1 Annual Health Summit 2005 2 Vision ASSURE A HEALTHY, PRODUCTIVE LIFE BY IMROVING PHYSICAL, SOCIAL,...
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Transcript of 1 Annual Health Summit 2005 2 Vision ASSURE A HEALTHY, PRODUCTIVE LIFE BY IMROVING PHYSICAL, SOCIAL,...
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Vision
ASSURE A HEALTHY , PRODUCTIVE LIFE BY IMROVING PHYSICAL, SOCIAL, MENTAL
AND SPIRITUAL WELL-BEING OF THE PEOPLE
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Mission To make curative care User friendly, More accessible, Comprehensive cost efficient and, to the satisfaction of the people in North Western Province of Sri Lanka
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North Western Province of Sri Lanka consists of two districts, Kurunegala and Puttlam.
Population in NWP = 2,157,711 Population in K’gala = 1,452,369 Population in Puttlam = 705,342
Persons per Sq. km : Kurunegala – 314 Puttlam - 245
( Colombo - 3305 Kandy - 664 Gampaha - 1541 )
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Government curative care network at present One Teaching Hospital – at Kurunegala,
administered by line ministry. One General Hospital – at Chilaw ( Putlam District )
Two Base Hospitals in Kurunegala District, Kuliyapitiya Nikaweratiya Two Base Hospitals in Puttlam District, Puttlam Marawila.
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Government curative care network at present
Kurunegala District 15 District Hospitals 12 Peripheral Units 14 Rural Hospitals 01 CD & MH 54 CDs
Puttlam District 04 District Hospitals:
03 Peripheral Units:
06 Rural Hospitals: 05 CD & MH:
19 CDs : Other : STD, Chest, Filaria, Malaria and Leprosy ClinicsOut reach Specialized Clinics:Maternal care:.DH Dankotuwa and DH Mundalama
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Distribution of specialists per 100,000 population
Kurunegala – 2.13 Puttlam - 2.26 ( Colombo – 8.72, Kandy – 6.83, Gampaha – 3.43 ) Distribution of Medical Officers per 100,000 population
Kurunegala – 25.8 Puttlam - 29.8 ( Colombo – 112.1, Kandy – 68.1, Gampaha – 30.3 ) Distribution of Dental Surgeons per 100,000 population
Kurunegala -- 3.6 Puttlam - 2.7 ( Colombo – 9.1, Kandy – 4.2, Gampaha – 2.4 ) Distribution of Nurses per 100,000 population
Kurunegala – 83.2 Puttlam - 43.7 ( Colombo –167.8, Kandy – 141.5, Gampaha – 52.4)
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Government Hospital Bed Strength per 1000 population
Kurunegala – 2.8 Puttlam - 2.2 (Colombo – 4.9, Kandy – 4.2, Gampaha – 2.4 ) Out-patient attendance by district per 1000 population
Kurunegala – 2627.5 Puttlam - 1969.0 (Colombo – 2417.2, Kandy –2670.4, Gampaha –1640.1 ) In-patients treated by district per 1000 population
Kurunegala – 224.0 Puttlam - 163.6 (Colombo – 307.2, Kandy – 267.9, Gampaha – 144.5 ) Number of patients transferred for specialized care Kurunegala – Puttlam - Average Bed Occupancy rate Kurunegala – Puttlam -
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Major issues identified
Over crowding of secondary and tertiary care institutions and under utilization of primary care institutions.
Emergency care services are not well established in all institutions to deliver necessary care to the people who deserve emergency attention.
In- adequate staff skills and poor attitudes of some categories to provide quality , user satisfied care.
Cost benefits of some supportive services such as laboratory, ambulance, and cleaning are low
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Over crowding of secondary and tertiary care institutions and under utilization of primary care institutions.
Major institutions Individual attention is low High incidence of cross
infections Congested environment Long waiting time Essential problems are not
dealt with Opportunity cost is high for
patients In-adequate basic facilities High incidence of mistakes
due to over work
Primary care level Cost per patient is high Staff is idling Certain malpractices
Solutions suggest Back & forward referral system Improve facilities in primary
care level Appoint necessary cadre to
Divisional & PMCU level
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Emergency care services are not well established to deliver necessary care to the people who deserve emergency
attention. Death within one hour after
admission is high Customer satisfaction is low Rush to private sector paying
high cost expecting quick care
Transfer rate of lower level institutions is high
Available skill is not utilized Big hospital overcrowding
would go down Utilization of lower level would
go up
Poor staff skill development
Solutions suggest Assure ETUU in all health
care institutions Appoint qualified cadre Provide necessary
equipment Continuous skill
development programmes Ambulance facilities
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Conflicts are high Customer satisfaction is low Low quality service delivery More patients seek care
from bigger institutions Poor Image to the hospital
Solutions suggest Adopt proper recruitment
procedures Introduce performance
appraisal system Regular staff development
progrannes
Poor commitment and skills of some categories o staff to provide quality , user satisfied care.
