26-28 March 2019 Saitama, Japan
Meeting Report
ACCELERATING HEALTH-CARE QUALITY AND SAFETY IMPROVEMENT IN
TRANSITIONAL ECONOMY MEMBER STATES –
COLLABORATIVE WORKSHOP 3
Accelerating Health-Care Quality and Safety Improvement in Transitional Economy Member States–Collaborative W orkshop 3 26-28 March 2019 Saitama, Japan
WORLD HEALTH ORGANIZATION
REGIONAL OFFICE FOR THE WESTERN PACIFIC
RS/2019/GE/08(JPN) English only
MEETING REPORT
ACCELERATING HEALTH-CARE QUALITY AND SAFETY IMPROVEMENT IN TRANSITIONAL ECONOMY MEMBER STATES –
COLLABORATIVE WORKSHOP 3
Convened by:
WORLD HEALTH ORGANIZATION
REGIONAL OFFICE FOR THE WESTERN PACIFIC
Saitama, Japan 26–28 March 2019
Not for sale Printed and distributed by:
World Health Organization Regional Office for the Western Pacific
Manila, Philippines
June 2019
NOTE
The views expressed in this report are those of the participants of the Accelerating Health- Care Quality and Safety Improvement in Transitional Economy Member States – Collaborative Workshop 3 and do not necessarily reflect the policies of the conveners.
This report has been prepared by the World Health Organization Regional Office for the Western Pacific for Member States in the Region and for those who participated in the Accelerating Health-Care Quality and Safety Improvement in Transitional Economy Member States – Collaborative Workshop 3 in Saitama, Japan from 26 to 28 March 2019.
CONTENTS
SUMMARY ... 1
1. INTRODUCTION ... 3
1.1 Background ... 3
1.2 Meeting objectives ... 3
2. PROCEEDINGS ... 3
2.1 Reviewing country work plans ... 4
2.2 Clinical governance ... 5
2.3 Hospital accreditation ... 5
2.4 Conflict management ... 6
2.5 Safety monitoring and reporting system ... 6
2.6 Hospital performance monitoring and quality indicators ... 6
2.7 Developing longer-term plans ... 7
3. CONCLUSIONS AND RECOMMENDATIONS ... 7
3.1 Conclusions ... 7
3.2 Recommendations ... 7
3.2.1 Recommendations for Member States ... 7
3.2.2 Recommendations for WHO ... 7
ANNEXES ... 9
Annex 1. Summary of 12-month action plans by country ... 9
Annex 2. List of participants, temporary advisers, observers and Secretariat ... 16
Annex 3. Programme of the meeting ... 19
Annex 4. Opening remarks of Dr Takeshi Kasai, WHO Regional Director for the Western Pacific .. 20
KEYWORDS:
Patient care / Quality Assurance, Health Care / Delivery of health care – standards / Regional health planning
SUMMARY
The World Health Organization (WHO) Regional Office for the Western Pacific is implementing a regional initiative to support transitional economy Member States to improve their health-care quality and safety and advance towards universal health coverage (UHC). The initiative is based on a multidisciplinary science-of-improvement approach comprising capacity-building, innovation, rapid- cycle field testing and spread.
The Accelerating Health-Care Quality and Safety Improvement in Transitional Economy Member States – Collaborative Workshop 3 was held in Saitama, Japan, from 26 to 28 March 2019. The workshop, co-hosted with the National Institute of Public Health, Japan, is the last of three planned collaborative workshops convened as part of activities in implementing the regional initiative on securing national systems for quality and safety. Twenty-one participants from the five countries (Cambodia, China, the Lao People’s Democratic Republic, Mongolia and Viet Nam) attended the third collaborative workshop.
During the workshop, the participating countries reviewed the plan–do–study–act (PDSA) cycle that they had implemented over the past six months and analysed their progress and what was left undone.
They shared with each other their challenges and lessons learnt. The experience of other countries gave them an opportunity to expand their knowledge on relevant topics, such as clinical governance and hospital accreditation systems. At the end of the workshop, the participants designed their longer- term plans for the next 12 months based on their existing implementation plans of the national policy/strategies for quality and safety.
The key aims for the 12-month action plans by countries are as follows:
Country Aims
Cambodia To increase the utilization of health centre services with improved quality of services
China To organize a China National Venous Thromboembolism
(VTE) Prophylaxis and Treatment Union
To investigate the practicability of the simplified assessment scale for the psychological status of common patients
Lao People’s Democratic Republic To improve health-care quality and patient safety Mongolia To strengthen health-care quality and patient safety
Viet Nam To implement the Incident Reporting System
1. INTRODUCTION 1.1 Background
Quality is core to universal health coverage (UHC) and is a key attribute on which health systems need to improve their performance. Improving service quality and safety is part of national health plans, strategies and policies, and it has been a stated priority for transitional economy Member States. However, efforts have been fragmented and uncoordinated, as many countries lack a systems- building approach as well as an institutional culture of continuous quality improvement.
