups.com http://health.groups.yahoo.com/group/ocil_admitting_service
  • 15. ocil_breastwellnesscenter@yahoogroups.com http://health.groups.yahoo.com/group/ocil_breastwellnesscenter
  • 16. ocil_breastwellnesscenter@yahoogroups.com http://health.groups.yahoo.com/group/ocil_breastwellnesscenter
  • 17. http://philhospitaladmittingservice.wordpress.com
  • 18. http://breastwellnesscenter.wordpress.com
  • 19. https://sites.google.com/site/admittingserviceprimer
  • 20. Use of Online Tools for Collaboration and Interactions and Archiving of Inputs and Learning Documents Participants are asked to open their emails at least once a week. They can interact with other learners either through individual emails of participants or preferably, through the egroup. They can see the interaction between and among the learners through the egroup.
  • 21. Use of Online Tools for Collaboration and Interactions and Archiving of Inputs and Learning Documents Two websites created for archiving purposes and take-off points for interactions. Late-comer learners or those who miss some online interactions for one reason or another can visit the two websites to catch-up.
  • 22. Online Collaborative and Interactive Learning (OCIL) OCIL Processes: 1. Brainstorming and discussion on questions and issues 2. Collation, analysis, and recommendations 3. Synthesis of outputs - Primer on Administrative Design and Development Program
  • 23. Online Collaborative and Interactive Learning (OCIL) OCIL Processes: • Facilitator sends weekly set of questions and issues for brainstorming and discussion • Participants email their responses to the questions and issues • Facilitator collates, analyzes, and makes recommendations • Facilitator synthesizes outputs into Primer on Administrative Design and Development Program
  • 24. A Department Design and Development Framework Architectural Design / Engineering / Construction Whole Hospital Concepts and Design Whole Hospital Governance Policies Procedures Determinants of Functions / services requirements Functions (authorized) Whole Hospital Operations Policies Procedures Interfacing Units Operations Policies Procedures Leadership Services (authorized) DOH Licensing & Structural Requirements Policies & Procedures / Clinical Practice Guidelines/ Clinical Pathways Risk Management Program Physical Structure (Location, space) Human Resource Program Equipment / Material Program Data / Documents Records Program Business Development Program Services Costefficient / valuebased Budget Program IT-enabled System Administrative Design and Development Program Regular Performance Evaluation and Continual Improvement Program
  • 25. Online Collaborative and Interactive Learning (OCIL) OCIL Processes: • Facilitator sends weekly set of questions and issues for brainstorming and discussion • Participants email their responses to the questions and issues • Facilitator collates, analyzes, and makes recommendations • Facilitator synthesizes outputs into Primer on Administrative Design and Development Program
  • 26. Online Collaborative and Interactive Learning (OCIL) Questions and Issues for Brainstorming and Discussion Brainstorming and Discussion on Obtaining an Informed Consent at the Admitting Service in a Hospital Duration of BD: One week (August 19 to 25, 2010) Questions and Issues (QI): QI.7.1 What is the concept of an informed consent of patients to be obtained by the staff of an Admitting Service in a hospital? QI.7.2 What should be the contents of an informed consent of patients to be obtained by the staff of an Admitting Service in a hospital?
  • 27. Online Collaborative and Interactive Learning (OCIL) Questions and Issues for Brainstorming and Discussion Brainstorming and Discussion on Obtaining an Informed Consent at the Admitting Service in a Hospital Duration of BD: One week (August 19 to 25, 2010) Questions and Issues (QI): QI.7. 3 How should an informed consent of patients be obtained by the staff of an Admitting Service in a medical center or hospital? Is signing a proforma informed consent form the same as obtaining an informed consent? Is signing a proforma contract of admission the same as obtaining an informed consent?
  • 28. Online Collaborative and Interactive Learning (OCIL) Questions and Issues for Brainstorming and Discussion Brainstorming and Discussion on Obtaining an Informed Consent at the Admitting Service in a Hospital Duration of BD: One week (August 19 to 25, 2010) Questions and Issues (QI): QI.7.4 Who should sign an informed consent for the hospital admission of a patient for it to be legally binding? QI.7.5 What is a Patient’s Bill of Rights? QI.7.6 How does the Patient’s Bill of Rights relate to the informed consent to be obtained by the staff of an Admitting Service in a medical center or hospital?
  • 29. Online Collaborative and Interactive Learning (OCIL) Questions and Issues for Brainstorming and Discussion Brainstorming and Discussion on Obtaining an Informed Consent at the Admitting Service in a Hospital Duration of BD: One week (August 19 to 25, 2010) Questions and Issues (QI): QI.7.7 Present and share scanned copies of proforma informed consent form and/or proforma contract of admission and a patient’s bill of right of a selected hospital in the spirit of collaborative learning.
