observerQuality is something that everyone strives for. People flock to where there is evidence of quality services in terms of timely delivery, service satisfaction on the product that will give you positive outcomes, positive attitude from service providers etc. 

They value life more that money. Once customers start complaining about your services it means the trend has been broken, you need to go back to the drawing board and involve the very service consumers to find out where the gaps are for you to precisely address them. Ensure the operating systems are effective and efficient. The Rights of the customers should always be observed.

In response to some of the requests made to the program I will give a brief introduction of the program so that the community can understand the background of the programme then we will move on periodically since a lot has been done by the program; however a lot is still yet to be done to reach our destiny. The good effort done by the program is evident if you get to the health facilities. More will be achieved through a collaborative network with all key players from the ministry of health top level leadership and other stakeholders including the community. You have a right to information; my duty is to disseminate it.

Background

In 2007, the ministry of health embarked in some reforms to improve service delivery and health outcomes. These reforms emanated after the review of the National Health Policy (NHP) and National Health Strategic plan 2008-2013. The Quality Assurance program was established as direct response to the NHP 2007 which requires that the health sector ensures provision of quality health services that are relevant and also improve access to affordable health care services to all citizens regardless of their socio- economic status. Furthermore, it was response to public outcry on the decline of health care service delivery in health facilities andattitude of health care providers resulting to clients receiving poor service satisfaction. 

Quality Assurance (QA) activities recognize that standards, guidelines, policies, protocols, good leadership and governance, essential equipment, medicines and supplies, appropriate infrastructure, monitoring and evaluation etc. must be in place and requirements met in order to maximise the potential for achieving desired health outcomes, hence the development of the EHCP which aims at achieving the major goals of the National Health Policy (2007) as mentioned above. Quality is defined by standards. We cannot talk of quality unless there are set standards. Hence quality is a crosscutting phenomenon. The Swaziland Medical and Dental Council and Nursing Council have defined Standards of practice and Code. This aims at shaping the image of the medical and nursing profession within   the health sector. 

Roar of “The Lion”

His Majesty KMIII has implored the nation to work towards reaching the 1st World status in 2022.The Swaziland Government has responded promptly by convening a big stakeholders meeting to develop a plan of action to that effect. Applying the quality improvement and management concepts and methodologies including the ISO 9001:2008 (Quality Management System) is a vehicle towards the 1st World status. These approaches can be used by all ministries, organisations, communities and Corporate Partners to achieve quality results. Some Organisations have actually adopted the concept and methods and are using them in their day to day activities. They have amazingly institutionalised quality management.For those who have not started implementing quality improvement and management system, this is the time. Allow me to first share some key quality termsfrom the health perspective,and then we can move on together.

Quality Terms:
What is quality? – 

  1. a). Quality – (According to standards) …proper performance of interventions that are known to be safe, affordable to the society in question, and have the ability to produce an impact on morbidity, mortality, Disability and malnutrition. (M.I. Roemer and C. Montoya Aguilar WHO 1988)
    1b).Quality: is the degree to which a health or social service meets or exceeds established professional standards and client expectations
  2. Quality Assurance:  is that set of activities that are carried out to set standards and to monitor and improve performance so that the care provided is as effective and as safe as possible.”
  3. Quality Improvement: is a continuous process of addressing gaps in service delivery which involves setting and monitoring the achievement of set targets.
  4. Quality of Care: Is the degree to which health services for individuals and Populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
  5. Customer Care: is a requirement for any organisation to ensure that intended services are utilised by customers to satisfy their needs 
  6. What is a standard?
    • A standard is an optimal level of achievement against which performance is measured, or a statement of expected performance against which measurement and/or judgment takes place. It includes performance standards, product specifications, clinical practice guidelines, administrative or management procedures

In order to assess whether we are making any improvement and progress, we need to measure/monitor and evaluate regularly

Functions of a Standard:

  • The quality assurance function – giving confidence to customers that the services are what they are claimed to be
  • The quality management function – defining, planning, organising and achieving goals
  • The social responsibility function – managing the impact of operations on other stakeholders
  • The integrated management functions- visualizing the organisation as a system of interconnected processes and managing these processes so as to satisfy the expectations of all stakeholders. 
  1. Monitoring: Is the routine reporting of data on implementation and performance it involves tracking of processes for improving the quality of health service delivery, because quality is always evidence based
  2. Evaluation: is a process that systematically and periodically investigates effectiveness, efficiency, ownership, impact and sustainability

The key AIMS of the Quality Management program in the MOH

  • To enforce good public practices and ensure provision of high standards of health services delivery in accordance with the laws of the kingdom of Swaziland.
  • To strengthen leadership and Governance through ISO 9001:2008. (QMS)
  • Strengthen Supplies chain management (Pharmaceuticals and equipment etc.)
  • Ensure Human resources/Staffing norms requirements are met
  • To ensure availability and compliance to Infrastructure standards 
  • Improve and strengthen Customer care service satisfaction systems
  • Strengthen Data use and management systems through Monitoring and Evaluation.
  • To share results and celebrate successes

Health Standards Documents:

The MOH in collaboration with SWASA has been able to come up with Health Standards documents for Hospitals, Health centres and Clinics in order to effectively and efficiently improve its performance. This is one of the vehicles towards ISO Certification and Accreditation of health facilitiesin Swaziland. The standards documents were officially handed over to the ministry by SWASA in July 2012. The documents were disseminated to all regions for implementation.

From the SZNS 008:2012 for General Hospitals and Health Centres- Requirements can I share the Patients and Family Rightstandard and clauses and the milestone made by the MOH in that regard since the ministry is Customer focused.
Standard 9.2 clauses9.2.1

“The Facility shall inform each Patient at the time of admission of Patients’ rights and support the exercise of the Patients’ Rights” (question is does this happen?) if done the patients will attest to that and documentation in the patients file will show evidence.

9.2.4 States that “The Patients’ Rights Charter shall be displayed such that it is visible and easy to read” (evident compliance on this clause seen in facilities).

To the reader I want to share that the Ministry of Health through the Quality Assurance Program has been able to develop The Charter in English and SiSwati then disseminated it to all Public health and four Private health facilities for display in strategic areas as part of compliance to the Standard Customer Care requirements. The facilities are therefore required to come up with an action plan that will state how they will be able to meet each of those rights. The plan will be monitored periodically to see if it is well implemented or not.

To my colleagues and other disciplines in all levels of health care I want to encourage them to continue complying with the Patients’ Rights so as to contribute to the Customer service satisfaction as these form part of patients’ expectations. Maintain efficiency in service delivery and display competence. Don’t forget that our patients are customers,

“ACUSTOMER IS A KING” Always wear a smile since“Quality is a smile” it is like a “password” in patient management.
As we enter to the year 2015, let us aim for implementing services to the satisfaction of our customers, ensure consistent adequate supplies of medicines and medical supplies, strengthen our leadership and governance system, maintain cleanliness in our facilities, good communication skills with our patients/clients, timely service delivery, apply the Quality improvement and management approaches, aim for institutionalization of quality management systems etc.

LET’S STRIVE FOR EXCELLENCE IN HEALTH CARE
HAVE A PROSPEROUS NEW YEAR!

By: Thulile Dlamini
MOH- Quality Assurance Manager
E-mail: thulilat@yahoo.com
Cell: 76068158

Source: http://www.observer.org.sz/features/69127-quality-management-in-health-care-part-1.html

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