The World Health Organization (WHO) Regional Office for the Western Pacific is implementing a regional initiative to support transitional economy Member States to improve their health-care quality and safety and advance towards UHC. The initiative is based on a multidisciplinary science-of- improvement approach comprising capacity-building, innovation, rapid-cycle field testing and spread.
Five transitional economies – Cambodia, China, the Lao People’s Democratic Republic, Mongolia and Viet Nam – established national collaborative networks on securing systems for quality and safety and conducted a stocktake of existing efforts and implementation bottlenecks on improving quality and ensuring patient safety. Based on the situational analysis and discussions on addressing current challenges, countries have developed plan–do–study–act (PDSA) rapid field testing plans of innovative solutions at the Accelerating Health-care Quality and Safety Improvement in Transitional Economy Member States – Collaborative Workshop 1 in September 2018 in Melbourne, Australia.
They reconvened at the second collaborative workshop in December to review implementation and further refine PDSA plans with technical experts.
The third collaborative workshop was held in Saitama, Japan, from 26 to 28 March 2019, in collaboration with the National Institute of Public Health, Japan. This third workshop aimed at evaluating the country PDSA plans and providing further capacity-building on topics relevant to their quality improvement work. Twenty-one participants from the five countries attended the third collaborative workshop. The list of participants is available in Annex 1 and the meeting programme in Annex 2.
1.2 Meeting objectives
The objectives of the workshop were:
1) to share lessons learnt from the implementation of rapid field testing of the PDSA cycle;
2) to review the implementation process and areas for improvement; and
3) to reach a common understanding on the next steps in quality and safety at the national level.
2. PROCEEDINGS
The workshop commenced with opening remarks by Dr Yasumasa Fukushima, President of the National Institute of Public Health. Mr Toru Kajiwara, Director of the Office of Global Health Cooperation at the Ministry of Health, Labour and Welfare of Japan, also welcomed all participants to the workshop. Dr Yu Lee Park, Acting Coordinator for Integrated Service Delivery, delivered opening remarks on behalf of Dr Takeshi Kasai, WHO Regional Director for the Western Pacific.
2.1 Reviewing country work plans
In the first session, Dr Azhar Ali, Head of Middle East and Asia Pacific, Institute for Healthcare Improvement, guided participants in the group work to review the PDSA cycle over the past six months and analyse their progress, what was left undone and challenges. Countries shared their situation and lessons learnt.
Participants from Cambodia monitored their progress with process indicators collected before and after the implementation. Their challenges were:
limited knowledge of health workers on clinical vignette in outpatient (OPD) and maternal and child health (MCH) services;
low knowledge of outpatient staff and midwives on teamwork, communication and community engagement;
lack of appropriate data collection tools for patients with noncommunicable diseases (NCDs), as well as materials and medicines in most of the health centres;
lack of follow-up with patients by health centre staff;
need for improved drug management systems; and
limited capacity of community leaders.
Participants from China explained what they have done to achieve their two action plans. They identified concrete needs, especially regarding venous thromboembolism (VTE) prophylaxis, such as:
changing physicians’ behaviour;
raising community awareness about VTE; and
more funding for anticoagulation drugs for VTE prevention.
Participants from the Lao People’s Democratic Republic briefly summarized their progress, including organizing a national workshop on quality and safety and developing 60 policy checklists. However, they have not been able to set up standard operating procedures (SOPs) for a baseline survey because no national policy is available.
Participants from Mongolia had developed draft quality and safety standards and conducted their planned patient satisfaction survey. However, they still had outstanding activities to fully realize their objectives, such as:
needing to develop a methodology to implement the indicators since clinical staff (such as medical doctors and nurses) are not familiar with the indicators;
completing the quality and safety standards and pilot; and
defining the process and outcome indicators.
Participants from Viet Nam reported achieving their goal of increasing incident reporting, but they found several challenges, such as:
patient safety culture;
working environment where health-care staff have no time to report incidents due to the overwhelming number of patients;
need to protect incident reports from social media pressure; and
national-level leadership, such as policy and approval, for activities.
2.2 Clinical governance
Dr Ali gave a presentation on quality management system and clinical governance. Clinical governance is a component of the national quality strategy. According to the British model, the concept, though it may differ by country context, consists of: clinical audit, clinical effectiveness, research and development, openness (transparency of clinical practice), risk management, and education and training. The WHO Handbook for National Quality Policy and Strategy will guide policy-makers from planning to implementation of quality through the eight key elements required to produce such a policy and strategy. Stakeholder engagement is also an important component of clinical governance and patient safety culture.