  • 30. Online Collaborative and Interactive Learning (OCIL) Questions and Issues for Brainstorming and Discussion Sample Questions and Issues for Brainstorming and Discussion Breast Wellness Center
  • 31. Online Collaborative and Interactive Learning (OCIL) Questions and Issues for Brainstorming and Discussion Brainstorming and Discussion on Concept of Breast Wellness, Breast Wellness Program, Breast Wellness Center, and Breast Clinic / Center Duration of BD: One week (August 16, 2010 to August 22, 2010) Questions and Issues (QI): QI.1.1 What is /are the usual and recommended concepts of BREAST WELLNESS? QI.1.2 What is /are the usual and recommended concepts of BREAST WELLNESS PROGRAM?
  • 32. Online Collaborative and Interactive Learning (OCIL) Questions and Issues for Brainstorming and Discussion Brainstorming and Discussion on Concept of Breast Wellness, Breast Wellness Program, Breast Wellness Center, and Breast Clinic / Center Duration of BD: One week (August 16, 2010 to August 22, 2010) Questions and Issues (QI): QI.1.3 What is /are the usual and recommended concepts of BREAST WELLNESS CENTER? QI.1.4 What is /are the usual concepts of the BREAST CLINICS / CENTERS that have been established in the Philippines (that you know of)?
  • 33. Online Collaborative and Interactive Learning (OCIL) OCIL Processes: • Facilitator sends weekly set of questions and issues for brainstorming and discussion • Participants email their responses to the questions and issues • Facilitator collates, analyzes, and makes recommendations • Facilitator synthesizes outputs into Primer on Administrative Design and Development Program
  • 34. Online Collaborative and Interactive Learning (OCIL) Collation and Recommendations ROJOSON’S INPUTS (Collation and Recommendations) Concept of Informed Consent for Admission The concept of an informed consent of patients to be obtained by the staff of an Admitting Service in a hospital means that the staff of an Admitting Service should secure an informed consent for admission to the hospital. It is different from the informed consent for medical procedures to be done to the patient in the inpatient services.
  • 35. Online Collaborative and Interactive Learning (OCIL) Collation and Recommendations ROJOSON’S INPUTS (Collation and Recommendations) Breast Wellness for a Person (Concept) • Usual: Absence of breast abnormality or disease • Recommended: A state wherein there is NO breast issue (in the domain of symptoms, diseases, and fear and anxiety even in the absence of disease) that affects the physical, psychosocial, and spiritual well-being and / or the socioeconomic productivity of a person. This concept is deduced from the World Health Organization’s definition of HEALTH and the common definitions of WELLNESS.
  • 36. Online Collaborative and Interactive Learning (OCIL) OCIL Processes: • Facilitator sends weekly set of questions and issues for brainstorming and discussion • Participants email their responses to the questions and issues • Facilitator collates, analyzes, and makes recommendations • Facilitator synthesizes outputs into Primer on Administrative Design and Development Program
  • 37. https://sites.google.com/site/admittingserviceprimer
  • 38. Online Collaborative and Interactive Learning (OCIL) Topics for BD -AdmS (21 Sessions from June to October, 2010) Topics for Brainstorming and Discussion Schedule Concept of an Admitting Service in a Hospital June 1 to 7, 2010 Functions of an Admitting Service in a Hospital June 8 to 15, 2010 Bed Assignment Function / Service of an Admitting Service June 24 to July 1, 2010 Physician-associated Issues on Bed Assignment Function / Service of an Admitting Service July 3 to 10, 2010 Making-Beds-Available Issues on Bed Assignment Function / Service of an Admitting Service July 21 to 28, 2010 Inpatient Record Establishment of an Admitting Service August 5 to 11, 2010
  • 39. Online Collaborative and Interactive Learning (OCIL) Topics for BD - AdmS (21 Sessions from June to October, 2010) Topics for Brainstorming and Discussion Obtaining Informed Consent at the Admitting Service Schedule August 19 to 25, 2010 Orientation of Patients for Admission by the Admitting August 26 to September Service 1, 2010 Account Arrangement September 2 to 9, 2010 Transport of Patients from Admitting Service to Inpatient Service September 10 to 17, 2010 Human Resource Requirements of an Admitting Service September 18 to 24, 2010 Risk Management Program of an Admitting Service September 27 to October 3, 2010
  • 40. Online Collaborative and Interactive Learning (OCIL) Topics for BD - AdmS (21 Sessions from June to October, 2010) Topics for Brainstorming and Discussion Schedule IT-enabled System of an Admitting Service October 5 to 11, 2010 Physical Structure, Equipment and Materials, Business Development and Budget of an Admitting Service October 12 to 18, 2010 Regular Performance Evaluation, Continual Improvement Program, and Leadership of an Admitting Service October 20 to 26, 2010 Case Study October 27 to November 30, 2010
