Online Collaborative Interactive Learning Among Hospitals in the Philippines

Online Collaborative and Interactive Learning Among Hospitals in the Philippines

REYNALDO O. JOSON, MD, MHA, MHPEd, MSc SurgDesigner and Facilitator, Online Collaborative and

Interactive Learning in Hospital Services Administration

31ST ANNUAL NATIONAL CONVENTION AND EXHIBITIONPrivate Hospitals Association of the Philippines

November 22, 2010Manila Hotel


“Online” Methodology being done through Internet (group emails and websites)

“Collaborative and Interactive Learning”

Objectives group of people contributing their abilities, experiences, and insights and interacting with each other for learning

“Among Hospitals in the Philippines”

Contents implies problems, issues and concerns in Philippine hospitals being brought forth for collaborative and interactive learning

OCIL Project (started in June, 2010)


Objectives of Talk:

• To share by describing my two ongoing OCIL projects on hospital services administration, namely, OCIL on Admitting Service and OCIL on Breast Wellness Center, with focus on the mechanics.

• To send out an open invitation to members of PHAP and to anybody in the audience who would find the OCIL beneficial to their hospital services to join my current and future OCILs.

Online Collaborative and Interactive Learning (OCIL)

Objective 1:

• To share with you by describing my two ongoing OCIL projects on hospital services administration, namely, OCIL on Admitting Service and OCIL on Breast Wellness Center, with focus on the mechanics.


Two ongoing OCIL projects on hospital services administration:

OCIL on Admitting Service (OCIL_AdmS)

OCIL on Breast Wellness Center (OCIL_BreastWC)

*Part of mother OCIL on Health Care Service Administration, Hospital Service Administration, and Hospital Administration (OCIL_HCSA_HSA_HA)

** Other OCILs to be put up:

OCIL on Operating Room, OCIL on Department of Surgery; OCIL on Infection Management Center; etc.


Objectives and End-points

Development of:

Admitting Service

Breast Wellness Center

Primer (Administrative Design and Development Program)

√ √

Business and Operational Plan Template

√ √

Operations Manual Template √ √Manager-leaders √ √Mentors √ √

Clinical Practice Guidelines

Education on Breast Wellness


“Who,” “How,” and “Fee” of Joining OCILs

*People with interest to improve the health care services in the Philippines and in their health care organizations through "administration"

are invited or can be referred to the OCILs

*Know how to use emails and open them at least once a week!

NO FEE is charged for joining and participating in the OCILs!


Categorization of Online Participants

Categorized by their declared and requested roles in OCIL:

Facilitators

Mentees (with manifestation of desire to get a formal certification of completion = actively participating)

Anecdotalists (intermittent commenters / sharers)

Bystanders (do not interact and collaborate = read emails, observe online interactions)


Certification of Mentees:

Minimum Requirements for Certification:• Active online collaboration and interaction (at least once a

week) for minimum of 48 weeks (out of 52 weeks in a year) on all questions and issues posted by facilitator (guided by contents of learning)

• Case study of an existing Admitting Service / Breast Wellness Center of a hospital with at least a proposed improvement design and development program or a design and development plan for a new Service


Certification of Mentees:

Issuance of Certificate:• Upon complete fulfillment of requirements for certification• Issued by the facilitator


Learning Methods

using primarily emails and electronic discussion group


Online Tools Admitting Service Breast Wellness Center

Emails Individual emails of participants

Individual emails of participants

Group Emails Yahoo Groups Yahoo Groups

Websites Yahoo Groups Yahoo Groups

Wordpress.com Wordpress.com

Google.com Google.com

[email protected] http://health.groups.yahoo.com/group/ocil_admitting_service

[email protected] http://health.groups.yahoo.com/group/ocil_admitting_service

[email protected] http://health.groups.yahoo.com/group/ocil_breastwellnesscenter

[email protected] http://health.groups.yahoo.com/group/ocil_breastwellnesscenter

http://philhospitaladmittingservice.wordpress.com

http://breastwellnesscenter.wordpress.com

https://sites.google.com/site/admittingserviceprimer

Use of Online Tools for Collaboration and Interactions and Archiving of Inputs and Learning Documents

Participants are asked to open their emails at least once a week. They can interact with other learners either through individual emails of participants or preferably, through the egroup. They can see the interaction between and among the learners through the egroup.

