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Quality and Excellence in Healthcare: Best Practices

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Quality and Excellence in Healthcare: Best Practices

Quality and Excellence in Healthcare: Best Practices

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  • Correction in Slide No. 23:
    Aiming for highest level of quality and performance excellence does not just mean getting more certificates from external reputable standard-bodies but more importantly, strategy should be to have more documented specific best practices aside from the Parent Best Practice.
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  • 1. Quality and Excellence in Healthcare: Best Practices REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg MINDANAO REGIONAL MANAGEMENT SEMINAR Private Hospitals Association of the Philippines April 30, 2014 Marco Polo Hotel, Davao
  • 2. Quality and Excellence in Healthcare: Best Practices Greetings and Salutations From REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg 0918-804-03-04 rjoson2001@yahoo.com
  • 3. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” Main Contents • Aiming for best practices in quality and performance excellence in hospitals • How to aim for best practices in quality and performance excellence in hospitals • Examples of best practices in quality and performance excellence in hospitals
  • 4. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” Main Contents • Aiming for best practices in quality and performance excellence in hospitals • How to aim for best practices in quality and performance excellence in hospitals • Examples of best practices in quality and performance excellence in hospitals Delimitations Specifications Operational definitions
  • 5. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” “Quality” - “degree to which a set of inherent characteristics fulfils requirements.” [ISO] • Degree: refers to a level to which a product or service satisfies. ~depending upon level of satisfaction, excellent good poor
  • 6. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” “Quality” - “degree to which a set of inherent characteristics fulfils requirements.” [ISO] • Inherent characteristics: those features that are a part of the product or service and are responsible to achieve satisfaction.
  • 7. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” “Quality” - “degree to which a set of inherent characteristics fulfils requirements.” [ISO] • Requirements: refer to needs of customer, organization and other interested parties (e.g. regulatory bodies, suppliers, employees, community & environment). – expectations may be stated, generally implied or obligatory.
  • 8. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” “Performance Excellence” - an integrated approach to organizational performance management that results in (1)delivery of ever-improving value to customers and stakeholders, contributing to organizational sustainability; (2)improvement of overall organizational effectiveness and capabilities; and (3)organizational and personal learning. [Baldrige / PQA Criteria for Performance Excellence]
  • 9. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” “Best Practice” – a formally documented method or technique that has been institutionalized in the hospital and that has consistently shown performance excellence results at least if not yet proven superior to those achieved with other means and which can be or is being used as a benchmark by other hospitals. [ROJoson]
  • 10. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” • Aiming for best practices in quality and performance excellence in hospitals
  • 11. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” “Setting the Bar of Excellence in Healthcare or Hospitals,” theoretically means putting standards of excellence in hospitals at a certain level in the continuum of excellence or defining the standards or criteria of excellence.
  • 12. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” Setting the bar may either be raising or lowering, it but usually raising, when one is talking of bar of excellence.
  • 13. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” • Various levels of excellence • Rating scale or categorization varies from one evaluating organization to another.
  • 14. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” • Categorization: –low, medium, high, and highest levels of excellence.
  • 15. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” • Categorization: –gold, platinum, and diamond levels with diamond being the highest level being used by Accreditation Canada International.
  • 16. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” • Categorization: –Center of Safety, Center of Quality, and Center of Excellence previously used by PhilHealth.
  • 17. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” • Categorization by the Philippine Quality Awards: – Level 1, Recognition for Commitment to Quality Management (just beginning quality journey; planted seeds of quality and productivity); – Level 2, Recognition for Proficiency in Quality Management (achieved significant progress in building sound process); – Level 3, Recognition for Mastery in Quality Management (demonstrated superior results; role model in the Philippines); – Level 4, Philippine Quality Award for Performance Excellence (highest level of excellence; national and global role model).
  • 18. Aiming for best practices in quality and performance excellence in hospitals All hospitals should continually aim for the highest level of quality and performance excellence.
  • 19. Aiming for best practices in quality and performance excellence in hospitals If a hospital has a documented “Journey towards Excellence” program with at least some positive evaluation results, then that hospital can say or boost that it has one “Best Practice” and this “Best Practice” is considered to be the Parent, either Mother or Father, Best Practice.
  • 20. Aiming for best practices in quality and performance excellence in hospitals ProgrammedJourneyofExcellence ParentBestPractice
  • 21. Aiming for best practices in quality and performance excellence in hospitals ProgrammedJourneyofExcellence ParentBestPractice
  • 22. Aiming for best practices in quality and performance excellence in hospitals MDH and CMZ have set the bar of quality and performance excellence and they are still continually aiming for the highest level.
  • 23. Aiming for best practices in quality and performance excellence in hospitals Aiming for highest level of quality and performance excellence does not just mean getting additional external reputable standard-bodies but more importantly, strategy should be to have more documented specific best practices aside from the Parent Best Practice.
