what’s up, doc?: delivering service excellence in health industry june 22, 2012; 6 – 9 pm ateneo...
TRANSCRIPT
What’s up, Doc?: Delivering Service Excellence in Health Industry
June 22, 2012; 6 – 9 pmAteneo Professional Schools Auditorium
Rockwell, Makati
MBA students from all the programs of AteneoMedical students from Ateneo School of Medicine and Public Health
What’s up, Doc?: Delivering Service Excellence in Health Industry
MBA students from all the programs of Ateneo
Medical students from Ateneo School of Medicine and Public Health
What’s up, Dr. Rey Joson?
What are your
thoughts, perceptions, opinions and recommendations (TPORs)
on delivering service excellence in the health industry in the Philippines with focus on hospitals?
ROJ’s TPORs on Delivering Service Excellence in Health Industry with Focus on Hospitals
Outline of Presentation
• When does one say there is service excellence in the health industry?
• When does one say there is service excellence in the hospital industry / in hospitals?
• .………..
• ………...
ROJ’s TPORs on Delivering Service Excellence in Health Industry with Focus on Hospitals
Outline of Presentation• .………..• ………...• What are some recommended strategies for
delivering service excellence in hospitals? • What are the most difficult (outstanding)
challenges in delivering service excellence in hospitals?
ROJ’s TPORs on Delivering Service Excellence in Health Industry with Focus on Hospitals
Questions (ROJ) Questions (Organizers) – Reference: MDH
•Service excellence in the health industry?
•Service excellence in the hospital industry / in hospitals?
Demonstration of service excellence Operating environment and key relationships
with patients and stakeholders, suppliers and partners
Well-being of society Legal and ethical requirements
•Some recommended strategies ?
What strategies How implemented How measured How communicated Cost-effectivity
•Most difficult (outstanding) challenges ?
Challenges
Q1. When does one say that the health industry in the Philippines is delivering service excellence?
The health or medical industry -
a sector within the economic system
that provides services and goods
to people with health concerns.
Q1. When does one say that the health industry in the Philippines is delivering service excellence?
Health or medical industry – a conglomeration of
• regulatory bodies and offices on health programs, goods, and services;
• health care facilities; • health care products and their manufacturers and
sellers; • health care practitioners and providers; • health care insurances; • health and medical educational and research
institutions; • other activities associated with human health.
Q1. When does one say that the health industry in the Philippines is delivering service excellence?
Just like any other industry,
health or medical industry is expected to deliver, in a collective effort, excellent services and products to the community.
Question:
what criteria and indicators do we use?
Q1. When does one say that the health industry in the Philippines is delivering service excellence?
Look atHealth care outcomes of catchment community –
Philippines, a province, a city, etc.Criteria Indicators
Average life span Acceptable percentage of Filipinos reaching targeted life span (e.g. 70 years old)
Infant mortality rate Acceptable rate (25 / 1000 vs 19 / 1000)
Maternal mortality rate Acceptable rate (94 / 100,000 vs 52 / 100,000)
Control of specific diseases
Controlled incidence, prevalence, mortality and morbidity rates (e.g. control of dengue and non-communicable diseases)
Quality of life index Acceptable rate (e.g. 7 vs 8 score – QLI; suicide rate
Access to health care Acceptable indices
Others
Q1. When does one say that the health industry in the Philippines is delivering service excellence?
Look atHealth care outcomes of catchment community –
Philippines, a province, a city, etc.Criteria Indicators
Average life span Acceptable percentage of Filipinos reaching targeted life span (e.g. 70 years old)
Infant mortality rate Acceptable rate (25 / 1000 vs 19 / 1000)
Maternal mortality rate Acceptable rate (94 / 100,000 vs 52 / 100,000)
Control of specific diseases
Controlled incidence, prevalence, mortality and morbidity rates (e.g. control of dengue and non-communicable diseases)
Quality of life index Acceptable rate (e.g. 7 vs 8 score – QLI; suicide rate
Access to health care Acceptable indices
Others
Are the set and agreed indicators being achieved or
not?
If yes, EXCELLENT!If no, NOT or “NOT SO”
excellent!
National / Local Government Health Departments
Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent?
Excellent hospitals contribute to the achievement of targeted health outcomes in catchment community.
Catchment Community Targeted Health Care
Outcomes
Life spanInfant mortality rate
Maternal mortality rateControl of specific
diseasesQuality of life
Access to health careOthers
Hospital
Programsfor targeted health care outcomes
Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent?