Use of Online Tools for Collaboration and Interactions and Archiving of Inputs and Learning Documents

Two websites created for archiving purposes and take-off points for interactions. Late-comer learners or those who miss some online interactions for one reason or another can visit the two websites to catch-up.


OCIL Processes:1.Brainstorming and discussion on questions and

issues

2.Collation, analysis, and recommendations

3.Synthesis of outputs - Primer on Administrative Design and Development Program


OCIL Processes:• Facilitator sends weekly set of questions and

issues for brainstorming and discussion• Participants email their responses to the

questions and issues• Facilitator collates, analyzes, and makes

recommendations• Facilitator synthesizes outputs into Primer on

Administrative Design and Development Program

Whole Hospital

Concepts and Design

Whole Hospital

GovernancePolicies

Procedures

Whole Hospital

OperationsPolicies

Procedures

Interfacing Units

OperationsPolicies

Procedures

A Department Design and Development Framework

Regular Performance Evaluation and Continual Improvement Program


Architectural Design / Engineering / Construction

Services

Cost-efficient/ value-based

Determinants of Functions / services

requirements

Functions(authorized)

Services(authorized)

Leadership

IT-enabled System

DOH Licensing

& Structural Requirements

Policies & Procedures /

Clinical Practice

Guidelines/Clinical

Pathways

Risk Management

Program

Physical Structure

(Location, space)

Human Resource Program

Equipment / Material Program

Data / Documents

Records Program

Business Development

Program

Budget Program







Online Collaborative and Interactive Learning (OCIL)Questions and Issues for Brainstorming and Discussion

Brainstorming and Discussion on

Obtaining an Informed Consent at the Admitting Service in a Hospital

Duration of BD: One week (August 19 to 25, 2010)

Questions and Issues (QI):

QI.7.1 What is the concept of an informed consent of patients to be obtained by the staff of an Admitting Service in a hospital?

QI.7.2 What should be the contents of an informed consent of patients to be obtained by the staff of an Admitting Service in a hospital?






QI.7. 3 How should an informed consent of patients be obtained by the staff of an Admitting Service in a medical center or hospital? Is signing a proforma informed consent form the same as obtaining an informed consent? Is signing a proforma contract of admission the same as obtaining an informed consent?






QI.7.4 Who should sign an informed consent for the hospital admission of a patient for it to be legally binding?

QI.7.5 What is a Patient’s Bill of Rights?

QI.7.6 How does the Patient’s Bill of Rights relate to the informed consent to be obtained by the staff of an Admitting Service in a medical center or hospital?






QI.7.7 Present and share scanned copies of proforma informed consent form and/or proforma contract of admission and a patient’s bill of right of a selected hospital in the spirit of collaborative learning.


Sample

Questions and Issues for Brainstorming and Discussion

Breast Wellness Center



Concept of Breast Wellness, Breast Wellness Program, Breast Wellness Center, and Breast Clinic / Center

Duration of BD: One week (August 16, 2010 to August 22, 2010)


QI.1.1 What is /are the usual and recommended concepts of BREAST WELLNESS?

QI.1.2 What is /are the usual and recommended concepts of BREAST WELLNESS PROGRAM?



Concept of Breast Wellness, Breast Wellness Program, Breast Wellness Center, and Breast Clinic / Center

Duration of BD: One week (August 16, 2010 to August 22, 2010)


QI.1.3 What is /are the usual and recommended concepts of BREAST WELLNESS CENTER?

QI.1.4 What is /are the usual concepts of the BREAST CLINICS / CENTERS that have been established in the Philippines (that you know of)?







Online Collaborative and Interactive Learning (OCIL)Collation and Recommendations

ROJOSON’S INPUTS (Collation and Recommendations)

Concept of Informed Consent for Admission

The concept of an informed consent of patients to be obtained by the staff of an Admitting Service in a hospital means that the staff of an Admitting Service should secure an informed consent for admission to the hospital.

It is different from the informed consent for medical procedures to be done to the patient in the inpatient services.

Online Collaborative and Interactive Learning (OCIL)Collation and Recommendations

ROJOSON’S INPUTS (Collation and Recommendations)

Breast Wellness for a Person (Concept)• Usual: Absence of breast abnormality or disease• Recommended:

A state wherein there is NO breast issue (in the domain of symptoms, diseases, and fear and anxiety even in the absence of disease) that affects the physical, psychosocial, and spiritual well-being and / or the socioeconomic productivity of a person.

