Roadmap to attaining quality in public healthcare centers through accreditation

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  • 1. CoH11www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement Programme(Toward Excellence Health center for the Community)“Roadmap to attaining Quality in PublicHealthcare Centers through Accreditation"Dr. J. L. MeenaState Quality Assurance OfficerCommissionerate of Health & FWGovernment of GujaratEmail:- sqipgujarat@gmail.comWeb:- www.gujhealth.gov.in/quality-assurance-program.htmDr. J. L. Meena
  • 2. CoH22www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeQuality is very Sweet for speak,but difficult to implement.becauseQuality is Never Improvedwithout accepting facts.Dr. J. L. Meena
  • 3. CoH33www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratOld Scenario of Health Centers.Building maintenance wasextremely unsatisfactory –Leaking roof, eroded floors,over flowing toilets, brokendoors, No patient safety, Nosafe drinking water facilities.no employee safety, poorlighting and no ventilationsign.Dr. J. L. Meena
  • 4. CoH44www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratOld Scenario of Health Centers.• Poor sanitation andcleanliness.• Very poor Drainage facility.• Poor housekeeping service.• Very poor Biomedicalwaste & infection controlpractice.• No cattle guard.Dr. J. L. Meena
  • 5. CoH55www.gujhealth.gov.in Health & Family Welfare, Govt of Gujarat• Non sterile suctiontube & oxygen mask?• Empty OxygenCylinders.• Instrument with rust& Non sterile.Old Scenario of Health Centers.Dr. J. L. Meena
  • 6. HOW TO ACHIEVE EXCELLENCE INHEALTH IN TRIBAL AREATQM-
  • 7. 8
  • 8. CoH99www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratHealth centers is committed to provide qualityhealthcare services.To provide the treatment as per the national andinternational standards.To provide treatment with the latest technology.To conduct trainings and workshops on regularintervals for skill development of the staffs.To improve the quality on continuous basis.To improve the quality of treatment as per thepatient satisfaction survey.Quality PolicyDr. J. L. Meena
  • 9. CoH1010www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality ObjectivesTo achieve standards as per IPHS & NABH.To provide 24X7 quality services to the community.To implement and monitor all the national programsrunning in the district.To provide right treatment through latesttechnology.To ensure safety of employee.To ensure safety of patient.To manage Human Resources for enhancingproductivity.Dr. J. L. Meena
  • 10. CoH1111www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratA Case StudyJOURNEY TOWARDS QUALITYCont….
  • 11. CoH1212www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratA Case StudyJOURNEY TOWARDS QUALITYDr. J. L. Meena
  • 12. CoH1313www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratOutcomes…..Dr. J. L. Meena
  • 13. CoH1414www.gujhealth.gov.in Health & Family Welfare, Govt of Gujarat5 Years Back TodayLack of standards NABH Standards for Health CentersNo Gap analysis report in standard format. Gaps identified and addressed.Lack of Statutory requirements (e.g. Licenses,Acts, Rules & Certificates).Statutory requirements fulfilledAbsence of written policies & procedures. Written policies & procedures available.Poor sanitation, cleanliness & infection controlpractices.Hygienic, Clean & Green Hospital environment withinfection control audit.Staff shortage so very poor specialist service. Recruitment of staff as per workload through RKS andtake specialist service outsource.Lack of trained health care staff for emergency(resuscitation) services and patient care service.Staff trained in Basic Life Support and AdvancedCardiac Life SupportNo concept of internal audits (medical audit,clinical audit & death audit etc).Staff trained as internal auditors, audits conducted tofind out non conformances, corrective & preventivemeasures taken to rectify itJourney of Quality Improvement(Cont)…Dr. J. L. Meena
  • 14. CoH1515www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratJourney of Quality Improvement (Cont)…5 Years Back TodayInadequate infrastructure for handlingbiomedical waste and infection control safetypracticesAll required practices in placeNo Blood storage, CSSD, no separate OT for Eye& Gynec., Patients attendant launch facilities.Blood storage, CSSD, separate OT for Eye & Gynec,Patients attendant launch facilities are available.Damaged and poor condition of building &Staff Quarters.Repairing & renovation done gynecologyNo Calibration system of Instruments forQuality check.Calibration system of Instruments for Quality checkare available.Shortage of equipments and properambulances (transport vehicle) .Sufficient equipments and ambulances with regularmonitoring by a responsible person.Lack of accountability & planning. Policy and processes for care of the patients in placeAbsence of quality standards. Quality standards e.g. medical audit, management ofmedication, care of patients etc practicedNo participation in EQAS/ inter laboratorycomparisonsParticipation in EQAS / inter laboratory comparisonand achieving good scores in it.Dr. J. L. Meena
