Quality Healthcare Flashcards
6 dimensions that constitute Quality in Healthcare (WHO & IOM)
1) Safety - Minimise risk & avoid injuries
2) Effective - Healthcare is adherent to an evidence base & results in improved health outcomes, based on need (indication)
3) Patient-centredness - Care is respectful & responsive to pt’s preferences, needs & values
4) Accessible - Ensure timeliness, care provided in the right setting (site)
5) Efficient - Maximise/optimise resource use, avoid waste
6) Equitable - Care that does not vary in quality bc of personal characteristics
Gist of Quality Healthcare
- Meets the needs of pts/community in a timely manner
- Most effective, minimises risk, optimise use of resources
Barriers to Quality Healthcare
1) Rapid changes
- Medical science & tech advanced @ an unprecedented rate
2) Growing complexity of healthcare
3) Change in public health needs (ie. aging population, ppl living with chronic diseases in the community)
4) Healthcare delivery is disorganised
- Complex & uncoordinated (esp at transitions of care), institutions working in silos
What is SG’s healthcare policy
- Ensure quality & affordable basic med services
- Achieve better health for all
- -> Promoting healthy living
- -> Promoting preventive health programmes
- Anchored on indv responsibility
- -> Co-payment, pay for higher lvl of service
Core issues in SG’s healthcare scene & their impacts
1) Rapidly aging society
2) More people with chronic diseases
Impacts:
- Increases out-of-pocket costs
- Increase bed occupancy rates
- Decrease ILTC capacity
Goals of “Beyond Healthcare 2020”
1) Move beyond hospital to community
- So that SGpreans can receive care in the community nearer to home
2) Move beyond quality to value
- Streamlining & integrating care to give every SGprean best value, while keeping system sustainable
- 3 clusters in 2017: Optimise resources & capabilities to provide > comprehensive, integrated & patient-centred care
3) Move beyond healthcare to health
- Help & support SGpreans to lead healthier lives
SG Healthcare’s Financing Approach
- Twin philosophies of indv responsibility + affordable healthcare for all
- Multiple tiers of protection to ensure no SGprean is denied access to basic healthcare needs bc of $ issues
S + 3Ms:
- Subsidies (up to 80% in public healthcare institutions)
- Medisave - To pay for smaller healthcare bills
- Medishield Life - Basic health insurance to help with larger hospital & healthcare bills
- Medifund - Safety net to provide for needy SGpreans
Drug subsidies & schemes
Standard Drug List
- SDL I & II
Medication Assistance Fund (MAF)
- Indication specific
- Means testing (ability to pay)
- Lvl of subsidies vary
Legislative framework for Quality Healthcare
Private hospitals & Medical clinics act
- Mandatory to have quality (assurance) committees
- Empowers MOH officials to inspect premise & ensure compliance
- Mandates monitoring of services & clinical indicators (quality indicators)
Professional registration & conduct
- Licensed healthcare professional
- Empower respective professional Councils & Boards to uphold professional standards
- Empower Councils & Boards to remove those deemed unfit to practice from register
- Mandates CPE for license renewal
Medical products & diseases
- Rigorous regulation of Health Products (ie. HPA)
- Spell out what medical profession can & cannot do in relation to specific situations (ie. Termination of pregnancy act, human organ transplant act)
Non-legislative framework for Quality Healthcare
Evidence-based clinical practice guidelines & practice standards (eg. MOH website)
- ie. MOH set up ACE to drive btr decision-making about clinically & cost-effective patient care
Monitoring patient satisfaction
- Surveys to gather feedback from pts recently discharged frm restructured hospitals, specialty centres, polyclinics
Market-based mechanisms to provide competition & transparency
- Comparison of performance index eg. LOS, Cost of procedures
- Fee benchmarks & bill amount info
Voluntary accreditation for Quality & Safety Standards
(eg. ISO 9000)
List the 5 key thrusts of the National Pharmacy Strategy (NPS)
1) Pharmaceutical care excellence
2) Confident pharmacy workforce
3) Re-design supply chain
4) Information enablement
5) Technology enablement
What does the NPS envisions?
- Necessary medications & services are AFFORDABLE to pts who require them
- Pts/consumers have TIMELY, ACCESSIBLE meds & pharmacy expertise @ each point of care
- Pharmacy services focus on QUALITY by providing health & preventive care within community
- Ensure safe & effective med use
- Delivering integrated care across all settings
[NPS] Pharmaceutical care excellence
- Establish role of pharmacy in community care setting
- Improve drug stewardship in non-acute care settings
- Establish collaborative models of care for med reconcilation
- Implement a clinical governance framework for med management
- Promote pharmacists as part of multidisciplinary healthcare team
[NPS] Confident pharmacy workforce
- Implement advanced practice framework for pharmacists
- Establish pharmacy residency programmes
- Enhance pre-reg pharmacist training programme
- Develop & train pharm technicians
- Build up manpower capabilities for community care setting
- Build capability in collaborative prescribing
[NPS] Re-design supply chain
- Centralise procurement, packaging, compounding & distribution
- Deliver meds where pts need it, where patients need it
