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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

sina cme
SINA CME

SINA HEALTH EDUCATION AND WELFARE TRUST

slide13
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

slide14
Recordkeeping System
    • Patient Files
    • Patient Registration Cards
    • 14 Algorithmic Protocols

Compromise On Quality

SINA HEALTH EDUCATION AND WELFARE TRUST

slide15
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

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

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

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

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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