  • 15. CoH1616www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratJourney of Quality Improvement(Cont)…5 Years Back TodayPoor signage system. Well developed signage and displays for patientinformation.Absence of Patient & Employees’ satisfaction. Established.No measurable parameter for patient safety. Measurable parameters for patient safety areavailable.No realization of problems and weaknesses. A clear understanding of what is lacking and whatneeds to be done.No monitoring or reporting of adverse events,needle stick injury, Sentinel events etc.These are being reported and are monitored.Practically non-existent security arrangement Availability of well trained security guardsNon Implementation of Different Codes in thefacilities.RED for FIRE,YELLOW for EXTERNAL CALAMITIES,BLUE for CARDIAC ARREST,BLACK for BOMB THREAT,PINK for CHILD ABDUCTIONDr. J. L. Meena
  • 16. CoH1717www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratJourney of Quality Improvement(Cont)…5 Years Back TodayNo team work, only Individual approach ratherthen team . Unidentified role and responsibilityof staffs.Team work is available, role and responsibility of allstaff is cleanly mention.No Evaluation and monitoring system by PRImembers (3rdparty evaluation).3rdParty evaluation & monitoring system by PRImembers.Poor publicity of available services in thevillages and in the community.All the service which are provide by the healthcarecentre are display in the community and emergencycontact number also display.No monitoring of Up time & down time of theinstruments.Proper monitoring of Up time, down time &utilization of the instrument & equipment.No responsibility of referred patients . Progress of the referred patient also monitoring bythe health centre on regular basis.( Bi directionalreferral service).No display of the Right and responsibly of thepatients and employees in the facilities.Proper display of Right and responsibly of thepatients and employees in the facilities.Dr. J. L. Meena
  • 17. CoH1818www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratAchievement:India’s 1stNABH / NABL Accredited Govt.Facilities:-•Dist. General Hospital Gandhinagar•Primary Health Centre Gadboriad, Dist:Vadodara•Medical College Hospital Labs Bhavanagar•Blood Bank (BJMC Ahmadabad)•Food & Drug laboratory Badodara•Mental Hospital BadodaraCommunity Health Center, Bardoli-SuratDr. J. L. Meena
  • 18. CoH1919www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratIndia’s 1st& 2ndNABH Accredited PHCDr. J. L. Meena
  • 19. CoH2020www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratIndia’s 1stNABH Accredited CHCDr. J. L. Meena
  • 20. CoH2121www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratA Success StoryQuality Improvement Programme:- GujaratName of the Facility Total FacilityUnderNABH /NABLTotal Facility UnderNABH /NABL whichcatering TribalpopulationTotalAccreditedfacilitiesTotal Accreditedfacilities whichcatering tribalpopulationDistrict Hospitals 23 11 2 0Medical college Hospitals 6 2 0 0Medical college, Blood banks 6 2 5 2Medical college, Laboratories 6 2 4 2Mental Hospitals 2 1 2 1Dental Hospitals 2 0 0 0Paraplegia Hospital,Ahmedabad1 1 0 0Primary Health Centers (PHCs) 29 14 12 6Community Health Centers(CHCs)26 11 1 1NABL Food & Drug Laboratories 2 1 2 1Total 103 45 28 13Dr. J. L. Meena
  • 21. CoH2222www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratBenefits to PatientsBenefits to PatientsAvailability of Health services with High quality ofcare.Dedicated and sincere medical staffAccess to a quality focused organizationRights respected and protectedPatient Satisfaction evaluatedInvolvement in care processPatient safetyPain managementSafe transportContinuity of careDr. J. L. Meena
  • 22. CoH2323www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratAvailability of Services at PHC levelSr Name of service Day Time1 OPD Services Daily ( Exceptholidays)Morning: 9.00 to 13.00Evening: 16.00 to 18.002 Certificates of age, fitness and sickness ,, ,,3 Lab services ,, ,,4 Homeopathic treatment ,, ,,5 Indoor services Daily 24 hours6 Delivery ,, ,,7 Emergency services ,, ,,8 Vehicle for referral ,, ,,9 Medico legal services ,, ,,10 MAMTA Clinic ( Immunization, medical checkup,treatment, IEC & Family planning services forexpectant mothers, children & adolescent)Monday 9.00 to 14.0011 NSV, Abdominal tubectomy , MTP & HydroceleoperatiponTuesday & Friday 9.00 to 16.0012 All National Programme Daily ( Exceptholidays)Morning: 9AM to 1 PMEvening: 4 to 6 PMDr. J. L. Meena
