Quality assurance in primary health care
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QUALITY ASSURANCE IN PRIMARY HEALTH CARE. ASIF IMAM, M.D. MARCH, 2011. THE ORIGINS OF SINA HEALTHCARE SYSTEMS. STARTED AS A PROTOTYPE PRIMARY HEALTH FACILITY IN BALDIA TOWN, KARACHI IN 1998 OBJECTIVES : To evaluate the existing primary healthcare systems in Pakistan

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Quality assurance in primary health care

QUALITY ASSURANCE IN PRIMARY HEALTH CARE

ASIF IMAM, M.D.

MARCH, 2011

SINA HEALTH EDUCATION AND WELFARE TRUST


The origins of sina healthcare systems

THE ORIGINS OFSINA HEALTHCARE SYSTEMS

STARTED AS A PROTOTYPE PRIMARY HEALTH FACILITY

IN BALDIA TOWN, KARACHI IN 1998

OBJECTIVES :

  • To evaluate the existing primary healthcare systems in Pakistan

  • To develop an indigenous, practical, evidence-based, quality-managed, auditable primary healthcare system for developing countries


Vision

Vision

  • Quality primary healthcare should be accessible to everyone in our society

SINA HEALTH EDUCATION AND WELFARE TRUST


Our quality mission

Our quality mission

TO DEVELOP A STANDARDIZED, QUALITY-MANAGED,

INDIGENOUSLY COMPATABLE PRIMARY HEALTHCARE

SYSTEM FOR WIDESPREAD APPLICATION IN PAKISTAN

SINA HEALTH EDUCATION AND WELFARE TRUST


Sina healthcare system and quality assurance

SINA Healthcare System And Quality Assurance

SINA HEALTH EDUCATION AND WELFARE TRUST


Development of quality management components

DEVELOPMENT OF QUALITY MANAGEMENT COMPONENTS

  • STANDARD OPERATING PROCEDURES

  • QUALITY MANAGEMENT DOCUMENTS AND PROCEDURES

  • TRAINING OF STAFF IN THE STANDARDIZED SYSTEM

  • QUALITY AUDITING PROCEDURES AND TOOLS

  • REMEDIAL AND REPRIMANDING POLICIES ON AUDIT RESULTS


Sina healthcare quality management components

SINA HEALTHCARE QUALITY-MANAGEMENT COMPONENTS

  • DOCTOR TO PATIENT HEALTHCARE DELIVERY QUALITY

  • PARAMEDIC TO PATIENT HEALTHCARE DELIVERY QUALITY

  • PHARMACY TO PATIENT SERVICE QUALITY

  • LABORATORY SERVICES QUALITY

  • INFECTIOUS DISEASE CONTROL / FACILITY HYGIENE QUALITY

  • MEDICAL INSTRUMENTS CALIBERATION / MAINTENANCE

  • FACILITY ADMINISTRATION / PATIENT SATISFACTION QUALITY


Recordkeeping system

Recordkeeping System:

Registration Card

Patient Files

SINA HEALTH EDUCATION AND WELFARE TRUST


Doctor to patient healthcare delivery quality

DOCTOR TO PATIENT HEALTHCARE DELIVERY QUALITY

  • DOCTOR RECRUITMENT CRITERIA

  • PRE-EMPLOYMENT ( INDUCTION) SYSTEM TRAINING

  • DOCUMENTING OF PATIENT CARE ON QUALITY MONITORING TOOLS

  • AUDIT OF DOCUMENTED PATIENT HEALTHCARE

  • ON-GOING ON JOB RE-TRAINING (CME)

  • REMEDIAL MEASURES OR REPRIMAND ON QUALITY AUDIT RESULTS


Employment system

Employment System:

  • Doctors Selection Criteria:

    • Family Medicine experience

    • FCPS / MRCGP, prefered

    • Entrance Test

  • Pre-employment ( Induction) Training

    • To be system trained before doing clinics

SINA HEALTH EDUCATION AND WELFARE TRUST


Candidate evaluation form

Candidate Evaluation Form


Sina cme

SINA CME

SINA HEALTH EDUCATION AND WELFARE TRUST


Quality assurance in primary health care

Feedback on

MCQ and SMS

performance

Monthly

audit and

1-to1 teaching

CME SMS Service

X3/ week

CME

Half yearly 1-to-1 review

and PDP development

Monthly

½ day

group teaching

Pre-reading

materials

Learner-led

sections

Pre and post

Session MCQs


Quality assurance in primary health care

  • Recordkeeping System

    • Patient Files

    • Patient Registration Cards

    • 14 Algorithmic Protocols

Compromise On Quality

SINA HEALTH EDUCATION AND WELFARE TRUST


Quality assurance in primary health care

FEVER

PROTOCOL


Sina audit system

SINA Audit System

SINA HEALTH EDUCATION AND WELFARE TRUST


Monthly doctors audit

Monthly Doctors’ Audit:

  • Protocol based audits

  • Clinic based audits

  • Proper one to one feedback to every doctor

  • Review for improvement every month

  • Proper record keeping

SINA HEALTH EDUCATION AND WELFARE TRUST


Protocol based audit

Protocol Based Audit


Clinic based audit

Clinic Based Audit


Half yearly evaluation of doctors

Half Yearly Evaluation Of Doctors

  • Every six months

  • Record of the last 6 months performance

  • One to one feedback

  • Discuss about the weaknesses and solutions for improvement

  • Personal development planning forms

SINA HEALTH EDUCATION AND WELFARE TRUST


Half yearly evaluation form

Half Yearly Evaluation Form


Pdp form

PDP form


Sina paramedics evaluation

SINA Paramedics Evaluation

SINA HEALTH EDUCATION AND WELFARE TRUST


Sina health manpower training program internal

SINA Health Manpower Training Program : Internal

  • Lack of quality human resource

  • Training upon employment

  • Continuous education

  • Periodic exams & evaluation

  • Performance feedback


Sina paramedics osce

SINA Paramedics OSCE

SINA HEALTH EDUCATION AND WELFARE TRUST


Quality assurance in primary health care

OSCE CHECKLIST


Tpr station

TPR Station:


Dressing station

Dressing station:


Dispensing station

Dispensing station:


Sina pharmacy system

SINA Pharmacy System

SINA HEALTH EDUCATION AND WELFARE TRUST


Sina pharmacy services

SINA Pharmacy Services

  • Standard Formulary

  • GMP Certified Medicines

  • Central Purchasing

  • FIFO Inventory Control

  • Hygienic Practices

  • Trained Staff

  • Quality Control

SINA HEALTH EDUCATION AND WELFARE TRUST


Sina laboratory services

SINA Laboratory Services

SINA HEALTH EDUCATION AND WELFARE TRUST


Laboratory quality control

LABORATORY QUALITY CONTROL

  • Internal Assessment

    • Continuous quality improvement

  • External Assessment

    • Monthly comparative testing with AKUH lab

    • Adherence to SOP manuals

    • Quarterly audits


Sina infrastructure maintenance

SINA Infrastructure Maintenance

SINA HEALTH EDUCATION AND WELFARE TRUST


Medical centre audit

Medical Centre Audit:

  • Monthly audit by head office staff

  • Follow proper checklist

  • All registers and written documentations are checked

  • Medical equipments checking

  • Corrective actions taken

SINA HEALTH EDUCATION AND WELFARE TRUST


Quality assurance in primary health care

MEDICAL CENTRE AUDIT CHECKLIST


Sina infectious disease control system

SINA Infectious Disease Control System

SINA HEALTH EDUCATION AND WELFARE TRUST


Standard operating procedures

Standard Operating Procedures

  • Instrument Sterilization 

    • Clean the dirty instruments with cotton swabs.

    • Wash with tap water.

    • Dip the instruments in antiseptic solution for 5-10 min.

    • Wrap the instrument in cotton and keep in the instrument tray

    • Keep the tray in sterilizer at 150 F for 20 min.

SINA HEALTH EDUCATION AND WELFARE TRUST


Clinical waste segregation

SINA Waste Management

Service

Clinical Waste Segregation

Red Bags Hazardous Waste

Danger Box

Sharps & Needles

Green Bags

General Waste

SINA HEALTH EDUCATION AND WELFARE TRUST


Sina waste management service

SINA Waste Management Service

  • 78 km twice a week

BALDIACLINIC

MACHAAR CLINIC

CDGK INCINERATOR

SABZIMANDICLINIC

HIJRAT CLINIC

SINA HEALTH EDUCATION AND WELFARE TRUST


Sina management system

SINA Management System

SINA HEALTH EDUCATION AND WELFARE TRUST


Sina management system1

SINA Management System

Monthly Meeting of Clinical Coordinator and Clinic Manager

Solutions Provided To Clinic Manager

Minutes By Clinic Managers

Clinical Coordinator

Trustees and Operation Manager

SINA HEALTH EDUCATION AND WELFARE TRUST


Thankyou for listening

Thankyou For Listening

SINA HEALTH EDUCATION AND WELFARE TRUST


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