Cost-effective-efficient medicine
Value-based medicine(Porter & Teisberg)
Quality and safe medicine
Evidence-based medicine
Excellent hospitals provide value-based health services (inclusive of cost-effective-efficient, quality and safe services).
Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent?
Value-based Medicine or Health Services
• Value created for and appreciated by patients served and for services rendered.
• Value = health outcomes achieved per peso spent, not just access, convenience, volume, and cost containments.
Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent?
Value-based Medicine or Health Services
• Good health care outcomes (good results) on community and individual patient indices
• Quality and safe services
• Reasonable costs and expenses
Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent?
ROJoson’s Survey on Excellent Hospital (2010)[141 Hospital Administrators; Physicians; Non-physician Health Care
Providers; Patient-clients]
Parameters of Excellence Overall Frequencies
With affordable / reasonable hospital / medical costs
52%
With financial sustainability program 46%
With state-of-the-art equipment 40%
With quality and patient-friendly infrastructure and facilities
40%
With quality services 30%
Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent?
ROJoson’s Survey on Excellent Hospital (2010)[141 Hospital Administrators; Physicians; Non-physician Health Care
Providers; Patient-clients]
Parameters of Excellence Overall Frequencies
With affordable / reasonable hospital / medical costs
52%
With financial sustainability program 46%
With state-of-the-art equipment 40%
With quality and patient-friendly infrastructure and facilities
40%
With quality services 30%
Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent?
Excellent hospitals are those that are managed to be sustainable while providing excellent services.
A hospital is sustainable if it has the ability to continue
to achieve its operating objectives and fulfill its mission
over the long term and is resilient over time!
ROJ TPORs on Sustainability of a Hospital
Financial Sustainability
Management Practice Sustainability
Indicators:• Constantly positive net
income• Constantly adequate
liquid asset• Constantly manageable
debt burden
Indicators (COMPLIANT):• Baldrige Health Care
Criteria for Performance Excellence
• Quality and safe patient care standards
• Investors in People
ROJ TPORs on Sustainability of a Hospital
Financial Sustainability
Management Practice Sustainability
Indicators:• Constantly positive net
income• Constantly adequate
liquid asset• Constantly manageable
debt burden
Indicators (COMPLIANT):• Baldrige Health Care
Criteria for Performance Excellence
• Quality and safe patient care standards
• Investors in People
ROJ TPORs on Sustainability of a Hospital
Programs Ultimate Goal
Business development for the whole hospital and its units
Maximal utilization of services
Financial management NO unwarranted lossesEnough revenues and incomes to continue and expand
Business continuity and disaster resiliency
Business continuity after a disaster
Corporate social responsibility
Sustenance of catchment community
ROJ TPORs on Sustainability of a Hospital
Programs Ultimate Goal
Business development for the whole hospital and its units
Maximal utilization of services
Financial management NO unwarranted lossesEnough revenues and incomes to continue and expand
Business continuity and disaster resiliency
Business continuity after a disaster
Corporate social responsibility
Sustenance of catchment community
Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent?
Excellent hospitals are those that are managed to be sustainable while providing excellent services.
Excellent hospitals contribute to the achievement of targeted health outcomes in catchment community.
Excellent hospitals provide value-based health services (inclusive of cost-effective-efficient, quality and safe services).
Q3. What are some recommended strategies in
delivering service excellence in hospitals?
Strategic Framework:
• Set 3 key indicators of an excellent hospital as goals.
• Design and develop hospital performance excellence program.
• Get committed support of top management and staff.
• ………• ………• ………
Q3. What are some recommended strategies in
delivering service excellence in hospitals?
Strategic Framework:
• ……….• ……….• ……….• Implement program perseverently.• Evaluate results of implementation.• Continually improve program until 3 key
indicators of performance excellence are achieved to the highest degree.
Q3. What are some recommended strategies in
delivering service excellence in hospitals?