  • 23. CoH2424www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratList of Laboratory Services Available at PHCSr No Name of test Availability1 Hb Yes2 Blood Group Yes3 Sickeling Test Yes4 H.I.V. Yes5 Leptospirosis strip test Yes6 Pregnancy test Yes7 Blood Malaria Parasite (BMP) Yes8 AFB Yes9 Urine Sugar /Alb. Yes10 Routine urine Yes11 Bleeding Time/ Clotting Time Yes12 TC,DC,ESR Yes13 Syphilis Yes14 Typhoid Yes15 Water quality Yes16 Hb Electrophoresis YesDr. J. L. Meena
  • 24. CoH2525www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratList of services Outsourced at PHCProper Net working ofambulances with 108 for safereferral service.X -RAYSonographyGynaecologist services on call.Pediatric Services on call.Dr. J. L. Meena
  • 25. CoH2626www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeHigh Quality of Care cont…High Quality of Care cont…Dr. J. L. Meena
  • 26. CoH2727www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratProvided baby kits to new born forprevent Infection & hypothermiaDr. J. L. Meena
  • 27. CoH2828www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeHigh Quality of Care cont…High Quality of Care cont…Dr. J. L. Meena
  • 28. CoH2929www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeHigh Quality of Care cont…High Quality of Care cont…Dr. J. L. Meena
  • 29. CoH3030www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeHigh Quality of Care cont…High Quality of Care cont…
  • 30. CoH3131www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeQualitative Laboratory services…Qualitative Laboratory services…Dr. J. L. Meena
  • 31. CoH3232www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeManagement of Medicine…Management of Medicine…
  • 32. CoH3333www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratChange the Scenario…….Safety of patients & employees…Before AfterDr. J. L. Meena
  • 33. CoH3434www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratBefore AfterChange the Scenario….Biomedical waste practice…Dr. J. L. Meena
  • 34. CoH3535www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratChange the Scenario……Safe drinking water……Before AfterRO plant providedby TSP GrantDr. J. L. Meena
  • 35. CoH3636www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeQuality food services to patients & attendantsQuality food services to patients & attendants……CHC Bardoli, which catering Tribal Population
  • 36. CoH3737www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratRecreational & skill developmentDr. J. L. Meena
  • 37. CoH3838www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratRecreational & skill developmentDr. J. L. Meena
  • 38. CoH3939www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratRecreational & skill developmentDr. J. L. Meena
  • 39. CoH4040www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratRecreational & skill developmentDr. J. L. Meena
  • 40. CoH4141www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratRecreational & skill developmentDr. J. L. Meena
  • 41. CoH4242www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratRecreational & skill developmentDr. J. L. Meena
  • 42. CoH4343www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratOccupational Therapy UnitBehavior modificationtraining.Social skill training.Vocational Training.Day care servicesJob placement whereverpossible.Dr. J. L. Meena
  • 43. CoH4444www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratOccupational Therapy UnitDr. J. L. Meena
  • 44. CoH4545www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratOccupational Therapy UnitDr. J. L. Meena
  • 45. CoH4646www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratVocational therapyDr. J. L. Meena
  • 46. CoH4747www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratNO. OF DELIVERY AT PHCPHC:- Salun, Dist:- Kheda
  • 47. CoH4848www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratAdverse Donor ReactionBlood Bank:- Civil Hospital Ahmedabad
  • 48. CoH4949www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratIssue of ComponentsBlood Bank:- Civil Hospital Ahmedabad
  • 49. CoH5050www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratSpecimen AnalysisBiochemistry Lab:- Sir T Bhavnagar
