3．途上国の事例（PDF/275KB） - JICA Research Institute
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1. T iz E CLE E 21 11 a E E L3 L3 r3 Eas EZ E 1 1 ES EST Ee 1 e 5 5 5 um E EE J es AA E L3 Er EST 3 4E ET Bee D gt lt ti Disciplinary ODO OOO E ET E pr E ESSE Oo L1 oO L1 L1 El oO L1 L1 L1 oO L1 LE D 5 1 5 1 4 21 E E E 5 5 Ess ty Ey 1 1 6 1 SERT Tl TE 13721011772. DUUIDDDUDDDUDDUDDUDUDDUDUDBDUDUDUDUDUDBUDUDBDDUDDUDUUDDUGDUDUUUDU UUIDDUDDUDDDUDUDUDDUDGUDUUUDDUDUGUDUDUUUDUUDDUBUDUUDDUDBDUDUUuDLDU 9 00 0 1 10900090 00 Teamwork Documentation Patient s Education Patient s Rights Clinical Quality and Risk Management Utilisation Review 59 EE Oo o CoO Ooo
3. 0 8 089 9 088000800000000000000 E EF nm 0 0 0 0 E LT 1 E REGEL EE ET O EJ OOOOGOOOOOOOOOOOOOCOOCOOOOOOOCOOOOOOOOO 57 E m RI 53 ES ERSTES FI EH ESTEE L ES E ESSE EST ET ES SES ESTEE TESTS ESTE EE EST ESSE EI r E ogad EIT ESI ES TES ESI a QT E E E E23 1 ES Ee ee 217221 2E EJ EY E E TERMS 3 EIE EST E IH S DEI EE E L E E ELE H E POCO DOO eo ODEO Ee Ey EZ 111 BERE BE BEI B EE DBUOBDBOBDUEH D dul P BES
4. 1 0 1 11 1 Asian Productivity Organization APO Oo 0 1111 11 1111 11 gg DE EIL FF ET EJ EE E 0 0 0 0 0 0 0 0 0 0 0 0 OOOOOOOOOOOOOOOOOOOOOOOCOOOOOOOOOO F3 FH p4 FJ EJ EJ p4 1 2 L1 L3 yo OOOH 0 0 00000 TQM 0 90 0 00 0 0
5. 51 AKIMOTO 000000 Quality Secretariat 0000000000000 39 oO Soogocea E EI qr iE 2 L3 r3 r3 oOo 1 bz En mT 3 Bn T ES 217 1 129 027 pr Ee i usa 271 SETA En ET i E EJ Er E LET E E EET ERES ES ES ET EZ EI pz OOo 1 11 ET 7 L1 57 21 p EX E LT I 40 oO oo oo Ete ei Se CES Se EE EE CERES Se ae ono oo oo T SS A a noooo 3 32 ono0p0 N Tooog onoooo 1 noooo BAGON onoooo a 1 LJ ono0p0 N 2AGA 32 JA a z1 E El o
6. 9 554 0 0 0 00 0 100 008 080 80 0 00 8 000080 80 0000010000 OooooooossMOOOOOOOOOOOOOOOOOOOOOOOOOOA OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOBOCOOCOOOOOOOGO 0
7. 69 DUUDDUDDUDUDUDUUDUDUDBDUDBDUUDGUDUDUDUDUDUDBUDDUUDUDUDUDUDBU uDULDLU DUUIDDDUDDUDUDUDUUDUDUDBDUDBDDUDUDUDUDUDUDUDUDUDDUDUDUDUDUDBBUuDULDLU OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOOOOOOOOOOO 000l 42 ET E 1 E a Gal ECT E E EE 8 Epi Ell LI ESTERI Es FE EIE m nm nm D D ET E WF ES National Health Security Office 0 Coverage Populationg 00 0000 GDPO User 38 52000 Access 0101000100 00 0 De
8. E 0 0 0 Ministry of Health and Women s Affairs O Quality Secretariat 0 National Quality Assurance Program 00000000 10 11 1 1 Quality Secretariat 1111111 1 1
9. Outcome 0 0 0 72 0 0 gBUBBDBDU br Hasani OOOO DU uu DU Uu OOOH 0 0 0 0 0 E TO E OU OU OU 0 0 0 0 0 00 lU 10 U
10. 1 Health and Population Sector Programme HPSP 19982003 0 0 0 QAP 0100000000 0 00 0 0 GD Quality Assurance Cell I B D Health Nutrition and Population Sector Programme HNPSP 20032003 02000000 0 10 0 UUIDDUDDBDDUDUDUUDDDUDDBDDBDUGUDUDUDUDUDUUDUDUUDUDUDUDUDBU uDULU
11. 00 000000 8 49 19990 UUDDUDUDUDUDUUDUDDDDBDDUDUUDUDUDUDUDUDUDUDUDUDUDUDUDUDBU uDULU DUUIDDUDDUDUDUDUUDDDUDDBDDDUUDGUDUDUDUDUDUDBDDDUDUDUDDUDUUDUuDULU DUUIDDUDDUDUDUDUDUDDUDDBDDBDUUDUDUDUDUDUDUDBDUDDUDUDUDUDUDUDUUDUuDLU U uu POA OEE ORE BOO EE EE EE EB EGET POPE BEBE eo LUE BEDS 0 0 0
12. Autonomous n I D OD D DT Quality Review System OOOOOOOOOOOOCOOOOOOOOOOCOOOOOOOOOOOG D UBDDut Analyze the Organization 000000000000 OOOO 111 1 Look at Standardi 000000 Quality Culture 121 1 E E ET ESI FT E 1 21 5 1 27 1 Oo LET D E E EJ EZ LESE EST SET AEST E Eds ES CES 1 1 GE E Improvement QAM