He explained what differentiates quality assurance and quality improvement. Due to its origins in manufacturing, quality assurance is focused on removing anything that does not meet specific quality standards or targets. On the other hand, quality improvement focuses on implementing a change process towards better quality. Both concepts are necessary for health care, for example quality assurance for laboratory tests and quality improvement for performance. He added that, for quality assurance/control, guidelines and standards are needed in the system but do not improve its performance, and monitoring is needed to determine the current situation. Other interventions that bring about change are required to improve the performance of health-care staff or facilities.
Dr Kok Hian Tan, Group Director of SingHealth Duke–NUS Institute for Patient Safety and Quality, and Ms Nguk Lan Pang, Director of Quality, Safety and Risk Management and Medical Administration, briefly shared their experiences with stakeholder engagement in clinical governance and building the right patient safety culture in Singapore. They had achieved this by introducing various activities such as patient safety champions, training workshops and competency development, and an engagement platform.
2.3 Hospital accreditation
Mr Naohiro Wakisaka, Senior Advisor at the Japan Council for Quality Health Care (JQ), started his lecture with a definition of quality care and patient safety and the Council’s definition of medical safety.
After a brief introduction of the Japanese health system, he explained the work of JQ and the accreditation systems. He also traced the history of the Council with its establishment in 1995 and the commencement of hospital accreditation in 1997, highlighting the involvement of multiple stakeholders including the Ministry of Health, Labour and Welfare, the health professional associations and the National Federation of Health Insurance Societies. JQ has been accredited under the International Accreditation Programme (IAP) of the International Society for Quality in Health Care (ISQua) since 2013.
Compared to the mandatory annual public inspection, which is an obligation by law with a penalty on hospitals not meeting the requirement, the features of the hospital accreditation are optional, voluntary, done every five years and carries no penalty on health facilities.
The flow of the hospital accreditation system of JQ was explained. It starts with a document review and on-site survey by a multidisciplinary team of surveyors, leading to evaluation by three committees, before culminating in a final accreditation result. The accreditation standard is applied depending on hospital function, such as acute care, chronic care, rehabilitation and psychological care,
however, indicates that accreditation uptake was proportionately lower among private hospitals compared to public sector hospitals, although more private hospitals were accredited in absolute numbers. Also, larger hospitals were shown to be accredited to a greater extent than smaller ones.
2.4 Conflict management
Dr Hiroyuki Kojin, Specially Appointed Professor at the Department of Clinical Quality and Medical Safety Management, University of Yamanashi Hospital, gave a presentation about medical conflict management based on the experience in Japan. He outlined the principles of mediation, which is often the initial attempt to deal with medical disputes before legal options. With reference to the social cognitive framework, which finds that every person interprets a matter differently from others based on experience, knowledge, standpoint, culture, age and sex, he emphasized the importance of sharing information and understanding interests that underlie conflicts. He also highlighted the decrease in the number of medical lawsuits in Japan following the beginning of the medical conflict management movement in 2005. Nowadays, training courses on conflict mediation are available in Japan.
Ms Doungnapa Pichetkul, Director of the Bureau of Consumer Service and Right Protection at the National Health Security Centre, shared her experience in Thailand. About 900 out of 1000 hospitals in Thailand have an in-hospital complaint centre that communicates and mediates between patients, their families and health workers.
2.5 Safety monitoring and reporting system
Dr Nor’ Aishah Abu Bakar presented via videoconference on the Malaysian patient safety monitoring and reporting system. The system started as a part of the country’s quality assurance programme and was later changed to an online reporting system with a simplified reporting procedure. With appropriate leadership by the Ministry of Health and empowerment for all categories of staff, the number of incident reports has significantly increased, and various types of incidents have been reported. She highlighted the importance of action by decision-makers to ensure improvement, such as producing guidelines based on the issues reported.
Dr Irina Papieva, Consultant, Patient Safety and Risk Management at WHO headquarters, gave a presentation on the vision, concept and approach for patient safety. She explained that patient safety is an important cornerstone of UHC and that all elements of health systems should be considered for designing patient safety intervention. In addition, patient safety priorities should be set based on country-specific context. She introduced WHO’s global work on patient safety: the global collaborative network, the global ministerial patient safety summits and the third global health challenge to reduce the level of severe, avoidable harm related to medication use by 50% over five years.
2.6 Hospital performance monitoring and quality indicators
Dr Kenichiro Taneda, Chief Senior Researcher at the Department of International Health and Collaboration of the National Institute of Public Health, introduced the ongoing work to develop a conceptual framework and compendium of indicators to support the Regional Action Framework on Improving Hospital Planning and Management in the Western Pacific (2018).
