Quality and Excellence in Healthcare: Best Practices
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Transcript of Quality and Excellence in Healthcare: Best Practices
Quality and Excellence in Healthcare: Best Practices
REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg
MINDANAO REGIONAL MANAGEMENT SEMINARPrivate Hospitals Association of the Philippines
April 30, 2014Marco Polo Hotel, Davao
Quality and Excellence in Healthcare: Best Practices
Greetings and SalutationsFrom
REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg0918-804-03-04
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
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
DelimitationsSpecificationsOperational definitions
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
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.
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.
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]
Quality and Excellence in Healthcare: Best Practices“Setting the Bar of Excellence in Healthcare”
“Best Practice” – a formally documented method or techniquethat has been institutionalized in the hospital andthat 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]
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
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.
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.
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.
Quality and Excellence in Healthcare: Best Practices“Setting the Bar of Excellence in Healthcare”
• Categorization:–low, medium, high, and highest levels of
excellence.
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.
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.
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).
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.
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.
Aiming for best practices in quality and performance excellence in hospitalsProgram
med Journey of Excellence
Parent Best Practice
Aiming for best practices in quality and performance excellence in hospitalsProgram
med Journey of Excellence
Parent Best Practice
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.
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.
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!!!
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.”
Quality and Excellence in Healthcare: Best Practices
Welcome feedback and queries
REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg0918-804-03-04
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
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
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.
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
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.
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)
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.
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.
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)
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!!!
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.
Quality and Excellence in Healthcare: Best Practices
Welcome feedback and queries
REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg0918-804-03-04
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.”
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
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
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
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
How to aim for best practices in quality and performance excellence in hospitals
Comprehensive set of “Best Practices” in a Hospital
Systems perspective in governanceIntegrated value-based health care servicePhysician engagement (patronage and loyalty)Maximal utilization of services with controlled expenses and lossesCustomer delightFull compliance with the quality and performance standards (local and international)Integrated IT-enabled operations systemStaff engagementLearning organizationCSR program with tangible social impact
ROJ’s Recommended Steadfast Strategic Objectives for Hospitals
Develop one Best Practice per Category
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
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
Quality and Excellence in Healthcare: Best Practices
Welcome feedback and queries
REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg0918-804-03-04
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
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
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”
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”
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
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.”
Quality and Excellence in Healthcare: Best Practices
Welcome feedback and queries
REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg0918-804-03-04
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
Quality and Excellence in Healthcare: Best Practices“Setting the Bar of Excellence in Healthcare”
“Best Practice” – a formally documented method or techniquethat has been institutionalized in the hospital andthat 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]
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)
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)
Examples of best practices in quality and performance excellence in hospitals
• Strategic Planning • Balanced Scorecard
TPOR1: Journey towards performance excellence of MDH and CMZ
Strategic Planning ConferencesEvery 3 years since 1999
With a structured frameworkWith Annual Planning Conferences
Strategic Planning ConferencesEvery 3 years since 2009
With a structured frameworkUsing Baldrige / PQA Criteria
TPOR1: Journey towards performance excellence of MDH and CMZ
Balanced ScorecardSince 2004
Performance management and evaluation tool
Balanced ScorecardSince 2009
Performance management and evaluation tool
Quality and Excellence in Healthcare: Best Practices
Welcome requests for more info
REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg0918-804-03-04
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
Quality and Excellence in Healthcare: Best Practices
Thank you for your attentionWelcome feedback, queries, and requests for info and assistance
REYNALDO O. JOSON, MD, MHA, MHPEd, MSc Surg0918-804-03-04