FICCI

QUALITY IN HEALTHCARE DELIVERY:MARCHING TOWARDS GLOBAL STANDARDS

WITH LOCAL TOUCH.

THE MALAYSIAN EXPERIENCE

BY

Assoc. Prof. Dr Kadar Marikar

CEO,MSQH

7 September 2010

PRESENTATION OUTLINE

1.Introduction on Malaysian Healthcare and Quality in Healthcare Direction and Strategies.

2.Quality Improvement Activities in Action.

3.Regulatory, Statutory requirements and Enforcement.

4.Global Standards with Local Touch and

International Certification.

MALAYSIAN HEALTH SECTOR:

MINISTRY OF HEALTH Inpatient care services

-Total 140 hospitals-Primary-Secondary-Tertiary

-Specialized services(Range of beds 40-2000)

Public Health Services

Out-patient services: -Health Centre (10,000 centre) -Community Clinics (2,000 Clinics) (Estimated every 5 kilometers radius -> 1CC)

-In remote areas: Flying Doctors Services.

Preventive and Health Promotion services

Medical Training Institutions-University Hospitals: 3

Ministry Of Defense: 4 Hospitals.

Private Sectors

-Private Hospitals: 328 (Range of beds 2-350 beds)

- Private Medical clinics: 6000

- Maternity Centres :

- Hemodialysis centers :

- Day care centers :

- Nursing Homes:

Corporatised Hospital : National Heart Institute (IJN)

323 beds.

Ministry of Health Malaysia

• Provides the leadership and direction for the healthcare industry in the country.

• Enforcement arm• Driver for Safety and Quality improvement

activities in the country.• Plans for the future development of healthcare

services through the 5 year Malaysia Plans. (with participation of public and private sectors, professional bodies and consumers).

VISION FOR HEALTH

Malaysia is to be a nation of healthy individuals, families and communities, through the health system that is equitable, affordable, efficient, technologically appropriate, environmentally adaptable and consumer friendly, with emphasis on quality, innovation, health promotion and respect for human dignity and which promote individual responsibility and community participation towards an enhanced quality of life.

Strategic Plan For Quality

• Late 1996 & 1997: Evaluation of 17 Quality Initiatives in MOH was carried out at National Level.

• Outcome of the evaluation was deliberated in the 1998 National Conference on Quality in Health Care held in March 1998.

• A Strategic Plan for Quality was developed and implemented. This is due for review.