Dr Taneda clarified the scope of hospitals mapping care level, care setting and continuum of care. He explained hospital performance assessment dimensions, subdimensions and indicators referring to several conceptual models, such as the WHO model and the Organisation for Economic Co-operation and Development (OECD) model. Participants had the opportunity to provide inputs on the
conceptual framework and highlight existing work on monitoring hospital performance within their countries.
2.7 Developing longer-term plans
In the last session of the second day, participants worked in country groups to develop their longer- term plans for the next 12 months. Participants were asked to reflect on the feedback received on their previous PDSA plans, as well as new knowledge from the experts and experience shared by the other participating countries over the first two days of the meeting. All countries presented their longer- term plans on the last day of the workshop. A summary of the longer-term plans of participating countries can be found in Annex 3.
3. CONCLUSIONS AND RECOMMENDATIONS 3.1 Conclusions
Improving health-care quality and patient safety is core to achieving UHC. However, countries still face challenges in strengthening their systems at the national and facility levels. During this workshop, participants shared with each other their challenges and lessons learnt through the implementation of the action plans over the past six months. In addition, they had an opportunity for further learning on relevant topics, such as clinical governance and hospital accreditation systems, from the experience of other countries.
Participants recognized that:
The strategy and policy for quality and patient safety should be tailored to national context of each country and respond to national priorities and needs.
Sharing and learning from the experience of other countries is important to find solutions as some countries are facing or have faced common challenges.
More efforts are required to empower people at all levels of health care, including providers and patients/community, towards improved quality and patient safety.
Finally, participants were able to identify priority actions to further improve health-care quality and safety in their countries, building on their previous efforts.
3.2 Recommendations
3.2.1 Recommendations for Member States
Member States are encouraged toconsider the following:
1) Establish an environment and culture of quality and safety through the implementation of their 12-month plans.
2) Prioritize their activities based on country situation and previous discussion at the national level.
3) Identify and use existing opportunities for national- and provincial-level activities for efficient use of resources.
3.2.2 Recommendations for WHO
WHO is requested to consider the following:
1) Provide continued technical support for implementation of the 12-month action plan of each
2) Facilitate information sharing and dissemination of experiences of the Member States through the regional collaborative network.
3) Collaborate with relevant technical programmes to support implementation of the action plans on quality and safety more effectively.
ANNEXES Annex 1. Summary of 12-month action plans by country
Cambodia 12-month Plan (April 2019 – March 2020)
Aim To increase the utilization of health centre services with improved quality of services
Goal A-Follow up 42 health centres (HC) in three provinces (Kompong Speu, Kompot, Kompong Thom) had:
I-Improve quality of essential service package and function of selected health centres to expand service II-Expanding of essential service packages at selected health centres
III-Increase individual, family and community engagement for health protection and health promotion at selected villages B- Develop and implement quality and safety reporting system for 42 HCs and 5 additional hospitals
2019 2020 Who will do? TA needed
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar A
1 Improve supervision and monitoring at subnational level to improve upgrade-skilling coaching of health centre staff
DHS/QAO WHO/HEQIP/
Gov
2 Improving health centre leadership and management, including integrated supervision
DHS/QAO/
NatPro WHO/HEQIP/
Gov 3 Strengthening infection control, hygiene and
medical waste disposal
DHS/QAO/
NatPro
WHO/HEQIP/
Gov
B
1 Identify minimum set of quality and safety indicators for HCs and RHs
DHS/QAO/DPHI/PHD/OD WHO/HEQIP/
Gov
2 Develop and implement reporting system
DHS/QAO/DPHI/PHD/OD WHO/HEQIP/
Gov 3 Support Health facilities in implementing reporting
system through supervision
DHS/QAO/DPHI/PHD/OD WHO/HEQIP/
Gov 4 Integrate the reporting system into HMIS
routine reporting system
DHS/QAO/DPHI/PHD/OD WHO/HEQIP/
Gov
10 China 1 12-month Plan 1 (April 2019 – March 2020)
Aim Organize China National VTE Prophylaxis and Treatment Union
Goal 50 national demonstration centres over the country (＞400 facilities applied) Inpatient VTE risk assessment rate increase to 80%
Suitable VTE prophylaxis rate increase 20% overall, 25% in surgical cases and 15% in medical cases Establishing VTE KPI database in 100 facilities
2019 2020 Who will do? TA needed
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
1 11th National Congress on PE and Pulmonary Vascular Diseases
CMC
2 National prophylaxis manual and VTE guideline
CVPO WHO/
WHOWPR 3 National Demonstration Centre
Certification
CVPO Expert
Committees 4 National VTE Prophylaxis
Training Project in 5 cities
CVPO Expert
Committees 5 Modified Medical Care Quality
Management and Control Criteria for specific Disease (VTE )
NIHA NHC
6 Regional VTE Union in 10 provinces
CNDCs NHC
7 Database linked into 50 facilities CVPO Technical and
financial support 8 National VTE Prophylaxis and
Treatment Alley
CVPO WHO/
WHOWPR
China 2 12-month Plan 2 (April 2019 – March 2020)
Aim To investigate the practicability of the simplified assessment scale for the psychological status of common patients, providing a reliable psychological reference for the development of following diagnosis and treatment of patients. Then, the system, process and management standards and norms for psychological screening and evaluation of the patients can be designed, which provide implementation plan for standardized, reasonably and effectively evaluating patient psychology in China.