  • 24. Aiming for best practices in quality and performance excellence in hospitals Presence of a documented comprehensive set of “Best Practices” (as I have defined it) - ultimate single criterion to say that - a hospital has achieved the highest bar or level of quality and performance excellence!!!
  • 25. Aiming for best practices in quality and performance excellence in hospitals Presence should be validated and affirmed by a Level 4 PQA and a reputable external hospital standard accrediting body that puts emphasis on documented best practices and benchmarking. ROJ’s message in: “Aiming for Best Practices in Quality and Performance Excellence in Hospitals.”
  • 26. Quality and Excellence in Healthcare: Best Practices Welcome feedback and queries REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg 0918-804-03-04 rjoson2001@yahoo.com
  • 27. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” • How to aim for best practices in quality and performance excellence in hospitals
  • 28. How to aim for best practices in quality and performance excellence in hospitals Subtopics • Processes of developing a “Best Practice” • Comprehensive set of “Best Practices” in a Hospital • Strategies to have a documented comprehensive set of “Best Practices” in a hospital
  • 29. How to aim for best practices in quality and performance excellence in hospitals Processes of developing a “Best Practice” • Decide on a management system that will be developed into a “Best Practice.” One can choose from the list that I will provide later. For examples, communication management system and strategic planning management system.
  • 30. How to aim for best practices in quality and performance excellence in hospitals Processes of developing a “Best Practice” • Formulate a design and development plan or blueprint –systematic approach in planning of management system –deployment and implementation –evaluation, review, and continual improvement –management review and independent audit
  • 31. How to aim for best practices in quality and performance excellence in hospitals Processes of developing a “Best Practice” In the management system plan, adopt / adapt with innovations best practices from other institutions if there are.
  • 32. How to aim for best practices in quality and performance excellence in hospitals Processes of developing a “Best Practice” Use systems approach (looking at and managing the hospital as a whole) alignment (promoting consistency of all plans, processes, evaluations, actions of component systems to support whole hospital’s goals) integration (making all components function as an interconnected unit)
  • 33. How to aim for best practices in quality and performance excellence in hospitals Processes of developing a “Best Practice” In the evaluation, always include timelines and measurements with key performance indicators.
  • 34. How to aim for best practices in quality and performance excellence in hospitals Processes of developing a “Best Practice” • Track the implementation of the management system plan.
  • 35. How to aim for best practices in quality and performance excellence in hospitals Processes of developing a “Best Practice” • Evaluate results of implementation for at least 3 years in terms of –level (current level of performance based on formulated key performance indicators) –trends (rates of performance improvements and sustainability of good performance) –comparison (performance relative to appropriate comparisons such as other similar hospitals and benchmarks or hospital industry leaders)
  • 36. How to aim for best practices in quality and performance excellence in hospitals Processes of developing a “Best Practice” All the above must be formally and completely and accurately documented!!!
  • 37. How to aim for best practices in quality and performance excellence in hospitals Processes of developing a “Best Practice” If management system plan implemented for at least 3 years and has consistently shown performance excellence results, then it can be considered as a “Best Practice” for the hospital. Once publicized, can be used as a benchmark by other hospitals.
  • 38. Quality and Excellence in Healthcare: Best Practices Welcome feedback and queries REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg 0918-804-03-04 rjoson2001@yahoo.com
  • 39. How to aim for best practices in quality and performance excellence in hospitals Comprehensive set of “Best Practices” in a Hospital Aside from developing “Journey towards Excellence” program as the Parent Best Practice, hospital should develop other specific “Best Practices.”