Strategic Framework Facilitating Strategies
Design and develop hospital performance excellence program
• Baldrige Health Care Criteria for Performance Excellence
• Joint Commission International or Accreditation Canada International accreditation for hospitals
• PhilHealth Benchbook
Implement program Investors in People standards
Evaluate results of implementation
Balanced scorecard
Baldrige Health Care Criteria for Performance Excellence
US-based standard designed to help hospitals use an integrated approach to organizational performance management that can result to:
• Delivery of ever-improving value to patients and other customers, contributing to improved health care quality
• Improvement of overall organizational effectiveness and capabilities as a health care provider
Questions and guides on how to achieve performance excellence for hospitals
Comparison of Patient-care StandardsAccreditation Canada Joint Commission International PhilHealth Benchbook
Individual Client/Patient Care Groups (14) that correspond to particular episodes of care and treatment
Information Management
Human Resources Development and Management
Environmental Management
Leadership and Partnerships (one team for management and one team for governance standards)
Patient-centered Standards
• Access to Care and Continuity of Care• Patient and Family Rights• Assessment of Patients• Care of Patients• Anesthesia and Surgical Care• Medication Management and Use• Patient and Family Education
Health Care Organization Management Standards
• Quality Improvement and Patient Safety• Prevention and Control of Infections• Governance, Leadership, and Direction• Facility Management and Safety• Staff Qualifications and Education• Management of Communication and
Information
• Patient Rights and Organizational Ethics
• Patient Care
• Leadership and Management
• Human Resource Management
• Information Management
• Safe Practice and Environment
• Performance Improvement
Investors in People Standards
Business improvement tool designed to advance an organization's performance through its people!
Balanced Scorecard
Blueprint formulated by organization to be used as a guide and reference for
• implementation of strategies and tactical objectives
• monitoring • evaluation of actions taken
Management strategic tool as well as performance measurement system
Balanced Scorecard
Popularized by Kaplan and Norton in 1990
Scorecard with four perspectives:• Financial• Customer• Process• Learning growth
MDH BSC What is the template being used in MDH BSC?
MDH BSC Perspectives(2004 -2007)
MDH BSC Perspectives(2008 - 2012)
Financial Financial
Customer Customer
Process Process
Learning and Growth Learning and Growth (People)
Corporate Social Responsibility
Balanced Scorecard (Sample)Vision: Leading center of excellence and wellness in the Philippines
providing holistic quality patient carePerspective Goal Tactical
ObjectivePerformance Initiatives
(Programs) Measures Target
Financial Financial viability
Achieve profitable growth through normal operations
Gross revenue
XX% increase
Project Maximal Utilization of Services
Financial sustainability
Prevent account receivables
No. of admitted patients with account receivables –
less than XX%
Project Control of Account Receivables
Hospital Image and Reputation
Participate in programs of external award giving bodies promoting quality and excellence
Management Award
Submit at least 3 entries
Project External Awards for Excellence
Balanced Scorecard (Sample)Vision: Leading center of excellence and wellness in the Philippines
providing holistic quality patient care
Perspective Goal Tactical Objective
Performance Initiatives (Programs) Measures Target
Customer Quality service and care
Provide quality services – prompt, effective, and courteous
Customer satisfaction
rating
≥90% Project Customer Feedback and Relations
Process Excellent operational mgt system
Develop effective / efficient quality management system
Conduct of Continual Improvement Program
in 70% of units per division
Project Continual Improvement
Balanced Scorecard (Sample)Vision: Leading center of excellence and wellness in the Philippines
providing holistic quality patient care
Perspective Goal Tactical Objective
Performance Initiatives (Programs) Measures Target
People Competency Development
Provide training programs based on identified training needs
total number of units participated in one competency based training
At least 85%
People Growth and Development Program
Corporate Social Responsibility
Excellent corporate social responsibility program
Develop CSR Programs
No. of indigent patients served (inpatients)
Greater than 20XXtotal number
Project CSR
Has been useful in serving as
- communication
- alignment
- collaboration
- monitoring
- evaluation tool
in the implementation of strategic direction in Manila Doctors Hospital.
History of MDH BSC (2004-2011) Outcome
All departments have BSCs cascaded from hospital
BSC!
Q4. What are the most difficult (outstanding) challenges in delivering service excellence in hospitals?
Strategies
Challenges
Man Method Money Machine Monument Trends in Health
Design and Develop
√ √ √ √ √ √
Get CommittedSupport
√ √
Implement √ √ √ √ √ √
Evaluate √ √ √ √ √
Improve √ √ √ √ √ √
Goals and Objectives
of
Health Industry
Hospital
Alignment of Players, Processes and Systems
Integration of Processes and Systems
Coordination and Collaboration of Players
Alignment, Integration, Coordination and Collaboration (Teamwork)
Q4. What are the most difficult (outstanding) challenges in delivering service excellence in hospitals?