13. 19930 D U 5551 Ll Social Security Service 00000 199230 1993 1 000 8 0 800 000000800090 00000000 00 10 HA for Hospital Executive HA for T eam Leader F acilitator After 1st step bring forward to systematic development and HPH in Linkage New T rend of Quality Improvement Quality Improvement for Service Support HA for Lecturer Coordinator Quality Manager Advanced F acilitator Internal Inspector Professional nspector Medical Resource Administration Basic Level Medical Reso
14. LU LU 0 9 LU LU Duguuuu L1 E Lr 51753 Pela E 1 5 1 E L1 Co Lr Co EH HL BL D HE C D 165 udtgattattt Local Government Units o 1 Cc pc u CI 5 8 E EAE 127 Ez E 5021 1 1 ESSE 1 1 0 OOoOOOOOOOOOOOOSSMOOOOOOOOOUSAIDO 90 1 EH E Ooo UU DBpugu7zesasupngaungunpuaupngaunp uupngun
15. 2005 2010 IDA WB Health Services Project 2005 2010 Sri Lanka Health Sector Development Project ttt Subcomponent 24 Improving Hospital 4 Efficiency amp Quality H 11 1 1 Output product 4 1 601 amp TQM Initiation in Hospital in Uva amp Southern Provinces in Sri Lanka T Quality 80000 000 60009 2520 0000 20050 Secretariat QQ 73600 DU O O O Quality Secretaria D 00000000 Quality Secretariat caig WHO Li H Work Plan for 2040 000000000000000 O0O0000 No SRL OSDOO3I 0 00 0 0 0 Global Expected Result No 644 1 D
16. Improvement Organization 8 OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOGA orienred oo L3 oo 60 00 10 000000000 Vision to Action Objective KPIS Hospital Objective KPIS Department Division Job KPI s amp competencieg Position 00 11 000000000 Quality Improvement Organization Corrinu 61 00 12 000000000 OP voice QC 5S ESB 000 ESB Excellent Service OPHP Voice 01 Continuous Quality Improvement GO 00000 QA Quality Assurance 0 0 00 RMQ Risk Management 0 OOO00 00 0 0 0 OD Operation Design CPG
17. 0 0 0 20050 0000000000 D Project Appraisal Document PADO 0000000000 OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOOCOOOOOOOOOO ODOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOOOOOOOOOOOOGO 1 101 8008 00 80 80 00 08 00080 80 00100001000 0 73 L3 OA oo OO Oo E Strategic Implementation Plan 1 O00 HIV AIDS L3 r3 r3 L3 r3 r3 m Ooo OU
18. 1111 11111 11111111 11141 0111 1011011111111101 010110111111 1111010 110111111111110111 LU TMO 9 0 0 9 E LE E EI E E T E FEX EE L p P 3 Ez Ez SERT ES Es p L ET p Ba EJ E HERE E E E P CEST E E Ee l E L P EST ip j E E E EO P E E EET E Ey 0 0 0 0 0 0 0
19. 00 4700000000000 20060 00 300 0 1 0 0 Better Service OO 1 1 0 1 1 1 1 1 03000000 1
20. 1 0 107 0 20050 0 00 37 00 0 National Quality Assurance Program NQAP Main Objective Providing responsiveness health service to the people Objectives Introduce an institutional monitoring mechanism to Teaching Hospitals Provincial Hospitals and selected District hospitals Q Strengthen the middle level managers to develop managerial skills for the QA program Introduce Quality related data collection in T ertiary Care hospital eg Patients accidents and incidents Re admissions Complications management Customer care Human Resource Development Activities and Methodology Conduct workshop on developing Monitoring Mechanism in each institution Develop a core group at Quality Secretariat Quality management Units to function as facilitator G Developing education material Conduct monthly review meeting at institutional level amp Monthly reviews of Quality Secretariat Budget A pprox Rs 700 000 Product Quality Secretariat will be organized to facilitate quality of care in pilot hospitals QA standard review mechanism will be developed for the NQA P Institutionalize the monitoring mechanism at hospital level A Quality culture is developed in t