ENHANCED QUALITY OF LIFE

MEDICAL STAFF

LEADERSHIP

ORGANISATIONAL CULTURE & VALUES

FOCUS ON

PATIENT

FOCUS ON

PROCESS

QUALITY

SAFETY COMPETENCY

APPROPRIATENESS

EFFICIENCY

ACCESSIBILITY

CONTINUOUS QUALITY IMPROVEMENT

COMPETENCY

PEOPLE FOCUSEFFECTIVENESS

QUALITY MEASUREMENT FRAMEWORK

MSQH

OPERATIONAL MODEL

STRUCTURESTRUCTURE

Facilities and systems

STRUCTUREPROCESS

Healthcare activities

STRUCTUREOUTCOME

Outcomes of care

Quality Improvement Activities in Action

Hospital based: Since 1986

-The building blocks

QUALITY IMPROVEMENT ACTIVITIESQUALITY IMPROVEMENT ACTIVITIES IN MALAYSIAN HOSPITALS IN MALAYSIAN HOSPITALS

• NATIONAL INDICATOR APPROACH (NIA)NATIONAL INDICATOR APPROACH (NIA)• HOSPITAL SPECIFIC APPROACH (HSA)/HOSPITAL SPECIFIC APPROACH (HSA)/• DISTRICT SPECIFIC APPROACH (DSA)DISTRICT SPECIFIC APPROACH (DSA)• MATERNAL MORTALITY REVIEW/MATERNAL MORTALITY REVIEW/• PERINATAL MORTALITY REVIEWPERINATAL MORTALITY REVIEW• PERIOPERATIVE MORTALITY REVIEW (POMR)PERIOPERATIVE MORTALITY REVIEW (POMR)• MEDICAL AUDITMEDICAL AUDIT• TOTAL QUALITY MANAGEMENTTOTAL QUALITY MANAGEMENT• QUALITY CONTROL CIRLCEQUALITY CONTROL CIRLCE• QUALITY CONTROLQUALITY CONTROL• INFECTION CONTROLINFECTION CONTROL• CLINICAL PRACTICE GUIDELINES (CPG)CLINICAL PRACTICE GUIDELINES (CPG)• INCIDENT REPORTINGINCIDENT REPORTING• CORPORATE CULTURECORPORATE CULTURE• CLIENT’S CHARTERCLIENT’S CHARTER• INNOVATIONSINNOVATIONS• RENAL REGISTRY RENAL REGISTRY • Credentialing and PrivilegingCredentialing and Privileging• Specialist RegisterSpecialist Register• Accreditation of Healthcare Facilities and ServicesAccreditation of Healthcare Facilities and Services

ACTS , REGULATIONS AND ENFORCEMENT

• PRIVATE HOSPITALS ACT 1971

• PRIVATE HEALTHCARE FACILITIES AND SERVICES ACT 1998

• REGULATIONS 2006

• Others Related to Healthcare services

Safety and Quality

ORGANISATIONAL ASSESSMENT

• 1997-1999 Introduction of Hospital service standards

• Adopted from the Australian Standards• Customised to Malaysian Healthcare service

and patients needs.• Implementation in 2000.Voluntary• In 2008 Standards upgraded and to comply to

ISQua Accreditation Principles and• Inclusion of WHO patient safety strategies

AccreditationOf Healthcare

Facilities

Tool to =Demonstrate Accountability

Building, Sustaining and Uplifting Organizational Quality and Accountability

The Malaysian Healthcare

Accreditation Program

1st October 1999

Memorandum of Understanding

Active Participation of the Public, Private Sectors & Professional Organisations

PARTNERSHIP&

CONSENSUS

COLLABORATION&

SUPPORT

MOH

APHMMSQH

MMA

Organizational wide Service Standards 1.Governance, Leadership and Direction

2.Environmental and Safety Services

3.Facility Management and Safety

4.Nursing Services

5.Prevention and Control of Infection

6.Patient and Family Rights

7.Health Information Management System (HIMS)

STRENGTHENING OF PATIENT SAFETY STRATEGIES AND

INDICATORS INTO THE 3RD EDITION MSQH HOSPITAL ACCREDITATION

STANDARDS

II. Service Standards

8. Emergency Services 9. Clinical Services (Generic) - Specific Requirements for Specialist Services 9A Cardiology Services 9B Oncology Services 9C Rehabilitation Medicine Services

10. Anaesthetic Services11. Operating Suite Services12. Ambulatory Care Service13. Critical Care Services (Generic) Applicable for: ICU,

CCU, NICU & PICU - Specific Requirements 13A Labour /Delivery Services

14. Diagnostic Imaging Services15. Pathology Services16. Blood Transfusion Services 17. Allied Health Professional Services (Generic) - Specific Requirements 17A Physiotherapy Services 17B Occupational Therapy Services 17C Dietetics Services 18. Pharmacy Services19. Central Sterile Supply Services 20. Housekeeping Services21. Linen Services 22. Food Services 23. Forensic Medicine Services 23A Mortuary Services24. Standards for General Applications

3rd Edition MSQH Hospital Standards

• Private Healthcare Facilities and Services Act 1998 and Regulation 2006

• ISQua Accreditation Principles and Standards

• WHO World Alliance on Patient Safety

• Outcome focus

• International Certification

Achievement of MSQH Hospital Accreditation

Between 2000 to 2009:

• 80% of public hospitals (district hospitals without specialist and with specialist and tertiary levels) have received certification.

• 20% of major private hospitals received certification.

Thank you for your attention Thank you for your attention www.msqh.com.my

msqh@msqh.com.my