Most difficult challenge –
how to manage the people with different mindset and behavior, particularly in the face of a paradigm shift
(community health outcomes targets, value-based delivery system, and corporate social responsibility)
Q4. What are the most difficult (outstanding) challenges in delivering service excellence in hospitals?
ROJ’s Recommendations to meet the challenges:
• Facilitating strategies – Standards, IiP, and BSC
• Leadership – direction, motivation, commitment, innovation, etc.
• Managership – technical competence in planning, implementing and evaluating
• Communication – clear and closed-loop communication
• Education – mentoring and coaching of all concerned
ROJ’s TPORs on Delivering Service Excellence in Health Industry with Focus on Hospitals
Questions (ROJ) Questions (Organizers) – Reference: MDH
•Service excellence in the health industry?
•Service excellence in the hospital industry / in hospitals?
Demonstration of service excellence Operating environment and key relationships
with patients and stakeholders, suppliers and partners
Well-being of society Legal and ethical requirements
•Some recommended strategies ?
What strategies How implemented How measured How communicated Cost-effectivity
•Most difficult (outstanding) challenges ?
Challenges
ROJ’s TPOR on Hospital’s Medical Tourism Program
• A hospital can have a medical tourism program
as long as it does not forget
its primary responsibility to its nearby society or its catchment community.
ROJ’s TPOR on Hospital’s Medical Tourism Program
• A hospital – excellent based on the 3 key criteria – compliant with
• Baldrige Health Care Criteria for Performance Excellence
• international patient-care standards (JCI or ACI)• PhilHealth Benchbook
• Attract international patient-clients to its premises – part of the medical tourism program – foreigners who got sick while visiting the
Philippines as tourists
MDH Journey towards Excellence
1999 20122004 2009 201120102005
Integrated Value-based Health
Services (2012-2014)
V-M CSR Mission
Social Vision
PhilHealth BenchbookCenter of Excellence
Accreditation Canada International
ISO 9001:2000 /8
Balanced Scorecard
Baldrige Heath Care Criteria
for Performance Excellence
Investors in People
2007
MDH Journey towards Excellence
1999 20122004 2009 201120102005
Integrated Value-based Health
Services (2012-2014)
V-M CSR Mission
Social Vision
PhilHealth BenchbookCenter of Excellence
Accreditation Canada International
ISO 9001:2000 /8
Balanced Scorecard
Baldrige Heath Care Criteria
for Performance Excellence
Investors in People
2007
MDH Journey towards Excellence
1999 20122004 2009 201120102005
Integrated Value-based Health
Services (2012-2014)
V-M CSR Mission
Social Vision
PhilHealth BenchbookCenter of Excellence
Accreditation Canada International
ISO 9001:2000 /8
Balanced Scorecard
Baldrige Heath Care Criteria
for Performance Excellence
Investors in People
2007
Summary and Closing
ROJ’s TPORs on Delivering Service Excellence in Health Industry with Focus on Hospitals
Questions (ROJ) Questions (Organizers) – Reference: MDH
•Service excellence in the health industry?
•Service excellence in the hospital industry / in hospitals?
Demonstration of service excellence Operating environment and key relationships
with patients and stakeholders, suppliers and partners
Well-being of society Legal and ethical requirements
•Some recommended strategies ?
What strategies How implemented How measured How communicated Cost-effectivity
•Most difficult (outstanding) challenges ?
Challenges
Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent?
Excellent hospitals are those that are managed to be sustainable while providing excellent services.
Excellent hospitals contribute to the achievement of targeted health outcomes in catchment community.
Excellent hospitals provide value-based health services (inclusive of cost-effective-efficient, quality and safe services).
Why deliver excellent service in health industry?
Obligation
Health industry and its components owe it to the clients they have decided to serve!
Clients = communities with families and individual citizens therein.
They should do what is right for their clients.
Why deliver excellent service in health industry?
Sustainability
With excellent service, value-based services,
• more clients, • maximal utilization of services,• enough revenues and incomes to
continue to operate and to expand the business of the hospital when and as needed!
Why deliver excellent service in health industry?
Sustainability
With a social vision, corporate social responsibility,
there will be sustainability of the catchment community and, in the end,
sustainability of the hospital!
Hospital Performance Excellence - a Long Journey
Advice:
Start early as the journey is long and tedious!
Need to be very very perseverant as there are a lot of challenges and things to learn!
Thank You!
Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg
0918-804-03-04For queries and for my Websites!