21. 1 3 103110 0 1 0 8808 0 8 00808008 DO0O00000000000000 2020 00000000000000 0 2004 000000000000 Quality Improvement 0000000 0 Ej m FE rr L3 E El L1 EISE 0 0 0 0 0 1 EZ OOOO E E J SE EST Ee EE EST ET ZI 8
22. 1509001110110 100 0000000000000000000 150 0 0000000000 0 1111111 1 118881801180118181101 01 1111111111 111111 11 1111 141111111111111 11 0 00 0 History of HA CHIA 1 Under Health Systems Research Instityde Standard implementation HA Project R amp D amp Compliance Assessment i Rewew Concept amp Requirement Standard US Canada Australia UK Seek Opinion fram Stakeholders Delphi ee Assessment Experience gt Improvement Tools 953 804 95 90 87 S88 88 00 01 02 03 50 2901
23. Joint Commission on O 20050 O Accreditation of Healthcare Organizations JCAHO I HH E HH E H E E 0000000 6 OO 14 Summary of the Different Institutions Organizations that Contribute to the Quality Improvement Efforts in the Philippines PCAHO A ccreditation Certification Voluntary Authorization from DOH Requirement for DOH accreditation Quality improvement Confirmatory drug testing laboratories OFW and Seafarer medical clinics Quality Standards Systems Training TA accreditation certification review PSQua Voluntary Quality Improvement Tertiary hospitals Training Manual for QA QI Training TA showcasing of Qlactivities DOH NCHFD Voluntary AO 172C 3 Quality Improvement DOH hospitals Department Order Training T echnical assistance SSM PHASE 2 Certification Voluntary AO 17 B s2003 Prerequisite for PHIC accreditation Quality Improvement Rural health units Sentrong Sigla Quality Standards List Desk review of document On site evaluation training and TA PHIC A ccreditation Voluntary RA 7875 Participat
24. Hospital DOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO 1 00 0 Commitment to Quality 1 Leadership 2 Policy Direction Resource M anagement 3 Resource Management 4 HR Human Resource 5 Environment amp Safety 6 Equipment amp Supply 7 Information Management Quality Process 8 Quality Process 9 Clinical Quality 10 Infection Control Professional Ethics 11 Medical Staff Organization 12 Nursing Administration Patient s Rights and Organizational Ethics 13 Patient s Right 14 Organizational Ethics Patient Care 15 Patient Care T eam 16 Preparation for Patient and F amily 17 Patient Assessment and Planning 18 Patient Care Delivery System 19 Patient Information and Record 20 Discharge Planning and Continuing Care 3 Advance HA 403 HA 502 HA 602 OOOOOOOOOOOOOOOOOCOOCOOOOOBOCOOCOOOOOOO
25. O10 000000 O Sarabun Regional Hospital O0 TOM Regional Hospital OOOOOOOOOOOOOOOOOOOMOOOOOOO General Hospital 000000000 199 OOU00 Autonomous Quality OU 0 0 nm HE ey E ET Eg EISE EJ ES E