This concept is deduced from the World Health Organization’s definition of HEALTH and the common definitions of WELLNESS.







https://sites.google.com/site/admittingserviceprimer

Online Collaborative and Interactive Learning (OCIL)Topics for BD -AdmS (21 Sessions from June to October, 2010)

Topics for Brainstorming and Discussion Schedule

Concept of an Admitting Service in a Hospital June 1 to 7, 2010

Functions of an Admitting Service in a Hospital June 8 to 15, 2010

Bed Assignment Function / Service of an Admitting Service

June 24 to July 1, 2010

Physician-associated Issues on Bed Assignment Function / Service of an Admitting Service

July 3 to 10, 2010

Making-Beds-Available Issues on Bed Assignment Function / Service of an Admitting Service

July 21 to 28, 2010

Inpatient Record Establishment of an Admitting Service

August 5 to 11, 2010

Online Collaborative and Interactive Learning (OCIL)Topics for BD - AdmS (21 Sessions from June to October, 2010)


Obtaining Informed Consent at the Admitting Service August 19 to 25, 2010

Orientation of Patients for Admission by the Admitting Service

August 26 to September 1, 2010

Account Arrangement September 2 to 9, 2010

Transport of Patients from Admitting Service to Inpatient Service

September 10 to 17, 2010

Human Resource Requirements of an Admitting Service


Risk Management Program of an Admitting Service September 27 to October 3, 2010

Online Collaborative and Interactive Learning (OCIL)Topics for BD - AdmS (21 Sessions from June to October, 2010)


IT-enabled System of an Admitting Service October 5 to 11, 2010

Physical Structure, Equipment and Materials, Business Development and Budget of an Admitting Service

October 12 to 18, 2010

Regular Performance Evaluation, Continual Improvement Program, and Leadership of an Admitting Service


Case Study October 27 to November 30, 2010

Whole Hospital

Concepts and Design

Whole Hospital

GovernancePolicies

Procedures

Whole Hospital

OperationsPolicies

Procedures

Interfacing Units

OperationsPolicies

Procedures

Admitting Service Design and Development Framework

Regular Performance Evaluation and Continual Improvement Program


Architectural Design / Engineering / Construction

Services

Cost-efficient/ value-based

Determinants of Functions / services

requirements

Functions(authorized)

Services(authorized)

Leadership

IT-enabled System

DOH Licensing

& Structural Requirements

Policies & Procedures /

Clinical Practice

Guidelines/Clinical

Pathways

Risk Management

Program

Physical Structure

(Location, space)

Human Resource Program

Equipment / Material Program

Data / Documents

Records Program

Business Development

Program

Budget Program

Online Collaborative and Interactive Learning (OCIL)Topics for BD – Breast WC (13 Sessions from August to November, 2010)


Concept of Breast Wellness, Breast Wellness Program, and Breast Wellness Center

August 16 to 22, 2010

Functions and Services August 23 to 30, 2010

Drafting a Breast Wellness Program August 31 to September 7, 2010

Magnitude of the Breast Wellness Problems in the Philippines, Catchment Community, and Focal Hospital


Presenting Chief Complaints of Patients with a Breast Wellness Concern and List of Breast Disorders and Diseases




Recognition (Clinical Diagnosis) of More Common Breast Conditions, Changes, Disorders, and Diseases


Application of Pattern Recognition and Validation of Essential Clinical Diagnostic Criteria on More Common Breast Conditions, Changes, Disorders, and Diseases

September 29 to October 5, 2010

Diagnostic Procedures of the Breast October 6 to 12, 2010

Inflammatory Disorders of the Breast October 14 to 20, 2010

Physiologic Conditions and Changes of the Breast




Nipple Discharge October 29 to November 4, 2010

Breast Pain November 4 to 10, 2010

Breast Mass November 11 to 18, 2010


Current Situation / Status


OCIL on Admitting Service

OCIL on Breast Wellness Center

Date officially started(To end)

June 1, 2010(May 31, 2011)

August 16, 2010(August 15, 2011)

Number of participants

74 (Admitting Service staff; nurses; staff from finance, business development, human resource units; hospital administrators; others)

74 (physicians, nurses, hospital administrators)


OCIL on Admitting

Service


Number of facilitators

4 1

Number of mentees 9 27Number of anecdotalists

22 5

Number of bystanders

39 41


OCIL on Admitting

Service


Geographical distribution of participants

NCR = 60Outside NCR = 14(Zamboanga; Samar; Bicol; Batangas; Sta. Rosa, Laguna; Biñan, Laguna; Cavite; Bulacan; Pampanga; Tarlac;Bataan; Isabela; Quezon)