  • 41. Admitting Service Design and Development Framework Architectural Design / Engineering / Construction Whole Hospital Concepts and Design Whole Hospital Governance Policies Procedures Determinants of Functions / services requirements Functions (authorized) Whole Hospital Operations Policies Procedures Interfacing Units Operations Policies Procedures Leadership Services (authorized) DOH Licensing & Structural Requirements Policies & Procedures / Clinical Practice Guidelines/ Clinical Pathways Risk Management Program Physical Structure (Location, space) Human Resource Program Equipment / Material Program Data / Documents Records Program Business Development Program Services Costefficient / valuebased Budget Program IT-enabled System Administrative Design and Development Program Regular Performance Evaluation and Continual Improvement Program
  • 42. Online Collaborative and Interactive Learning (OCIL) Topics for BD – Breast WC (13 Sessions from August to November, 2010) Topics for Brainstorming and Discussion Schedule Concept of Breast Wellness, Breast Wellness Program, and Breast Wellness Center August 16 to 22, 2010 Functions and Services August 23 to 30, 2010 Drafting a Breast Wellness Program August 31 to September 7, 2010 Magnitude of the Breast Wellness Problems in the Philippines, Catchment Community, and Focal Hospital September 8 to 14, 2010 Presenting Chief Complaints of Patients with a Breast Wellness Concern and List of Breast Disorders and Diseases September 15 to 21, 2010
  • 43. Online Collaborative and Interactive Learning (OCIL) Topics for BD – Breast WC (13 Sessions from August to November, 2010) Topics for Brainstorming and Discussion Schedule Recognition (Clinical Diagnosis) of More Common Breast Conditions, Changes, Disorders, and Diseases September 22 to 28, 2010 Application of Pattern Recognition and Validation of Essential Clinical Diagnostic Criteria on More Common Breast Conditions, Changes, Disorders, and Diseases September 29 to October 5, 2010 Diagnostic Procedures of the Breast October 6 to 12, 2010 Inflammatory Disorders of the Breast October 14 to 20, 2010 Physiologic Conditions and Changes of the Breast October 21 to 28, 2010
  • 44. Online Collaborative and Interactive Learning (OCIL) Topics for BD – Breast WC (13 Sessions from August to November, 2010) Topics for Brainstorming and Discussion Schedule Nipple Discharge October 29 to November 4, 2010 Breast Pain November 4 to 10, 2010 Breast Mass November 11 to 18, 2010
  • 45. Online Collaborative and Interactive Learning (OCIL) Current Situation / Status
  • 46. Online Collaborative and Interactive Learning (OCIL) Date officially started (To end) Number of participants OCIL on Admitting Service June 1, 2010 (May 31, 2011) OCIL on Breast Wellness Center August 16, 2010 (August 15, 2011) 74 (Admitting Service 74 (physicians, staff; nurses; staff nurses, hospital from finance, administrators) business development, human resource units; hospital administrators; others)
  • 47. Online Collaborative and Interactive Learning (OCIL) OCIL on Admitting Service Number of facilitators Number of mentees Number of anecdotalists Number of bystanders OCIL on Breast Wellness Center 4 1 9 22 27 5 39 41
  • 48. Online Collaborative and Interactive Learning (OCIL) OCIL on Admitting Service Geographical distribution of participants NCR = 60 Outside NCR = 14 (Zamboanga; Samar; Bicol; Batangas; Sta. Rosa, Laguna; Biñan, Laguna; Cavite; Bulacan; Pampanga; Tarlac; Bataan; Isabela; Quezon) OCIL on Breast Wellness Center NCR = 67 Outside NCR = 7 (Zamboanga; Cagayan de Oro; Cebu; Batangas; Cavite; Sta. Rosa, Laguna; Biñan, Laguna)
  • 49. Online Collaborative and Interactive Learning (OCIL) AdmS Mentees’ Home Bases Ciudad Medical Zamboanga
  • 50. Online Collaborative and Interactive Learning (OCIL) AdmS Mentees’ Home Bases Sta. Rosa Hospital and Medical Center
  • 51. Online Collaborative and Interactive Learning (OCIL) AdmS Mentees’ Home Bases Daniel Mercado Medical Center
  • 52. Online Collaborative and Interactive Learning (OCIL) AdmS Mentees’ Home Bases Manila Doctors Hospital
  • 53. Online Collaborative and Interactive Learning (OCIL) AdmS Mentees’ Home Bases National Children’s Hospital
  • 54. Online Collaborative and Interactive Learning (OCIL) AdmS Mentees’ Home Bases Tarlac Provincial Hospital
  • 55. Online Collaborative and Interactive Learning (OCIL) Email Interactions as registered in Yahoo Egroups: OCIL_AdmS Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2010 29 129 105 121 78 61 41 Total 567 OCIL_BreastWC Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total 457 2010 83 161 127 86
  • 56. Online Collaborative and Interactive Learning (OCIL) Visits on http://philhospitaladmittingservice.wordpress.com 146 posts with 46 categories of topics Jan 2 0 1 0 Feb Mar Apr May 9 Jun 54 Jul 1 Aug 51 Sep 62 Oct 56 Nov Dec Total 17 250
  • 57. Online Collaborative and Interactive Learning (OCIL) Feedback from Members of the OCIL_AdmS: • This project gives us information on how admission is being done in other institutions and helps us a lot in improving our own. • I find the primer very very useful in my unit. I can share this with my staff and together work to have an efficient Admitting Service.