Goal Create a simplified assessment scale for the psychological status scale form of ordinary patients, provide guidance about intervening of patients with psychological problem, promote use of psychological status scale form in China.
2019 2020 Who will do? TA needed
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
1 Ethical approval of the control studies of the “two-expectation and eight-question” scale and SCL-90 scale was implemented in each hospital.
Each hospital
2 Training of assessment worker using SCL-90
Each hospital
3 Enlarge scale of use in china, plan to more 300 hospitals
Every hospital
4 Create an Outpatient-specific and emergency-specific scale form and use it
Project team
5 Create a guideline about intervention of patients with psychological problem
Mental specialist
6 Apply for set up of project from National Health Commission
Project team and
NHC 7 Enlarge scale of assessment of
patients, including assessment of patients of social economical and his family etc.
Project team
12 Lao People’s Democratic Republic 12-month Plan (April 2019 – March 2020)
Aim Improving health care quality and patient safety
Goal Set up indicators for the healthcare quality and patient safety
Guideline for monitoring and evaluating in health facility, training of trainers (TOT), implementation, monitoring and evaluation
2019 2020 Who will do? TA needed
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
1 Meeting with WHO country office to modify check list
Team WHO
2 Set up indicators for the healthcare quality and patient safety
Team WHO
3 Guideline for monitoring and evaluating in health facility
Team WHO
4 TOT for central hospital Team WHO
5 TOT for local hospital Team WHO
6 Implementation into health facility Team WHO
7 Monitoring and Evaluating Team WHO
8 Annual meeting Team WHO
9 Reporting to WHO Team WHO
Mongolia 12-month Plan (April 2019 – March 2020)
Aim To introduce quality and safety standards for national accreditation
To implement quality and patient safety indicators to healthcare settings To have a policy documents on patient safety
To move from patient satisfaction to patient experience
Goal To strengthen health care quality and patient safety in Mongolia
2019 2020 Who will do? TA needed
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
1 To define and classify the quality indicators which initiated
MOH
CHD Working group 1-a To develop the methodology for each
indicator for quality and patient safety
MOH
CHD Working group 1-b For methodology development to invite
consultant from WHO and others
MOH WHO
WHOCO 1-c On completion of the list of quality
indicators, start to implement to health care facilities.
MOH
Hospitals 2 To improve and finish up the quality and
safety standards
MOH
CHD Working group 2-a To develop the methodology for
accreditation standards
2-b For methodology development to invite
consultant from WHO and others
MOH WHO
WHOCO 2-c Pilot the new standards in health care
facilities.
MOH
Hospitals 2-d Start to implement the new standards for
accreditation
MOH
CHD
14
2019 2020 Who will do? TA needed
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
3 To develop the policy document (standard…) for patient safety
MOH
3-1 To adopt patient engagement tools of WHO and others
MOH
3-2 To organize meeting and discussion with NGOs and associations of the patient representatives
MOH
3-3 To provide education and training on patient safety for medical
professionals
MOH
CHD 4 To conduct survey or situational
analysis on medical conflict in all level of hospitals.