26. 1 1 00 OO Health Service Provider Acti 19890 O0 Standard 1 00000000000000 00000000000000 CO00000000000000000000 0 Minimum Requirement OOO Improving 1990 O0 10 6 1 T E ET 31 OU OU OU OU 0 0 0 0 0 0 0 0 0 0 0 0 0 utt 1101111011 399811 Quality and 1 1 1 1 1111 11111 1 1011 Health Service Standard Constitutional Law BH D 19995 1 E BO Health System Research Institute HSRIQOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
27. 1 1 Inspector J Awardg 1 1 3 Quality Reliance Team 107 TH TQM 1 11111 1 1 45 b System OOOO Standardi 0 O0 Process 111111111111 00 000 D 0 0 0 0000000000000 HNQAQ 8 Ogg EFE EE HE EE HE fk 11111111111 111 111111 141111111111111 111 8
28. 55 0000000000 A0xg000000000000000000000000000 O0 Development Academy of the Philippines PSQua 0O 1 D OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOCOOOOOOO 0 0 1 21 E 0 OOOOOOOOOCOOOOOOOOOOCOOOOOOOOOOCOOOOOOOOG Dr Mercado OO SSMI JJ Dr Dayrit OOOOOOOOOCOOOOOOOOOOCOOOOOOOOOOOOOOOOOOOG 0 0 OOMs 0000 Quirino Memorial Medical Center QM MC Dr Arandiaq C 69 DU uuu OOOO PCAHOQ OOO USAIDOOOOOOOOOOOOOOOPHICO WHOD D D EPA EPQiphg na unupnununununupnnnnuapnunununung upnanpnaunaun LU OU O 20000 D Uu L1 Ip FFT 121 E l 21 021 L3 0300000000 2 sssi EE 0 PSQua PCAHOD D D 0 D Dr Marambar OOOO ea E E
29. 000 urity servic 1000 800 800 90 080 00 900000000 0 Inter Committ tra Committee O Head Outpatient Department O 000000000000 BEBE D HA Thai 1I D HH D Dr Anuwat 0 n nm nm E EE 23 OOH ri e L1 L1 aga E Ez E Ez E ET ESSE E
30. 5654 0 OU OU OU 0 9 0 OOOO 0 0 8 0 0 0 OOOOGOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOOOOO UUIDDUDUDDUDUDUUDUDDUDUDBDDBDUDUDUDUDUDUDUDBDUDDUDUDUDUDUDUUuDLULU DUUDDUDDBDUDUDUUDDDUDUDBDDBDUUDUDUDUDUDUUDUDUDUDUDUDUUDUDU uDLDL 98 8
31. 68 LU 0 BE BED RISE 8 B WEE B 310 520011 1 0 0 LU UUDDUDDUDUDUDBDBDDBDUGUDUDUDUDUDUUuDUUUDU 0 0 0 0 0 0 0 ES E Ea GEI 0 0 53 EE o 0 Uu OOOOOOOOOOOOOOOOOOOOOOOG 0 0 0 0 ame Fa fg E Ed L3 Ed Ed 4 o r3 E Ey EE 1 EE CEST 2 3 r3 E3 H p n 0 0 0 0 LEE L1 r3 L3 L3 PCAHOD EF E L IEEE p E J E
32. O Public Sector Standard 44 A EE 00 0 1985 Health Service Provider A ct 1989 Standard for Medical Staff Minimum Requirement 1990 Improvement F rontlineg Environment 1995 Beginning TQM 1998 Health Service Standard Constitutional Law 1999 Establish HA T hai Develop Process Standard 2000 Publish Public Sector Standard 2002 Start 30 Baths Scheme 2003 Publish Guideline for Health Service Standard Constitutional Law 2004 Trial HNQA 4 provinces 2005 Expand HNQA 14 provinces 2006 Plan to Expand HNQA 30 provinces uuu
33. RCWNLI 000000000000 HH tion Control Committee ICC D Uu Uu 203 2 E EST E E CEST EZ LE 1 O33 ET SED ESI 1 1 Eg EE EDS EST ESSE ES E EI Ez ESL SES AEST ESSI EST l E EIE ESSE ESSET EIE ESAE EI ET EH SES GEHE ESI SESS 1 11 1 LESE ESSE EZ EE Cy Ee A E ESSE E 1 SERT 14 1 0 21 161 SEES EI es EE n ESSE E 1 1 gt ES EX ES a 5143 E E Eb 2 Iz 1 12 5 1 SESS a nm oo ET Ee TH L3 rrr Ooo m HD B EI Sao hai Hospital J TOM L1 221121 fy sa m OOOOU3Q0000000000000000000000 111 1 1 Public amp Private Administration LU L U DU OU OU 2151 E E oHooooe EI 3d pL EXE E E ES EI 0 0 0 0 0 00 0
34. 00 0 HA Thai 00 0 HA Thai Situation 2004 96 2005 May 05 Under development to Level 1 538 558 218 Level 1 213 221 601 Level 2 154 160 32 HA 59 61 113 Total 964 100 964 Gog Dr Srismithg NHSO 2 0300000000000 OOO 8111010000000 200000 StandaargOOOOOOOOO 0 Board of Accreditation 00000000000 O Minimum Requirements IDD BH HH 1 H B BH H E D 0 Benchmarking 000000 im Community