  • 50. CoH5151www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratCritical value reportingBiochemistry Lab:- Sir T Bhavnagar
  • 51. CoH5252www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratSurgical Site Infection (SSI)Dist Hospital:- Gandhinagar
  • 52. CoH5353www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratBenefits to StaffProfessional staff developmentProvides education on laid down standardsProvides leadership for qualityimprovement within medicine and nursingIncreases satisfaction with continuouslearning, good working environment,leadership and ownershipDr. J. L. Meena
  • 53. CoH5454www.gujhealth.gov.in Health & Family Welfare, Govt of Gujarat% of film wasted in radiologydepartmentDist Hospital:- Gandhinagar
  • 54. CoH5555www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratProfessional staff developmentManagerial / Administrativetraining to MO / Head.Dr. J. L. Meena
  • 55. CoH5656www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratInduction training to staff atall levels.Job based skills training.Professional staff developmentDr. J. L. Meena
  • 56. CoH5757www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratSpecial clinical skill training on minorsurgical procedure, obstetrics care, newborn care, basic life support and localanesthesia block.Professional staff developmentDr. J. L. Meena
  • 57. CoH5858www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratNABH ACCREDITATION AWARD FUNCTION BYGOVT. OF GUJARAT & QCI, NEW DELHIDr. J. L. Meena
  • 58. Award for NABH Accredited PHC :- Primary Health Center - Kandolpada, Navsari-Gujarat, Govt of Gujaratgiven by Shri Jaynarayan Vyas, Hon’ble Health Minister, Government of Gujarat
  • 59. Award for NABH Accredited PHC :- Primary Health Center - Tankal, Navsari-Gujarat, Govt of Gujaratgiven by Shri Jaynarayan Vyas, Hon’ble Health Minister, Government of Gujarat
  • 60. CoH6262www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratImproves careBrings in Corporate GovernanceStimulates continuous improvementDemonstrates commitment to quality careRaises community confidenceOpportunity to benchmark with the bestBenefits to HospitalDr. J. L. Meena
  • 61. CoH6363www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratMain entrance should be easily identifiable,welcoming, well lit and with mattress.PHC Mahuwas, Tribal area PHCDr. J. L. Meena
  • 62. CoH6464www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeWelcoming infrastructure……CHC Bardoli, which catering Tribal PopulationDr. J. L. Meena
  • 63. CHC Bardoli, which catering Tribal Population
  • 64. CoH6666www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeDistrict Hospital Godhara (Tribal area)DH Godhara, which catering Tribal PopulationDr. J. L. Meena
  • 65. CoH6767www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratFICCI Healthcare Excellence Award toIndia’s 1stNABH PHC:- GadboriayadDr. J. L. Meena
  • 66. CoH6868www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality revolutionDisaster preparedness- Epidemics- PhysicalAccess to comparative databaseBenefits to CommunityDr. J. L. Meena
  • 67. CoH6969www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratAll the Services provided by PHC Gadboriadare displayed in all the villages & roadsideDr. J. L. Meena
  • 68. CoH7070www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratMock drill and training for disastermanagementAmbulance providedby TSP GrantDr. J. L. Meena
  • 69. CoH7171www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratMock drill and training for disastermanagementPHC Tankal, Kandolpada & Mahuwas, NavsariDr. J. L. Meena
  • 70. CoH7272www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratMock drill and training for disastermanagementPHC Tankal, Kandolpada & Mahuwas,NavsariDr. J. L. Meena
  • 71. CoH7373www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeInvolvement in National Programme…Involvement in National Programme…Dr. J. L. Meena
  • 72. CoH7474www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeInvolvement in National Programme…Involvement in National Programme…
  • 73. CoH7575www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeMalnutrition awareness…Malnutrition awareness…
  • 74. CoH7676www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement ProgrammeAIDS awareness programme…AIDS awareness programme…Dr. J. L. Meena
  • 75. CoH7777www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratPRI Monitoring & Evaluation of CHCDr. J. L. Meena
  • 76. CoH7878www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Healthcare Service toPoorest of the Poor.Dr. J. L. Meena
