P.R.C.S. Presentation1

PRCS2

• Founded in 1968.• National, Humanitarian Society.• Member in the International movement of RC/RC.• Committed to the basic principles of RC/RC:

• Humanity• Unity• Independence• Volunteerism• International• Impartiality• Universality

PRCS/ basics

PRCS3

• Secondary Health Care (5 hospitals)

• Primary Health Care & Community Activities (in 9 health centers)

• Dental health programs

• Physiotherapy and rehabilitation programs

• Nursing and health education programs

• Community based health first aid (youth & volunteers)and health education programs.

PRCS/L

PRCS4

PRCS/L hospitals

Hospital Beds

Hamshary 80

Haifa 40

Safad 28

Balsam 28

Nasra 25

Total 201

PRCS5

Hospitals Specialist G.P. NurseTechnicia

n Other Total

Hamshari 26 15 65 14 24 144

Haifa 19 11 45 8 14 97

Safad 5 9 28 8 18 68

Balsam 12 6 23 11 18 70

Nasra 5 3 29 6 10 53

Total 67 44 190 47 84 432

PRCS/L Staff In Hospitals

PRCS6

Internal Medicine.Cardiology.ICU.General Surgery.Obstetrics & Gynaecology.Pediatrics.Kidney Dialysis and Uro-Surgery.Orthopedic Surgery.Ophthalmology.Dermatology.Neurology.Emergency care.Out-patients clinics.Radiology.Laboratory&Blood Bank services.Ambulance services.

Services by PRCS/L hospitals

PRCS7

1. G / E & Food poisoning.2. Chest Infections.3. Angina, IHD, MI.4. Anemia “ Sickle Cell, Talassemia”.5. Bronchial Asthma.6. Essential Hypertension.7. Congestive Heart Failure.8. Acute Tonsillitis.9. Chronic Obstructive Pulmonary Disease.10. Stroke “Cerebral Ischemia , cerebral

hemorrhage”.

Top 10 diagnosis

PRCS8

1- Vaginal Delivery.

2- Fractures and Orthopedic Operations.

3- Caesarean Delivery.

4- D/ C.

5- Tonsillectomy, Adenoidectomy and Sinus operations

6- Hernia Operations.

7- Uro-Surgery.

8- Appendicectomy.

9- Cholecystectomy

10- Haemorrhoidectomy & Anal Operations.

Top 10 surgical procedures

PRCS9

Worked on :• Community Based Health Education.• Community Based Primary Health Care.• Community Based Women Empowerment.• Community Mobilization.• Community Based Health Development.• First Aid Training.• Recruiting Volunteers• Community Participation

Community Based Health/First Aid

PRCS10

• Acceptable Quality .• Low fees .• Located in or near the Palestinian camps .• Connected to the community .• Continues services during crisis (NBC etc)• Complementary to UNRWA (renal failures,

car accidents.etc)• Impartial and neutral .• Support from RC/RC movement .

Importance PRCS For Community

PRCS11

• PRCS believes that the delivery of quality &efficient health care to its beneficiaries will be avehicle to the realization of its mission:

“ To improve the health status of Palestinian Refugees by providing preventive, health education, diagnostic and hospital care services.

Why Quality Improvement in PRCS/L Managed Hospitals?

PRCS12

Objective of PRCS Quality Improvement Initiative

• Is to improve the quality of SHC it provides to Palestinianpopulation through the 5 hospitals it manages in order to :-

a- Better profiles itself in the image of the community.

b- Match up with increasing competition.

c- Ultimately being at par with the Lebanese and international accreditation standards.

PRCS13

• Conducted Quality Assessments:

• ICRC 2007 ..

• UNRWA 2008 ..

• Dr Ziad Mansour 2009 ..

• Dr Rosena Alinn-Khan 2010

Quality In PRCS/L Hospitals

PRCS14

• “The quality of care in PRCS Hospitals in Lebanon is generallyacceptable, although it varies according to hospitals, within the services inside hospitals, and between categories of personnel and individuals. The majority of users have received acceptablecare.”

• “The major professional problem for hospital personnel, especially nurses and physicians, is that they are disconnectedfrom the international medical community.”

