Prof. Michael RichmondChief of Medical, Academic and Research Affairs

MedHealth – Cairo – March 2014

Partnering with Staff on Problem Solving

The Hamad Approach

1. A pen picture of Qatar

2. Hamad Medical Corporation

3. Academic Health

4. Key challenges

5. The science of quality improvement

6. The Hamad Way

Contents

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• Geographically small: 11,400 sq km;

• Small population: > 2 million people;

• Rapid population growth: tripled in ten years;

• Reliant on oil and gas: responsible for 70% of government revenue;

• Real GDP growth expected to grow by

5.3% in 2013• Budget spending set to jump 18% to $58bn in 2013/14

• Qatar National Visions 2030: diversify the economy and build a knowledge-based economy whilst maintaining Qatari culture:

•ambition to become a world leader in education, healthcare and medical research

•ambition to become a medical and education hub for the region

Qatar - A Growing NationWith a Great Ambition

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Qatar National Vision 2030A Healthy Population: Physically and Mentally

A Healthy Nation is a Productive Nation

Qatar National Health Strategy 2011 - 2016 The National Health Strategy 2011-2016 is intended to propel Qatar toward the health goals and objectives contained in the QNV 2030

A Unique Population

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Diverseexpatriate population

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Increase in demand for healthcare services due to more people, with more chronic disease, living longer

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-10

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0

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60

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90

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00

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05

20

10

An

nu

al p

op

ula

tio

n g

row

th (

%)

Bahrain

Qatar

Rwanda

UAE

Kuwait UAE

Rwanda

Kosovo

Equatorial Guinea

All other countries

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CountryBeds per 1,000*

Australia 3.9

Canada 3.2

UK 3

USA 3

Saudi Arabia 2.2

UAE 1.9

Qatar 1.4

Percentage change in growth from 2005

Healthcare Demand and Capacity

HMC is the Main Healthcare Provider

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• Established 1979 with 35 years of experience

• Government funded non-profit provider

• Eight hospitals, National Ambulance Centre – and growing, with 4 new hospitals planned for 2015

• Provide 90% of acute healthcare in Qatar

• Tertiary, Secondary and Continuing Care

• 750,000 emergency attendances

• 20,000 deliveries annually

• Expected healthcare budget increase fromQR8.8bn ($2.4bn)

• Joint Commission International accreditation

• ACGME-I accreditation

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HMC - A Growing Hospital Network

Nursing and Skilled Nursing Care

Tertiary Hospitals

General Hospitals

Continuing Care

National Ambulance Service

Key Statistics from 201310

HMC AT WORK IN NUMBERS

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Priority

Supporting Priorities

Core

Improvement

Academic healthas a means of transformation

Reforming organizational

capabilities

Clinical Research

Education & DevelopmentEnabling Human

Resources

Facilities

Information Systems

Community Engagement

Organizational Capabilities

Transformation

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Qatar’s Academic Health System

HMC is “uniting academia and healthcare for the benefit of the population”(Health Service Journal)

“It is a significant achievement…a collaborative model others will seek to emulate.”

(Dr S. Wartman, President and CEO, Association of Academic Health Centers)

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“We can't solve problems by using the same kind of thinking we used when we created them.”

Albert Einstein

BUILDING ‘THE HAMAD WAY’

Building Will, Ideas

& Teamwork for Execution

• Quality and Safety Strategy

• Middle East Forum in collaboration with IHI

• Best Care Always Campaign

• Open School

- 5000+ HMC staff registrations

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PDSA - a Model for Improvement

Developed by Associates in Process Improvement, the Plan-Do-Study-Act (PDSA) model is a valuable tool for accelerating improvement.

It has been used very successfully by hundreds of health care organizations in many countries to improve many different health care processes and outcomes.

Including the right people on a process improvement team is critical to a successful improvement effort

Testing the improvement solutions to verify their validity

is equally important for sustained improvement.

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Governance & Risk Management

Leadership & Behaviors

• Governance Review• Leadership for quality• Workforce development• Job planning and appraisal• Enhancing medical education

• Evidence based optimal care• CPD for quality• Awards for professional excellence• Privileging and credentialing

• Data on Harm (IHI Global Trigger Tool)

• Benchmarking / Dendrite/ ICD-10

• Mortality Review• Core investigation Committee• Never Events (SUI)• Access Targets

• Best Care Always Collaborative• Hospital Acquired Infections

• Clinical Service Reviews• Pressure Ulcers• VTE• Deteriorating Patient

• Review of complaints management system

• Decentralized complaints service

• Patient survey• Communication• Patient Information service• Staff safety culture survey

• Collaborative partnerships • Microsystems• IHI Fellows• HMC Internal Fellowship

• IHI Open School• IHI Mid East Forum• CCITP

• Nurse leadership• Allied healthcare professional

• Hospitalist program• Transfer burns services• Hospital at the weekend

Measurement & Benchmarking

Quality Initiatives

Patient Partnership & Complaints

Capacity & Culture for Continuous QI

Multi-Disciplinary Development

Reduce Avoidable Deaths

Reduce Patient Harm

Improve Outcomes

Reduce Length of Stay

Improve Patient Experience

Improve Access to Care

Quality Goals Primary Drivers Secondary Drivers

Quality Goals and Drivers

HMC and IHI’s 2nd Annual Middle East Forum on Quality and Safety in Healthcare is part of the Best Care Always quality improvement framework led by HMC in collaboration with IHI.

This world-class conference offers opportunities to learn the latest improvement ideas, connect with like-minded colleagues, and generate momentum for change in your department and across HMC.

Register at: http://ihime2014.hamad.qa

Storyboard Exhibition & Competition26/4/2914

Best CareAlwaysWe make the differenceCommitted to delivering the safest, most effective

and compassionate care to our patients

Quality & Patient Safety

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Quality & Patient Safety Capacity and Capability Development

Open School(5000 enrollments)

IHI Forum(2800)

Employee Induction (25000 staff)

Fundamentals in safety (200 PA)

CCITP(150 trained)

Best Care Always Collaborative ( 150 year one)

HMC Fellowship(12 PA)

Microsystems(60 PA)

IHI Fellows(2 PA)

Clinical Leadership

ExecutiveLeadership

High reliability ward(1 PA)

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HMC Quality Strategy agreed

Oct-12 Dec-12 Mar-13 Jun-13 Sep-13 Dec-13 Mar-14 Jun-14 Sep-14 Dec-14

IHI Partnership Agreed

IHI facilitated leadership

retreat

HMC-IHI Mid East Forum

Open School

enrolled

HMC-IHI Fellow commenced

BCA Launch

BCA Foundations

BCA LS-1

BCA LS-2

BCA LS-3

HMC-IHI Mid East Forum HMC-IHI Internal

FellowshipIHI Fellow x2

Microsystems

Increasing Capacity & Capabilityfor Quality Improvement

BCA Collaborative

Teams Review

JCI Surveys

* Best Care Always Learning Set

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LESSONS LEARNED

• Understanding the magnitude of the challenges

• Developing a quality and safety strategy

• Building capability and capacity at all levels

• Raising senior leadership visibility• Understanding the local culture• Encouraging huge appetite for change• Developing an environment of

openness and transparency• Realizing the need to fuse all things

best, both East and West

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“You can design and create and build the most wonderful place in the world, but it takes people to make the dream a reality.”

Walt Disney

Inform, Integrate, Improve