MOH
CHD 4-1 Discussion on medical conflict at
network meeting
Network members
5 Move from patient satisfaction survey to patient experience
MOH
CHD 5-1 To develop and adopt the
questionnaire for patient experience
MOH
Working group 5-2 Start to implement survey for
hospitals
MOH
Mongolia 12-month Plan (April 2019 – March 2020)
Aim To introduce quality and safety standards for national accreditation
To implement quality and patient safety indicators to healthcare settings To have a policy documents on patient safety
To move from patient satisfaction to patient experience
Goal To strengthen health care quality and patient safety in Mongolia
Viet Nam 12-month Plan (April 2019 – March 2020)
Aim Implementing Incident Reporting System (IRS)
Goal • At least 30 Hospitals (average 8%) will apply the national IRS
• At least 04 RCA (root causes analysis) meetings will be organized and recommendations given
• Guideline for incident report will be issued
• At least 02 training courses on patient safety and reporting will be given
• At least 02 articles on patient safety will be published in mass media
2019 2020 Who will do? TA needed
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
1 Launching the conference - MOH
- OS 2 Establishing Technical Working
Group - Collect data - Root cause analysis
Feedback (MOH, hospital -> staff)
- MOH
- Hospitals
3 Testing software - Users - Confidential
4 Scaling up to nationwide (software)
- 10% in big hospitals
(Provincial and national hospitals) 5 Training course
- Safety awareness - Encourage reporting - Guidelines
- MOH
- Hospitals - Partners’ supports
6 Revising - MOH
- Technical Team 7 Communication and social
advocacy
- MOH
- Hospitals
Annex 2. List of participants, temporary advisers, observers and Secretariat 1. PARTICIPANTS
Dr LO Veasnakiry, Director, Department of Planning and Health Information, Ministry of Health, Phnom Penh, Cambodia, Tel. No.: +855 2342 6372, Email: [email protected]
Dr SOK Srun, Director, Department of Hospital Services, Ministry of Health, Phnom Penh, Cambodia, Tel. No.: +855 1291 2122, Email: [email protected]
Dr SOK Po, Deputy Director, Hospital Services Department, Ministry of Health, Phnom Penh, Cambodia, Tel. No.: +855 1298 5126, Email: [email protected]
Dr LIM Taing, Deputy Director, Khmer-Soviet Friendship Hospital, Ministry of Health, Phnom Penh, Cambodia. Tel. No.: +855 12 367 969; Email: [email protected]
Dr ZHANG Qin, Director, Department of Quality Administration, Hangzhou, Zhejiang, China, Tel. No.: + 86135 8888 7282; Email:[email protected]
Dr LU Yong, Chief, Medical Affair Section, Ruijin Hospital, Shanghai 200025, China, Tel. No.: +86189 1776 2053; Email: [email protected]
Dr LENG Tingting, Senior Officer, Bureau of Medical Administration, National Health Commission Beijing, China, Tel. No.: +86010 6879 1856, Email: [email protected], [email protected] Dr GAO Quian, Hospital Doctor, China-Japan Friendship Hospital, Beijing, China, Tel. No.: +86010 8420 6269, Email: [email protected]
Dr RATTANA Sommana, Head of Administration of Division, Health Care Department, Ministry of Health, Vientiane, Lao PDR. Tel. No.: +85620 5561 4968; Email : [email protected] Dr LOUANGPRADITH Viengsakhone, Deputy Head Medical Administration Department, Mittaphab Hospital, Vientiane, Lao PDR. Tel. No: +856 21 710 663;
Email:[email protected]
Associate Professor Bouathep PHOUMINDR, Deputy Director, Department of Health Care and Rehabilitation, Ministry of Health, Vientiane, Lao People’s Democratic Republic,
Email: [email protected]
Dr Phisith PHOUTSAVATH, Director General, Mahosot Hospital, Ministry of Health, Vientiane, Lao People’s Democratic Republic, Email: [email protected]
Dr GUR-OSOR Oyuntsetseg, Officer in charge for Accreditation of Health Organizations, Department of Medical Services, Ministry of Health, Ulaanbaatar, Mongolia, Tel. No.: +976-9919 2744, Email: [email protected]
Dr AMARJARGAL Yadam, Head, Division of Health Quality and Patient Safety, Department of Medical Services, Ministry of Health, Ulaanbaatar, Mongolia. Tel. No.: +976-9903 0894; Email:
Dr Od JIGJIDSUREN, Director-General, Department of Health, Sukhbaatar, Selenge Province, Mongolia, Tel. No.: +976-9904 3444, Email: [email protected]
Dr Gantsetseg DORJSUREN, Director-General, Center for Health Development, Ulaanbaatar, Mongolia, Tel. No.: +976-99111179, Email: [email protected]
Dr TRA Ton Thanh, Manager, Hospital Quality Management Department, Cho Ray Hospital, Ho Chi Minh City, Viet Nam, Tel. No.: +84 903673451, Email: [email protected]
Dr NGUYEN Trong Khoa, Deputy Director, General Medical Service Administration, Ministry of Health, Hanoi, Viet Nam, Tel. No.: +84 246 2733021, Email: [email protected]