• “The major problems faced by the five hospitals are related toworking procedures and financial obstacles.”

ICRC Assessment 2007

PRCS15

“Although none of the hospitals reached full scoring in the survey, there is no doubt that they are all operating within the scope of care they should offer.”

UNRWA Assessment 2008

PRCS16

Hospitals were benchmarked according to high standards. Despite some drawbacks, they were able in their majority to have moderate scores.

Ziad Mansour assessment 2009

PRCS17

- Quality Indicators were decided on in coordination with UNRWA.

- Quality Indicators were mainly based on Lebanese

accreditation standards.

- Some indicators could and can not be achieveddue to the status of Palestinians in Lebanon(registered doctors and nurses)

Quality Indicators 2010

PRCS18

- 67% fully achieved- 21% partially achieved- 12% not achieved

Some partially or not achieved indicators:- Registered nurses.- Nurse call system in ER and ICU.- Fulltime physician in lab. medicine.- Fulltime doctor in radiology .

Quality Indicators 2010

PRCS19

PRCS/L survey overall satisfaction:

- 71% satisfied

- 20 % fair

- 5% not satisfied

- 4% no answer

Patient Satisfaction

PRCS20

UNRWA patient satisfaction:-

- General satisfaction: 93% satisfied.- Attitude of hospital staff: 72% satisfied.- Promptness of nurses: 72% satisfied.- Quality of nurses: 77% satisfied.- Comfort of hospital rooms: 68% satisfied.- Cleanliness of hospital: 85% satisfied.- Hospital environment: 72% satisfied.- Access to hospital: 81% satisfied.- Easy admission: 87% satisfied.

Patient Satisfaction

PRCS21

• Consolidation general indicators 2010.• Achieving not achieved indicators 2010.• Patient Safety.• Risk Management.• Hospital specific general indicators.• Evaluation professional practices.

Indicators 2011

PRCS22

PRCS/L General:- General Quality Committee- Scientific Committee

PRCS/L Hospitals:- Quality Committee- Infection Control Committee- Safety Committee- Risk Management Committee- Scientific Committee

Set up

PRCS23

• Standardizing and unifying quality of services and services delivery• Developing quality control mechanisms.• Supporting requirements for implementation of quality standards• Elaboration of clinical protocols • Training of staff.• Train the Trainer Program to improve hospital practice:

- Quality Assurance- Infection Control Measures- ICN & ICU- Occupational Safety- Communication Skills- Patient Safety- Risk Management

• Replacement of outdated medical equipments (assessment ICRC &PRCS)

• New equipments for PRCS/L Hospitals.”

SHCP 2011-2013

PRCS24

• Establishing maintenance department & availability of spare parts.• Updating list of medicine used in PRCS/L.• Support 75% of needed medicine.• Improve the quality of Hotel Services in the 5 PRCS/L Hospitals

by:- Improvement of the patient room- Upgrading kitchens & Laundries- Uniforms , Sheets- etc….

“ List of needs to improve hotel services”• Rehabilitation of some departments in hospitals.

SHCP 2011-2013

PRCS25

• Setting up Human Resource Management System in order to facilitate evaluation and development of the staff and review & complete the job descriptions for all PRCS Staff.

• Systematize internal and external audit systems.

• Increment of PRCS/L visibility (publishingaccomplishments of PRCS/L in a yearly newsletter ,conducting field visits and focus groups from local community).

SHCP 2011-2013

PRCS26

• Motivation of staff .• Quality of services .• Availability and maintenance of equipment .• Continuous education of staff .• Lack of resources of target group .• Dependency on donors and contract of UNRWA .• External interference .• Marketing & image .• Low occupancy of hospitals .• Status of the organizations .• Financial resources .

Challenges

PRCS27

PRCS/L Cost Price & Fees

• PRCS/L cost price 172 USD• Cost price Lebanese Hospitals 225-285 USD

• PRCS/L cost 172 USD• Current UNRWA fee for PRCS 67 - 100 USD

• PRCS fees for beneficiaries: 67 % of MoPH• PRCS fees for UNRWA: 34% of MoPM

PRCS28

Thank You