  • 58. Online Collaborative and Interactive Learning (OCIL) Feedback from Members of the OCIL_AdmS: • I learned so much in such a short period of time. • Thank you very much for the OCIL, it is one great learning experience for us! Thus, we can make improvements in this particular hospital unit of ours.
  • 59. Online Collaborative and Interactive Learning (OCIL) Feedback from Members of the OCIL_AdmS: • I am very thankful for the formulation of this virtual discussion – OCIL. Though the topic is beyond OR set up but by inputs of every member it expands my idea on how admitting section is and for this, it can also be applied to some extent in my department. Hoping that someday OR will have OCIL.
  • 60. Online Collaborative and Interactive Learning (OCIL) Feedback from Members of the OCIL_AdmS: • I believe this is one of a kind course being undertaken presently. This may be the start of a bigger endeavor between hospitals to improve our services while being present in our hospitals and working. This is a new mode of communications that we should take advantage of. Jose Rene de Grano, MD, MHA Chairman PHAP 2010 National Convention Organizing Committee
  • 61. Online Collaborative and Interactive Learning (OCIL) Why OCIL from me? With OCIL, I envision to facilitate collaborative learning among different hospitals and various hospital managers and multidisciplinary professionals and develop handy comprehensive and integrated primers and design and development programs on different hospital services in the Philippine setting.
  • 62. Online Collaborative and Interactive Learning (OCIL) Why OCIL from me? Realization that there is so much to learn in health care services administration, hospital services administration, and hospital administration that collaboration is needed among different hospitals and among various hospital managers and multidisciplinary professionals in searching for best practices.
  • 63. Online Collaborative and Interactive Learning (OCIL) Why OCIL from me? Lack of handy comprehensive and integrated primers and design and development programs on different hospital services in the Philippine setting makes learning difficult.
  • 64. Online Collaborative and Interactive Learning (OCIL) Why OCIL from me? Part of my advocacy, Education for Health Development in the Philippines, started since 1989.
  • 65. Online Collaborative and Interactive Learning (OCIL) Future plans for OCIL on Admitting Service Presently, conducting a formative evaluation and in the future, a summative evaluation.
  • 66. Online Collaborative and Interactive Learning (OCIL) Future plans for OCIL on Admitting Service For the online primer: • Continue to develop it to include samples of case studies, business and operational plan, and operations manual for Admitting Service.
  • 67. Online Collaborative and Interactive Learning (OCIL) Future plans for OCIL on Admitting Service Another OCIL _Admitting Service: • Will conduct another course with a new batch of mentees
  • 68. Online Collaborative and Interactive Learning (OCIL) Future plans for OCIL on Admitting Service For the mentees: • After certification, – it will be up to them to choose any one or combination of the following career pathways:
  • 69. Online Collaborative and Interactive Learning (OCIL) Future plans for OCIL on Admitting Service For the mentees: • To serve as a facilitator / mentor of the colleagues – staff in his currently affiliated Admitting Service who were NOT able to join the first OCIL on Admitting Service.
  • 70. Online Collaborative and Interactive Learning (OCIL) Future plans for OCIL on Admitting Service For the mentees: • To pursue further learning on Admitting Service to achieve excellence in the administrative design and development of his Admitting Service, particularly, in mastering the development of business and operational plan and operations manual.
  • 71. Online Collaborative and Interactive Learning (OCIL) Future plans for OCIL on Admitting Service For the mentees: • To become a resource person for the next batch of mentees of OCIL on Admitting Service. • To pursue further learning on Admitting Service until mastery and, therefore, be qualified to be a facilitator for the next batch of mentees of OCIL on Admitting Service.
  • 72. Online Collaborative and Interactive Learning (OCIL) Objective 2: • To send out an open invitation to members of PHAP and to anybody in the audience who would find the OCIL beneficial to their hospital services to join my current and future OCILs. Email: rjoson2001@yahoo.com http://philhospitaladmittingservice.wordpress.com https://sites.google.com/site/admittingserviceprimer http://breastwellnesscenter.wordpress.com
  • 73. Online Collaborative and Interactive Learning (OCIL) Thank you for your attention!