NCR = 67Outside NCR = 7(Zamboanga; Cagayan de Oro; Cebu; Batangas; Cavite; Sta. Rosa, Laguna; Biñan, Laguna)

Online Collaborative and Interactive Learning (OCIL)AdmS Mentees’ Home Bases

Ciudad Medical Zamboanga


Sta. Rosa Hospital and Medical Center


Daniel Mercado Medical Center


Manila Doctors Hospital


National Children’s Hospital


Tarlac Provincial Hospital


Email Interactions as registered in Yahoo Egroups:

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total

2010 29 129 105 121 78 61 41 567

Jan Feb Mar Apr May Jun Jul AugSep Oct Nov Dec Total

2010 83 161 127 86 457

OCIL_AdmS

OCIL_BreastWC


Visits on http://philhospitaladmittingservice.wordpress.com

146 posts with 46 categories of topics

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total

2010

9 54 1 51 62 56 17 250


Feedback from Members of the OCIL_AdmS:• This project gives us information on how admission is

being done in other institutions and helps us a lot in improving our own.

• I find the primer very very useful in my unit. I can share this with my staff and together work to have an efficient Admitting Service.


Feedback from Members of the OCIL_AdmS:• I learned so much in such a short period of time.• Thank you very much for the OCIL, it is one great learning

experience for us! Thus, we can make improvements in this particular hospital unit of ours.


Feedback from Members of the OCIL_AdmS: • I am very thankful for the formulation of this virtual

discussion – OCIL. Though the topic is beyond OR set up but by inputs of every member it expands my idea on how admitting section is and for this, it can also be applied to some extent in my department. Hoping that someday OR will have OCIL.


Feedback from Members of the OCIL_AdmS:• I believe this is one of a kind course being

undertaken presently. This may be the start of a bigger endeavor between hospitals to improve our services while being present in our hospitals and working. This is a new mode of communications that we should take advantage of.

Jose Rene de Grano, MD, MHA

Chairman

PHAP 2010 National Convention Organizing Committee


Why OCIL from me?

With OCIL, I envision to facilitate collaborative learning among different hospitals and various hospital managers and multidisciplinary professionals

and

develop handy comprehensive and integrated primers and design and development programs on different hospital services in the Philippine setting.


Why OCIL from me?

Realization that there is so much to learn in health care services administration, hospital services administration, and hospital administration that collaboration is needed among different hospitals and among various hospital managers and multidisciplinary professionals in searching for best practices.


Why OCIL from me?

Lack of handy comprehensive and integrated primers and design and development programs on different hospital services in the Philippine setting makes learning difficult.


Why OCIL from me?

Part of my advocacy, Education for Health Development in the Philippines, started since 1989.


Future plans for OCIL on Admitting Service

Presently, conducting a formative evaluation and in the future, a summative evaluation.



For the online primer:

• Continue to develop it to include samples of case studies, business and operational plan, and operations manual for Admitting Service.



Another OCIL _Admitting Service:

• Will conduct another course with a new batch of mentees


Future plans for OCIL on Admitting ServiceFor the mentees:• After certification,

– it will be up to them to choose any one or combination of the following career pathways:


Future plans for OCIL on Admitting ServiceFor the mentees:• To serve as a facilitator / mentor of the colleagues – staff in

his currently affiliated Admitting Service who were NOT able to join the first OCIL on Admitting Service.


Future plans for OCIL on Admitting ServiceFor the mentees:• To pursue further learning on Admitting Service to achieve

excellence in the administrative design and development of his Admitting Service, particularly, in mastering the development of business and operational plan and operations manual.


Future plans for OCIL on Admitting ServiceFor the mentees:• To become a resource person for the next batch of

mentees of OCIL on Admitting Service.• To pursue further learning on Admitting Service until

mastery and, therefore, be qualified to be a facilitator for the next batch of mentees of OCIL on Admitting Service.


Objective 2:• To send out an open invitation to members of

PHAP and to anybody in the audience who would find the OCIL beneficial to their hospital services to join my current and future OCILs.

Email: [email protected]

http://philhospitaladmittingservice.wordpress.comhttps://sites.google.com/site/admittingserviceprimer

http://breastwellnesscenter.wordpress.com


Thank you

for your attention!

Health & Medicine

Online Collaborative Interactive Learning Among Hospitals in the Philippines