A doctor takes care of a baby in HCM City-based
Children Hospital No 1. There is still a gap between policy objectives and
operations in hospitals, a pilot programme on national hospital quality
assessment says. — VNA/VNS Photo Chí Tưởng
A pilot
programme on national hospital quality assessment has resulted in positive
results, but a gap between policy objectives and operations still exists,
hospital officials have said.
"The
Ministry of Health’s 83 criteria on quality have been applied at all hospitals,
but more effort is needed," Lương Ngọc Khuê, director of medical services
administration, said at the third National Hospital Quality Forum that wrapped
up yesterday in HCM City.
The
quality assessment results will be publicised to motivate hospitals to improve
quality.
Despite
improvements, a number of hospitals, however, still do not recognise the role
of quality improvement and have not changed their minds on the role of patients
and health workers, according to Khuê.
Tăng Chí
Thượng, deputy director of HCM City’s Department of Health, said that treatment
incidents still occurred, causing dissatisfaction among patients.
He said
patients and families could call the Health Department’s hotlines to report
complaints about behaviour or treatment by hospital staff.
Hospitals
are still not paying sufficient attention to the management of compliance with
treatment protocols and prescriptions, according to Thượng.
The
application of IT in administrative procedures has not been done consistently,
and the hospital environment is not always safe and secure for patients and
health workers.
He
attributed the quality of health services to overcrowding and facilities that
have not kept pace with the development of professional techniques in
hospitals.
To
improve medical exam and treatment capacity, the department has piloted several
models, including emergency networks, an inter-hospital code blue process, and
hemodialysis at commune health stations and satellite departments of the city’s
hospitals and district-level hospitals.
The
Ministry of Health’s quality assessment criteria is an important legal basis
for hospital quality improvement to reduce complaints and patient
dissatisfaction.
The
department’s health service quality management council has set five objectives:
safer, better, faster, cheaper and more satisfied.
Results of Rapid Assessment goals
Jose
Cardona, EU Health Facility director, said there was a gap between the national
Quality Management and Quality Improvement (QM/QI) policies and the outcomes
reflected in daily operations.
Predominant
use of the national Quality Management Criteria is focused on scoring and not
on the elimination of essential deficits, according to results of a Rapid Check
conducted by experts at 13 health facilities.
Of the 13
facilities that have implemented the QM/QI policies, three hospitals said that
it was difficult to measure many of the quality management criteria.
Because
of training deficits, most of the strategies, priorities or activities are more
or less theoretical documents.
In
addition, hospitals have been constrained by the difficult mix of in-patients,
out-patients and many family members.
Patient
identification, quality of care and control of patient falls are also part of
QM/QI policies at most hospitals.
Many care
activities must be done by relatives such as patient transport, feeding,
washing and moving in and out of bed.
Patient
falls are focused only on floors and not on other situations such as transport,
falls from beds, and patient monitoring in difficult situations.
Besides
these issuses, medication was found not to be stored or controlled well.
Hand
hygiene, which is emphasised in QM policies, has not been implemented well,
according to the assessment.
Waste
management concepts and fire safety are also not being managed properly under
QM/QI.
Four of
the hospitals said that that specific training in QM/QI as well as in
management was not available. Three hospitals said they did not know how to
integrate QM/QI into management policies.
The Rapid
Check, which was conducted by one expert over a three to four hour period on
average per facility, showed deficits and risks in general and the main needs
for improvement.
A limited
number of modified criteria were used for the Rapid Assessment, with main focus
on implementation of quality/safety, patient care, hygiene, medication,
infrastructure, fire safety and staff safety.
Cardona
said that specific training regarding QM/QI and its systems and tools as well
as modern hospital management training should be conducted, and that the
national quality criteria must be updated and clarified.
At the
two-day forum, the national Medical Services Administration, in collaboration with
the European Union Health Facility, distributed a manual on good practices in
quality management to all 500 forum participants.
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