  • 40. How to aim for best practices in quality and performance excellence in hospitals Comprehensive set of “Best Practices” in a Hospital List of “Best Practices” - comprehensive - all hospitals should develop as part of the “Journey towards Excellence.” - at least 25
  • 41. How to aim for best practices in quality and performance excellence in hospitals Comprehensive set of “Best Practices” in a Hospital I formulated this list using as references • PQA Criteria for Performance Excellence • international hospital health care standards particularly on patient-care • ROJ’s steadfast strategic objectives for hospitals • Others
  • 42. How to aim for best practices in quality and performance excellence in hospitals Comprehensive set of “Best Practices” in a Hospital Using PQA Criteria for Performance Excellence as Reference: • Leadership • Strategic Planning • Customer Focus • Measurement, Analysis, Knowledge Management • Workforce Focus • Operations Focus Develop One Best Practice per Category
  • 43. How to aim for best practices in quality and performance excellence in hospitals Comprehensive set of “Best Practices” in a Hospital Using international hospital standards as reference: Access to Care and Continuity of Care • Patient and Family Rights • Assessment of Patients • Care of Patients • Anesthesia and Surgical Care • Medication Management • Patient and Family Education • Hospital Infection Control Develop One Best Practice per Category
  • 44. How to aim for best practices in quality and performance excellence in hospitals Comprehensive set of “Best Practices” in a Hospital Systems perspective in governance Integrated value-based health care service Physician engagement (patronage and loyalty) Maximal utilization of services with controlled expenses and losses Customer delight Full compliance with the quality and performance standards (local and international) Integrated IT-enabled operations system Staff engagement Learning organization CSR program with tangible social impact ROJ’s Recommended Steadfast Strategic Objectives for Hospitals DeveloponeBestPracticeperCategory
  • 45. How to aim for best practices in quality and performance excellence in hospitals Comprehensive set of “Best Practices” in a Hospital ROJ Additional Recommended Must-Have Management System or Program for Hospitals: • Communication Management System
  • 46. How to aim for best practices in quality and performance excellence in hospitals Comprehensive set of “Best Practices” in a Hospital ROJoson’s Recommendation: At least 25 documented “Best Practices” which all hospitals should develop as part of “Journey towards Excellence” Program
  • 47. Quality and Excellence in Healthcare: Best Practices Welcome feedback and queries REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg 0918-804-03-04 rjoson2001@yahoo.com
  • 48. How to aim for best practices in quality and performance excellence in hospitals Strategies to have a documented comprehensive set of “Best Practices” in a hospital What top management and senior leaders should do? • Leadership strategy • Management strategy • Communication strategy • Education strategy
  • 49. How to aim for best practices in quality and performance excellence in hospitals Strategies to have a documented comprehensive set of “Best Practices” in a hospital • Leadership Strategy –Commitment –Motivation –Support –Role model
  • 50. How to aim for best practices in quality and performance excellence in hospitals Strategies to have a documented comprehensive set of “Best Practices” in a hospital • Management Strategy –Technical competence in the processes of developing “Best Practice”
  • 51. How to aim for best practices in quality and performance excellence in hospitals Strategies to have a documented comprehensive set of “Best Practices” in a hospital • Communication Strategy –Clear communication –Close-loop communication –Information –Alignment and integration –Engagement of staff to the project “Best Practices”
  • 52. How to aim for best practices in quality and performance excellence in hospitals Strategies to have a documented comprehensive set of “Best Practices” in a hospital • Education Strategy –Education, coaching, mentoring on developing “Best Practices” to all hospital staff –Online Collaborative Interactive Learning
  • 53. How to aim for best practices in quality and performance excellence in hospitals Subtopics • Processes of developing a “Best Practice” • Comprehensive set of “Best Practices” in a Hospital • Strategies to have a documented comprehensive set of “Best Practices” in a hospital ROJ messages: “How to Aim for Best Practices in Quality and Performance Excellence in Hospitals.”
  • 54. Quality and Excellence in Healthcare: Best Practices Welcome feedback and queries REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg 0918-804-03-04 rjoson2001@yahoo.com
  • 55. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” • Examples of best practices in quality and performance excellence in hospitals
  • 56. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” “Best Practice” – a formally documented method or technique that has been institutionalized in the hospital and that has consistently shown performance excellence results at least if not yet proven superior to those achieved with other means and which can be or is being used as a benchmark by other hospitals. [ROJoson]
  • 57. Examples of best practices in quality and performance excellence in hospitals Disclosure: • Not fully matured • Being implemented for at least 3 years (institutionalized) – level of commitment at least, proficiency at most (not yet mastery)
  • 58. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” Examples of best practices in quality and performance excellence in hospitals • Governance and Leadership • Strategic Planning • Balanced Scorecard • Safety Promotion and Disaster Preparedness • Financial Management • Continual Improvement Program (MDH) • Corporate Social Responsibility Program (MDH)
  • 59. Examples of best practices in quality and performance excellence in hospitals • Strategic Planning • Balanced Scorecard
  • 60. TPOR1: Journey towards performance excellence of MDH and CMZ Strategic Planning Conferences Every 3 years since 1999 With a structured framework With Annual Planning Conferences
  • 61. Strategic Planning Conferences Every 3 years since 2009 With a structured framework Using Baldrige / PQA Criteria
  • 62. TPOR1: Journey towards performance excellence of MDH and CMZ Balanced Scorecard Since 2004 Performance management and evaluation tool
  • 63. Balanced Scorecard Since 2009 Performance management and evaluation tool
  • 64. Quality and Excellence in Healthcare: Best Practices Welcome requests for more info REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg 0918-804-03-04 rjoson2001@yahoo.com
  • 65. Quality and Excellence in Healthcare: Best Practices “Setting the Bar of Excellence in Healthcare” Main Contents • Aiming for best practices in quality and performance excellence in hospitals • How to aim for best practices in quality and performance excellence in hospitals • Examples of best practices in quality and performance excellence in hospitals
  • 66. Quality and Excellence in Healthcare: Best Practices Thank you for your attention Welcome feedback, queries, and requests for info and assistance REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg 0918-804-03-04 rjoson2001@yahoo.com

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