Dr HAN Viet Trung, Deputy Head of Quality Management Department, Bach Mai hospital, Hanoi, Viet Nam, Tel. No.: +84 909 186688, Email: [email protected]
Ms NGUYEN Quynh Chi, Secretary of the Board of Director, Duc University Hospital, Hanoi, Viet Nam, Email: [email protected]
2. TEMPORARY ADVISERS
Dr Azhar ALI Head of Middle East & Asia Pacific, Institute of Healthcare Improvement, Boston, Massachusettes, United States of America, Email: [email protected]
Dr Shinichiro NODA, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama Shinjuku-ku, Tokyo 162-8655, Japan, Tel. No.: + 813 3202 7181, Email: [email protected]
3. RESOURCE PERSONS
Dr Hiroyuki KOJIN, Specially Appointed Professor, Department of Clinical Quality and Medical Safety Management, University of Yamanashi Hospital, 1110, Kamikawahigashi, Chuo City, Japan, Tel. no.: +81 552731111, Email: [email protected]
Mr Naohiro WAKISAKA, Senior Advisor, Department of Quality Improvement, The Japan Council for Quality Health Care, 1-4-17, Toyo Building, Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan, Tel. No.: +81 03 5217 2320, Email: [email protected]
4. OBSERVERS/REPRESENTATIVES
Professor Kok Hian TAN, Group Director SingHealth Duke – NUS Institute for Patient Safety &
Quality, 31 Third Hospital Ave #03-03 Bowyer Block C, Singapore 168753, Tel. No.: +6563941319, Email: [email protected]
Ms Nguk Lan PANG, Director of Quality, Safety and Risk Management and Medical Administration, KK Women’s and Children’s Hospital, Singapore, Email: [email protected]
Ms Doungnapa PICHETKUL, Director, Bureau of Consumer Service and Right Protection, National Health Security Office, Bangkok, Thailand, Email: [email protected]
Ms LI Xiying, Dean, Medical Quality Management Department, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an City, Shaanxi Province, China. Tel. No. : +86139 9131 6636 / 8629 8767 8430; Email: [email protected]
5. SECRETARIAT
<World Health Organization>
Dr Yu Lee PARK, Acting Coordinator, Integrated Service Delivery, Division of Health Systems WHO Regional Office for the Western Pacific. Email: [email protected]
Dr Ogochukwu CHUKWUJEKWU (Responsible Officer), Technical Officer, Integrated Service Delivery, Division of Health Systems, WHO Regional Office for the Western Pacific. Email:
Dr Mai INADA, Junior Professional Officer, Integrated Service Delivery, Division of Health Systems, WHO Regional Office for the Western Pacific. Email: [email protected]
Dr VU Dinh Huy, Short-term Consultant, WHO Country Office for Viet Nam, 304 Kim MA Street, Ha Noi, Viet Nam, Email: [email protected]
Dr Irina PAPIEVA, Consultant, Patient Safety and Risk Management, Department of Service Delivery & Safety, World Health Organization, Genève 1211, Switzerland, Email: [email protected]
<Ministry of Health Labour and Welfare>
Mr Toru KAJIWARA, Director, Office of Global Health Cooperation, International Affairs Division, Minister’s Secretariat, Ministry of Health, Labour and Welfare, 1-2-2, Kasumigaseki, Chiyoda-ku, Tokyo 100-8916, Japan, Email: [email protected]
<National Institute of Public Health>
Dr Tomofumi SONE, Vice President, National Institute of Public Health, 2-3-6 Minami, Wako-shi, Saitama 351-6111, Japan, Email: [email protected]
Dr Hiroko MIURA, Director, Department of International Health and Collaboration, National Institute of Public Health, 2-3-6 Minami, Wako-shi, Saitama 351-6111, Japan, Email:
Dr Kenichiro TANEDA, Chief Senior Researcher, Department of International Health and Collaboration, National Institute of Public Health, 2-3-6 Minami, Wako-shi, Saitama 351-6111, Japan, Email: [email protected]
Dr Takuya MATSUSHIGE, Senior Researcher, Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako-shi, Saitama 351-6111, Japan, Email:
Annex 3. Programme of the meeting
Time Tuesday, 26 March 2019 Time Wednesday, 27 March 2019 Time Thursday, 28 March 2019
08:30 –09:00 Registration
09:00 – 10:00 1.1 Welcome and Opening
NIPH,
Japan MHLW,
WPRO RD (ISD ai)
Meeting objectives
Admin announcements
Group Photo
09:00 – 10:30 2.1 Clinical governance
Presentation – Dr Azhar Ali
Discussion Facilitator: Dr Yu Lee Park
09.00 – 10.30 3.1 Safety monitoring and reporting system
Presentation – Dr Nor’Aishah Abu Bakar
Discussion Facilitator: Dr Yu Lee Park 10:00 – 10:30 Coffee/ tea break 10:30 – 11:00 Coffee/ tea break 10.30 – 11.00 Coffee/ tea break
10:30 – 12:30 1.2 Reviewing country PDSA workplans
Group work by country team
Lessons, outcomes, challenges, what’s left undone
Facilitator: Dr Azhar Ali
11:00 – 12:30 2.2 Hospital accreditation
Presentation – Mr Naohiro Wakisaki
Exercise/ discussion Facilitator: Dr Ken Taneda
11.00 – 12.30 3.2 Hospital performance monitoring and quality indicators
[consultation on the hospital performance indicators]
Facilitator: Dr Ken Taneda
12:30 – 13:30 Lunch 12:30 –13:30 Lunch 12.30 – 13.30 Lunch