  • 77. CoH7979www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratEfficiency of Government hospitals as keycontributors for building trust and confidence forthe hospitals in the hearts of the citizens of theState through actively pursuing qualityimprovement programme in various facilities.Given a sense of pride to the government forensuring quality services to the poorest of thepoor.Confidence has been restored of thecommunity in Govt hospitalsBenefits to the GovernmentDr. J. L. Meena
  • 78. CoH8080www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratAward received by Government of Gujaratfor Quality ImprovementAppreciation awarded by QCI to Ministry of Health and Family WelfareGovernmentof Gujarat for establishing Quality Assurance framework in providing qualityhealthcare to the people of Gujarat in 5thNational Quality Conclave, New Delhi.Appreciation awarded to Department of Health and FamilyWelfare Government of Gujarat for their pioneering effort tospearhead the Quality and Accreditation Programme in healthcare organization. In 3rdInternational Health Care QualityConclaveFICCI Health care Excellence Award to Dist Hospital Gandhinagar & PHCGadboriad, Govt of Gujarat in FICCI Heal 2010, New Delhi Date: 6thSept2010FICCI Health care Excellence Award to Dist HospitalGandhinagar, Govt of Gujarat in FICCI Heal 2011,New Delhi Date: 8thSept 2011Dr. J. L. Meena
  • 79. CoH8282www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratStrategies Adopted forsustainability:•Appointment of Quality Assurance officers at State level, District level,Assistant Hospital Administrator (AHA) at facility level. We are designatedNABH Coordinators & NABL Directors at Facility level.•NABH lead assessor training (Total trained persons 290 for hospitals & PHC /CHC) & NABL Internal audit training (Total trained persons221) toadministrators, clinicians, paramedical & staff nurses etc.•Post Graduation Certificate Course in Quality Management and Accreditationof Health care Organization (PGQM & AHO) to the Additional Directors,Superintendents, Chief District Medical Officers, Clinicians and District QualityAssurance Officers (Total trained persons186) etc.•Other training as per requirement of NABH / NABL standards and mock drillsare being conducted.•New posts of clinicians, paramedical and other are sanction by Government ofGujarat as per requirement.•Extra budget as per requirement of NABH / NABL are sanction from 13thfinance commission, Government of Gujarat and NRHM.•Formation of the state level review committee under the Chairmanship ofCommissioner of Health, Medical Service & Medical Education and Membersecretary is State Quality Assurance Officer.Dr. J. L. Meena
  • 80. CoH8383www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratChallenges & SolutionChallenges Solution done by Govt. of GujaratInfrastructure Separate Project Implementation Unit (PIU) formedunder the Commissioner of Health.Manpower :- lack of Section posts Regular New posts (About 2200) are sanction by Govt.of GujaratManpower:- Vacant posts Campus Interview started in surrounding state e.g.Rajasthan, MP, Maharashtra etc.6 New Medical College start.Fund Section through Govt. of Gujarat, TSP, NRHM & Publicprivate partner though donation etc.Behavior & Motivation of thestaffsRegular skill development training & Award ceremonyMonitoring & Evaluation Regular Video conference, Meeting & HospitalInformation Management System (HIMS)Medical college Try to accredited Blood bank, laboratories & RadiologyDept. first for there motivation & confidence.Dr. J. L. Meena
  • 81. CoH8484www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratRoad AheadTo create a Quality culture basedon various standards which issustainable, affordable, equitable& reliable having state of arttechnology and which can be easyto follow and replicate.Dr. J. L. Meena
  • 82. CoH8585www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratIt has been a quality revolution which is a “rewarding experience”.The National delegates (Teams from Rajasthan, Bihar, Delhi, MadhyaPradesh, Kerala, Maharashtra, Chhattishghadh, Andhra Pradesh,Orissa, Karnataka etc) and International delegates(Nigeria, WHO, Ireland etc ) visited the organizations, observedtremendous changes and have commendable remarks “which werethought to be unattainable in public sector. thus setting up anexample for Health Care Organizations to deliver best health careservices to masses”.
  • 83. CoH8686www.gujhealth.gov.in Health & Family Welfare, Govt of GujaratQuality Improvement Programme:- GujaratDr. J. L. Meena
  • 84. CoH8787www.gujhealth.gov.in Health & Family Welfare, Govt of Gujaratwww.gujhealth.gov.inQuality Improvement ProgrammeEmail:- drjlmeena@gmail.comMobile No:- 09099075162Dr. J. L. Meena