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Cost benefits of some supportive services such as cleaning, diet and laboratory are low
Cleaning work force idling Poor cleaning of
environment
Solutions suggest Proper recruitment Out-sourcing
Laboratory Operational cost is high Regular breakdown Non skilled operation due to
shortage of technical knowledge
Solutions suggest Building up close link with
private sector Staff development
programmes
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Objectives
•To provide Infra – structure facilities to obtain expected services from identified institutions•To improve service provision according to the need and to the satisfaction of the people•To develop staff skills and attitudes to deliver quality service•To achieve close link with other health partners to make health services more accessible and qualitative•To develop a system to monitor and evaluation of services giving more attention on regular medical audit
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Proposed hospital network
General Hospital Chilaw and Kuliyapitiya
Base Hospitals: Puttlam, Nikaweratiya, Marawila and Galgamuwa
Divisional Hospitals: All existing District, Peripheral Units and Rural Hospitals.
Primary Medical Care Units; CDs and CD/MH
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Expected services from different category of Hospitals General Hospitals Make available comprehensive emergency care
through out the day Assure availability of residential specialized care
and out door care in all major specialties Assure a wide range of investigation facilities Provide comprehensive care to all needy people
in minimum waiting time Facilities to staff skill development provide information on any health related matter
by a special unit established
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Expected services from different category of hospitals
Base Hospitals Make available emergency care by a separate
unit 24 hours a day Assure availability of selected minor specialized
fields with high demand (out-door and in-door care) in addition to basic fields
Assure availability of a wide range of investigation facilities
Provide comprehensive care to all needy people in minimum waiting time
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Expected services from different category of hospitals Divisional Hospitals Limited emergency care for 24 hours. In-ward facilities for common minor illnesses Poly clinic facilities with, out - reach
specialized clinics Maternity care and labour room facilities Medical recording and referral centre Dental unit Availability of ambulance through a radio link
with other institutions
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Improve the efficiency of supportive services
CLEANING
Proper recruitment or out - source of services is recommended for cost effective & high quality service with management with ease
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Improve the efficiency of supportive services
DRUGS Assure availability of essential drugs in all
health care institutions
Establish a Drug Management unit at each DPDHS Office under direct supervision of Divisional Pharmacist
A Pharmacist/RMO of Drug Management Unit should order, transport from MSD to RDS, and handed over to store keeper at RDS
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Improve the efficiency of supportive services DRUGS Store keeper should take care of all the drugs
and issue to relevant institutions according to the instructions of Drug Management Unit.
improve drug transport facilities Improve facilities of stores in institutions to
reduce pilferage and spoilage Issue drugs in envelops with instructions of use Make people aware of cost of drugs
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Improve the efficiency of supportive services DIET Special Dietary Units are established in all
hospitals, above Base Hospital level, under supervision of a nutritionist
Most suitable diet is given to individual patient
Wastage is reduced by restructuring of diet schedules for staff and patients
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Develop a system to monitor and evaluation of services
Number of new specialized units started during the year
No of out reach clinics commenced for the year per district
Percentage of institutions above divisional Hospitals do have 24 hour ETU facilities
Percentage of Primary Care Units with Medical recording and referral unit
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Develop a system to monitor and evaluation of services
Number of deaths within one hour after admission per year
Number of public complaints received per month
Number of drugs out- of stock marked on prescriptions per month
percentage of institutional heads received management training per year
DR. RESHAN AMARASEKERA – DMO Kuliyapitiya
DR. DEMATAPITIYA – DMO Nikaweratiya
DR. M.FAREED – DMO Puttlam
DR. U.R. SIRIMANNE – DMO Galgamuwa
DR. D.K.SIRIMANNE – VP Chilaw
DR. M.A.M.FERNANDO – V Paed. Kuliyapitiya
DR. A PANADARE – VOG Nikaweratiya
DR. J.RANATUNGE – DMO Gokarella
DR. U.S.B.RANASINGHE – DMO Dankotuwa