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Quality development as a health promotion strategy

Quality development as a health promotion strategy. Amnach Sriratanaban * Krit Pongpirul Santawat Asvaroengchai Jinda Tangruamsab Charuwan Thadadej. Institute of Health Systems Research, Bangkok, Thailand Supported by a grant from Thai Health Foundation. * Email: amnach_s@yahoo.com. 1.

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Quality development as a health promotion strategy

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  1. Quality development as a health promotion strategy Amnach Sriratanaban * Krit Pongpirul Santawat Asvaroengchai Jinda Tangruamsab Charuwan Thadadej Institute of Health Systems Research, Bangkok, Thailand Supported by a grant from Thai Health Foundation * Email: amnach_s@yahoo.com 1

  2. Using Hospital Quality Development and Accreditation Process as a Tool to Develop Health Promotion in Hospitals. 2

  3. Quality development as a health promotion strategy Health promotion as a quality strategy 3

  4. The Institute of Hospital Quality Improvement and Accreditation(HA) since 1996 Health promoting hospitals (HPH) since 1998 Thai Health Foundationsince 2002 4

  5. The Institute of Hospital Quality Improvement and Accreditation(HA) 789 out of 1033 hospitals in the country are at various stages of quality improvement and accreditation 5

  6. The Institute of Hospital Quality Improvement and Accreditation(HA) Quality Development Accreditation 6

  7. Quality Development (HA Process) - Patient-center - Team-work - CQI 7

  8. Quality Development (HA Process) - Patient-center - Team-work - CQI The HA Process is an action learning process as well as an empowering process 8

  9. Objective :To utilize the HA Process as a strategy to integrate health promotion into hospital services. 9

  10. Method :Soft Systems Methodology (Peter Checkland 1999) 10

  11. 1. Problem in the real world that involves human interrelationship, e.g. health promotion (HP) in hospitals, is seen as a problem situation (not as a system) 11

  12. 2. A MODEL is built as a system to represent an idea, e.g. “to do HP by HA Process” 12

  13. 3. The MODEL is used to make inquiry into the problem situation (i.e. HP in hospitals) 13

  14. 4. Learning derived from the inquiry could be used by the problem owners to take “action to improve” the problem situation, and also used by the study team to improve the MODEL. 14

  15. 5. The cycle could be repeated for as long as it is useful. It is a learning system. 15

  16. HP in hospitals (Problem situation) Lead to selection of MODEL (An idea) (Feasible) (Desirable) Comparison (Question problem situation using models) Action to improve Find Accommodation which enables 16

  17. 1st cycle (MODEL I) - The HA Process - The Thai HPH Standards (Thai Department of Health. 2002) - The empowering strategies (WHO Working group. Putting HPH policy into action. 2003) - Situation in a community hospital (A) 17

  18. 2nd cycle (MODEL II) - MODEL I - Situation in 8 fully accredited hospitals (B) (Focus groups and in-depth interviews using questions derived from MODEL I) 18

  19. POLICY Lead Team Quality Team COMMUNITY 2 PCT 1 3 PERSONNEL ENVIRONMENT 4 IN-PATIENT (IPD) OUT-PATIENT (OPD) LIFESTYLE Health focus Empowering PDCA 19

  20. QUALITY TEAM ENVIRONMENT - Health Examination - Occupational Health * Health Data * Health Behavior Data * Health Promoting Activities * Health Outcome OPD ** - HA * HPH Thai ** Recommended Health focus Empowering PDCA 19a

  21. PCT ENVIRONMENT COMMUNITY **Self Care ** Participation ** Environment ** Chronic disease ** Lifestyle ** Community • - Holistic • Multi-disciplinary • Continuity of care * HP Activities * Health Data OPD ** - HA * HPH Thai ** Recommended Health focus Empowering PDCA 19b

  22. ENVIRONMENT PCT • ** Lifestyle Clinics • Cigarette • Stress • Weight control • etc COMMUNITY - Chronic Diseases Clinics *Activities*Data IPD * Data • Others • ANC • Dental • etc * HP activities ** - HA * HPH Thai ** Recommended Health focus Empowering PDCA 19c

  23. 2 - Outside services / activities *Outcomes *Data IPD OPD 1 * Inside activities 3 **Community initiated activities PCT 4 **Other sectors initiated activities ENVIRONMENT - HA * HPH Thai ** Recommended Health focus Empowering PDCA ** 19d

  24. LESSONS LEARNED • Prerequisites for success : • 1. Leadership • 2. Clear hospital policy • 3. Well-informed personnel • Key success factors : • 1. Concept of health promotion • 2. Care-based programs • 3. Hospital context • 4. PDCA • 5. Systematic planning 20

  25. 3rd cycle (MODEL III) - MODEL II - Local meetings at 11 hospitals (C) each joined by 1-10 nearby hospitals (D) - Website, Newsletters - One general meeting in Bangkok (one more to come next month) 21

  26. Lead to selection of Problem situation A (1 hospital) B (8 hospitals) C & D (39+ hospitals) MODEL I (after A) MODEL II (after B) MODEL III (after C&D) (Feasible) (Desirable) Comparison (Question problem situation using models) Action to improve Find Accommodation which enables 22

  27. PRODUCTS - MODEL II - One general meeting in Bangkok, joined by 121 participants from 37 hospitals, where 21 empowering health promotion programs were exhibited. - A learning network has been formed. 23

  28. EXPECTED PRODUCTS & OUTCOMES - MODEL III - More health promotion programs. - More participating hospitals become certified HPH - The network would survive despite the termination of the project 24

  29. Thank you for your attention Note: Slides 19a, 19b, 19c and 19d were excluded from the actual presentation because of time constraint. 25

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