Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Conference on Patient Safety23-26 June 2014, Manila Philippine

DEPARTMENT OF MEDICAL SERVICE ADMINISTRATION

VIETNAM MINISTRY OF HEALTH

Dr. VUONG ANH DUONG. MBA. PhDHEAD OF QUALITY MANAGEMENT DIVISION

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Country profile of hospitals at country

level

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

MEDICAL SERVICE NETWORK OVERVIEW Public Private (164,800 beds)

Ratio 22,5 beds/10,000 pop.

National level

Provincial level

Local level

38hospitals

409 hospitals

645 district hospitals and 48 departmental hospitals

10,748 Commune health stations

(6.289 beds)

121 Private hospitals, (05 with foreign

investment)

Private clinicsConference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

4

Medical errors

How safe of health services in vietnam ???

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

SOME FIGURES ON MEDICAL ERRORS IN VIETNAM

Hospital acquired infection rate: 5,4-8,0%Operation infection rate: 2,5-8,5%Ventilator associated Pneumonia: 40-50%

Obstetric complications: 9 months of 2013: 4.366/ 1.559.285 cases Obstetric complication Incidence of 2,8‰

One study in GIZ program show that: The rate of irrational treatment to diagnosis: 10-50% (31%)

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Bring to the court

Bring to the court

Requiring M

OH to

annually report i

ncident

rate of medical erro

r/

accidentRequiring M

OH to

annually report i

ncident

rate of medical erro

r/

accident

Accuse the errors’ doctor/ force to compensate (money)

Accuse the errors’ doctor/ force to compensate (money)

Lowing down the reputation of health

sector/ doctors

Lowing down the reputation of health

sector/ doctors

Violate doctor/ hospital

Violate doctor/ hospital

Social requirement.

.

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Law of examination and treatment 2009

• Article 60. Drug use in impatient healthcare facilities

• Item 1. Drug use principles• Item 2. Prescription regulations• Item 3. Drug distribution• Item 4. follow up complications after drug use

• Article 62. Infection controls in healthcare facilities

• Item 1. Infection control mesures• Item 2. Health care facilities responsibilities• Item 3. Health care staff responsibilities

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Law of examination and treatment 2009

Chapter 7. Medical errors, complaints resolution and disputes, accusations of medical treatment and examination

Item 1. Medical errors in medical treatment and examination• Article 73. Identify malpractice or not of practionners• Article 74. Establishment of professional boards• Article 75. Components, operating principles and duties of the

professional Board• Article 76. Responsibilities of practionners, medical facilities

when complications occur in health care.• Article 77. Determine level of the compensation due to

technical errors causing complications in health care• Article 78. Liability insurance in medical examination and

treatment

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Hospital regulations

• Was issued with the decision1895/1997/QD-BYT• Hospital Regulations comprise 5 elements, 153 rules and

regulations• Some regulations related to patient safety:• Regulation on permanent emergency• Regulation on diagnosis, medical records and prescriptions• Regulation on hospital infection control (18/2009/TT-BYT Circular

dated 14/10/2009)• Regulation on comprehensive patient care (07/2011/TT-BYT

Circular dated 26/01/2011 guiding nursing care of patients in the hospital).

• Regulation on the use of drugs (Circular23/2011/TT-BYT dated 10/6/2011)

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Circular No.19 - guiding quality management of medical services in hospitals

• Hospitals need to build quality indicators, database and hospital quality measurement

• Hospitals need to implement regulations, professional guidances

• Hospitals need to implement measures to ensure safety for patients and medical staff

• Hospitals need to apply standards, criteria for hospital quality management

• Hospitals need to assess hospital’s quality

10Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Hospital Hotline• To enhance receiving and handling feedback of citizens

regarding Quality of Medical Service through hotline

• Focus on “hot” topics: “5 topics”

• Publicize director’s telephone number to supervise

• Publicize Department of Health’s hotline to supervise

• Establishing Ministry of Health’s hotline number

• Having system of monitoring, reporting; supporting technology

• Having sanctions (on-site) for violating, not handling

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Other activities related to PS• Survey on patient/ staff satisfaction

• Set of hospital quality criteria assessment (83 criteria in 6 dimentions)

• Hospital infection control (committee, network in hospital, checklist, protocol)

• Out-patient examination: Reducing waiting time, cutting down administration procedures

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Other activities related to PS• Developing guideline:

– Standard guideline on diagnosis and treatment– Medical professional procedure protocols– Training materials:

• Hospital management• Patient safety• Hospital quality management

• Pilot quality and patient safety improvement piloted in different projects

• Annual workshops to advocate and share experience: quality management; patient safety

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Network of quality management and patient safety in all DeptsNetwork of quality management and patient safety in all Depts

THE STRUCTURE OF HOSPITAL QUALITY MANAGEMENT

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Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Role and responsibility of patient safety Committee

1. Developing medical errors and potential risk collecting and reporting system

2. Implementation of “learning from mistakes”

3. Developing standardized materials on patient safety to give training

4. Developing reminding system in hospitals

5. Establishing the system of monitoring - feedback

6. Establishing system of analyzing complication and causes

7. Implementing patient safety interventions

8. Monitoring and evaluating

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Form to report the potential risks

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Form to report the potential risks

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Reports

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Content of reports

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

CHALLENGES

1. Quality Management is quite a new area, which still hasn’t appropriate attention and direction of the units’ leader.

2. No task forces or persons in charge, lack of human resources on QM, no specialized train.

3. Limited qualification of the executives, mostly not yet been appropriately trained, educated on quality management.

4. Lack of budget for quality management operation.

5. Legal documents, needs time for medical service facilities to implement and achieve results…

6. Patient safety issue is now the big concern of publicity and government

20

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

Overcome• Hospital Quality Management Committee/ Department/

Team establishment • Hospital quality accreditation• Hospital quality assurance• Hospital quality continuous improvement• Establishing medical error reporting system: check list,

template to report potential risk…• Developing & issuing Circular on medical error

prevention and management:– Guidance how to prevent the potential risk– Manage and treat when the errors/complications occurred

Conference on Patient Safety23-26 June 2014, Manila Philippine

Hospital Quality Management, 10-14 March 2014, Saitama, Japan

THANK YOU FOR YOUR ATTENTION

Conference on Patient Safety23-26 June 2014, Manila Philippine