HOW DO YOU LIVE HOSPITAL?
2016-03-10
The Ministry of Health of KR is continuing evaluation of hospitals and the review of performance of hospitals will be conducted according to results of the first quarter of 2015, working with the support of World Bank, project “Health Results-Based Financing” (RBF).
On April 17, 2015 activities of Balykchy territorial hospital (TH) selected by the RBF project from the first group of hospitals, according to specific criteria of Scorecard of RBF project, has been evaluated with the participation of colleagues from Talas and Kochkor hospitals. It was taken into account even numbered buckets and wipers and equipped bathrooms and showers up to the level of knowledge and skills of staff in neonatal resuscitation. The improvement of indicators is obvious. In the result of the evaluation the hospital scored 900 points and got one of the highest evaluations and increased its budget up to 1 million 427 316 KG SOM. For comparison, in the past quarter the hospital gained 700 points.
As it is known, the procedure of selection of hospitals was held in the Ministry of Health by random method on June 18, 2014, 63 district and rural hospitals, including general practioners’ centers participated in it. Hospitals were divided into three groups: in first of which it was decided to carry out a quarterly assessment of medical services’ quality with payment of project funds, in the second to conduct only quarterly assessment of the quality of medical services without payment of funds and the third group will be a control group.
The system of financing of 21 randomly selected hospitals is based on the results of performance and carried out only in the presence of progressive indicators of quality of healthcare. For the evaluation of hospitals Scorecard was developed with specific set of criteria and indicators. The assessment is conducted on a quarterly basis with the participation of colleagues from other hospitals using Scorecard. According to the results of evaluation the payments from project funds are paid. The Scorecard includes several indicators of performance of hospitals, including patient satisfaction, staff training, hygiene and infection control, medical waste management, surgery, emergency care, neonatal care, and others.
Arsen Askerov, Deputy Director of RBF project: Conducted evaluation - is the intensive monitoring using the Scorecard, which has a set of indicators and additional verification checklist. In general, 35% of indicators will evaluate structure (which is needed to operation of the hospital), 55% - are indicators of clinical practice in regional hospitals (in maternity department, surgery, treatment, other clinical units) and 10% - indicators of patient satisfaction, i.e. we do structured interviews and assign points to puerperants, who gave birth in the last quarter. This monitoring shows that in a short time hospitals manage to arrange a lot of activities to improve the quality of services, provide resources. It is worth to note during six months the indicators of hospital resources have increased significantly and for nine months they have improved the process of clinical practice, have changed the approaches. According to the obtained results, they earn points, which are then converted into money. Today Balykchy Hospital is a leader in the second review. It received more than 70% of performance of indicators.
Dzjumabek Moldakunov, Director of Balykchy TH: Thanks to RBF project, we became a team, working under a slogan "The team has a motto - never fall down!", Because, the collective is a group of people having the same profession, and the team is a group of like-minded people aiming at winning, and perform common task. Currently, the hospital has a very good team, Quality Committee works, which is in each structural unit. The committee includes leading specialists, we can say, avant-garde, the locomotive of our hospital. They solve many problems, but our ultimate goal is improving the quality of treatment. Motivation is powerful, because there is financial interest. Since the beginning of RBF project we have earned 2 million 522 thousand soms. The main part of the money we spent on the purchase of medical equipment, its maintenance and improvement of infrastructure of the hospital, training of medical staff. For example, for the Department of transfusion, we bought centrifuge which cost 244 thousand soms, and the other day, April 17, Ministry of Finance held a tender for the purchase of medical equipment in the amount of 550,000 soms, among of which oxygen concentrators, oximeters, suction and electronic scales. Now I think that we should buy more equipment for the remaining funds. Due to the money earned from RBF, we have invited professors who will conduct two-day training on obstetric, cardiology, intensive care, infection control. Previously, we had only one source of water, which often was out of order, and we were three days without water, there was a problem with clean water. Due to RBF we have solved this issue, we are now connected to the source of urban water supply, we have two sources, and we have no threat that the hospital will work without water. From amount of money we spend for infrastructure and medical equipment, we spend 30% of it for salary payment. Motivation is very good. In each review the staff tries to get more points, earn more.
Camille Setova, Head of Department on Transfusion, Balykchy TH: Our hospital is considered to be one of the best hospitals. According to its scores, we always occupy a leading position. With the introduction of our RBF, self-consciousness of our workers has increased. We are now working for quality standard. We have good discipline now, people want to work on indicators, equipment became better, hospital purchases a lot of medical equipment. For example, RBF has bought centrifuge for my Department on transfusion and plasma extractor to improve separation of whole blood into components. Our old device has been repaired two times. We purchased a refrigerator for the amount of 18 thousand and 500 soms and freezer which cost about 60 thousand soms, medical tools were bought for each donor, disposable packing was made. The quality depends not only on equipment, but also on water supply. Recently, we have made water supply system. Water is now going very well. According to coefficient of labor participation, salaries were increased. Highest score on RBF is 30 erythrocytes mass and 30 points for fresh frozen plasma, total 60 points. From the very beginning of RBF project, from July 2014, in each of the three quarters we earned 60 points.
Demisinova Kuluy, Head nurse of Department on central sterilization of Balykchy TH: Today I'm going to work in a good mood, because I have everything to work, because we purchased the missing equipment, and we can hope for a raise of salary payment. I have dedicated the hospital all my life, and now, finally, I can be proud of my work and work of my team.
Degembaev Kudus, anesthesiologist, resuscitation specialist of Balykchy TH: I am anesthesiologist, resuscitation specialist. I have more than 40 years of experience. Now everything has changed. There are no problems with medicines, we have equipment, buy new ones. If we compare with the beginning of the 90s, the difference is big.
Janylcha Bektenova, Nurse of Balykchy TH: The difference is that we have stimulus. Salary was increased a little. Equipment is purchased.
Elvira Dzjakypbaeva, Senior nurse of Balykchy TH: Now in our emergency department everything meets requirements, it makes our work easier and improves the quality of service provided to our patients.
Janara Sharshenalieva, Nurse- Receptionist of Balykchy TH: Slowly it gets better, work becomes easier, wages were increased slightly, conditions changed. For us the most important thing is to make comfortable for patients.
Satty Dzjumagazieva, Head of clinical laboratory, laboratory doctor of Balykchy TH: It became interesting to work, because we work on the new machines, the conditions became more comfortable. The entire staff is involved in the distribution of earned money.
Puerperant of Balykchy TH: I am very pleased with how the process of child birth past, how I was met at the hospital. Very friendly staff and very good conditions. They have changed for the better.