13:30 – 15:00 1.3 Reviewing country workplans
Feedback from group work
Discussion Facilitator: Dr Azhar Ali
13:30 –15:30 2.3 Conflict management
Presentation – Dr Hiroyuki Kojin
Question and answer
Hands-on exercise on conflict management
13.30 – 15.00 3.3 Finalizing longer term plans
Finalization of plans from second day
Group feedback on next steps in operationalizing longer term plans
Facilitator: Dr Shinichiro Noda 15:00 – 15:30 Coffee/ Tea break 15:30 – 16:00 Coffee/ tea break 15.00 – 15.30 Coffee/ tea break
15:30 – 17:00 1.4 Hands-on exercise
Teamwork training: How to work as a team
Facilitator: Dr Ken Taneda
16:00 – 17:00 2.4 Developing longer term plans Based on training topics, identify:
Main actions for quality improvement in the medium term
TA required
Facilitator: Dr Shinichiro Noda
15.30 – 16.30 3.4 Closing
NIPH
WPRO 17:00 Welcome Reception
Annex 4. Opening remarks of Dr Takeshi Kasai, WHO Regional Director for the Western Pacific
Good morning ladies and gentlemen:
1. I am very pleased to welcome you all to the third collaborative workshop for accelerating health-care quality and safety improvement in transitional economy Member States in the Western Pacific Region.
2. I also take this opportunity to thank the Ministry of Health Labour and Welfare Japan for their support for this meeting and the President and staff of the National Institute of Public Health, for hosting us in the lovely and serene city of Wako.
3. Dr Takeshi Kasai, WHO Regional Director for the Western Pacific, regrets not being able to join us due to previous commitments. He has asked me to send his regards and deliver these words.
4. All people and communities, everywhere in the world, should have access to safe and high-quality health services – promotive, preventive, curative, rehabilitative or palliative – without facing financial hardship. This is the vision of universal health coverage.
5. WHO’s regional action framework Universal Health Coverage: Moving Towards Better Health recognizes quality as one of five core health system attributes that must be strengthened to accelerate progress towards UHC and to realize the vision of the 2030 Agenda for Sustainable Development.
6. While efforts to achieve UHC have focused on expanding coverage of essential health services and financial protection, health outcomes would remain poor if services were unsafe or poor quality.
7. Across the Region, we continue to see and read about incidents of treatment errors and health facility-acquired infections that are preventable. This threatens our joint efforts towards universal health coverage and the achievement of the SDGs in the Western Pacific Region.
8. Ensuring patient safety is the first step. But preventing harm is not enough. High- quality care should be safe, effective, efficient, timely, integrated, equitable and people-centred.
9. Quality does not come automatically. Quality needs to be built into the foundations of the health system. It is a product of continuous and complex interventions at the facility and health system levels.
10. We need to invest in the care environment and the workforce. Proven interventions and practices need to be implemented. These include infection prevention and control, treatment protocols, checklists, education, reporting and feedback, performance benchmarking and facility accreditation.
11. Member States in the Western Pacific Region are making efforts to improve and institutionalize a culture of quality and safety across their health systems.
12. The regional collaborative network on health-care quality builds on the efforts in the Member States to secure links between policy and implementation, and strengthen institutional arrangements for quality and safety.
13. Over the past six months, you have participated in the first and second regional collaborative workshops looking at the existing efforts and challenges in our Member States. In Melbourne, you developed pilot projects to improve quality in your health systems and facilities and in Manila, you were able to review your progress and refine your plans.
14. At this third workshop, we hope you will share what you have been able to achieve, the lessons you have learnt in implementing these pilot projects, the challenges you have faced and how you will take this forward beyond the meeting in your daily work.
15. As always, WHO stands ready to support Member States to achieve universal health coverage, good health and well-being for all. We hope this multidisciplinary approach to continuous quality improvement will result in better health outcomes in countries as part of their progress towards UHC.
16. Thank you for your active participation, and I wish you all a fruitful workshop.
17. Thank you.