35. Cr 013 LJ LJ EJ CJ CJ C3 L3 3 2 CJ C3 EJ r3 E oo D ra EJ EH EH E E C C3 EH CH BH 0 Ey l E L1 L3 5 1 2 1 21 EZ 0 0000 0000 0M Hospital L Accreditation Cooperation Center HACCOIQOOOOOOOOOOOOOOOOOOOOOO 0 80 0 0 8000080 80 00000000 00 0 1 How to Review Patient Care 2 Patient Report Complain 3 Risk All Risk Patient Personnel Hospital 4 Incident 5 Medication Error Drug Control 6 Infection Control 7 Important Events Incidents etc 8 Medical Records 9 Utilization 10 Indicators Review Set up by the Hospital 11 Refer Case 12 New Comer Expert Less Experience 51 226 623 117 100 00 0 HAThai 3 Steps to HA Step 1 Risk prevention Identify OFI from 12 reviews pem
36. 0 110 01 90 0 0 4 8 000000 000000 63 6 QA OU nm 48 0 0000000 Qual OOOOOOOOOOOOOOOOOOOOOOOOOGO OOOOGOOOOOOOOOOOOOOOOOO pL E n 000000 19960 6 0 20040 0 QA QM0 Essential PCAHOD OO Uu OOO 6551 Uu UU United States Agency for International Development OOO0G00000000 0 Quality Assurance Program QAP
37. Bumble Adulate Hospital TQM 0 Primary Care Unit tL tu O40000 0 0 0 0 0 D uu 1 l iu 0 8000 oamp Excellent Service Behavior ESBO OO OO H HH 1 HH BH HH B BH HH DH HH D 1 0 0o Ul Dr Anuwat 0000000000
38. m Thai II HD B D 0 D 000 B Health Promotion 0 00000000 00 L1 0 Kanthina OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO 0 0 0 0 0 0 0 0 56 unit Optimization Vertical Alignment 1 O Horizontal Integration Quality Steering Team O l Committee 0 D 0000000000 0 1 EE EF E
39. L1 IE E E EF 3 n E L1 L1 oO 0 0000 00000026 OOOO oO EJ E 111 E E Ea P Eek E E EZ 0 UE oo noo ra L1 O0000000 National Health Care Quality Plan 0000 no DU Uu 6 EJ Exi Ei 1 1 r3 r3 0 L EJ E ELE Dp 3p T ET ea ES L3 EI 3 EI E OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOOOOOOOOOOOO S OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOCOOOOOOOOOOGO OOOOOOOOOOOOOCOOOOOOOOOOOOOOCOOOOOOOOOOOGO 76
40. UD Heath Quality Team OOO 10 HNQAT OOO 000000 0 000 Quality CentergOOOOOOOOOOOOOO 8 1 0 0 0 00 00 00 Network Quality Centreg 0000000000000 Quality Network Director OO D D U D D D General Practitioner 0 0 38 000 00 0 HNQA Quality Centre 46 2 o E EST Ed L 7 2E DEE ESSE 5 ET EI oO oo C oo oO oo ETE E EZ ESTE TE ES 1 E 01 EZE ESSE TE ET E a EST EST ESTE 5 1 3 3 ET 3 E 00 0 00000 What is Quality Public Health Standard G Quality Control Management of Quality Kinds of Services Lecture and Workshop 3 days Lecture amp Workshop 2 days Workshop for A uditor Checklist Peri Managem
41. Standard Operating Procedure SOP O 0 1 1 E E L3 Ed r3 r3 rr H rn rm H 3 r3 H g 0 0 0 0 Ed Ed LJ r3 r3 OU OU 0 0 0 0 00000 OOS000000000000000000000000000 EE 1 EI E SEO ESE BS ESESESE EST ESI 52 ESSE p 1 1 8 0 117127 ETT E l 51 0
42. 897 0 UUIDDUDUDUDUUUnun OOOO Hospital Bill Collection 2002 2004 16 Y ear Number of Patients Income Collected US 96 Increase 2002 23 049 5245417182 2003 20 075 71 56156000 26 7 2004 19 515 103 391 892 85 30 8 OO 0 QMMCIJ 2004 71 8 0 0
43. 199 206 0 1 1 1 1 0 0 0 E AE p L3 F3 1 1 r3 r3 0 0 0 0 0 0 O gt 1 NEZ T ESSE SESS EST Hm Iz Eze Ez E E p E E 501151 E Te SEE s ESSI FR E TEBE OE Pee oOo HE BEEF 1111111111111111111 Quality
44. Ep D EET EAE p E ET E E E Eu D E E E JES E Fg E E ES E EST E FEE Ez 8 Ca 1 C 1 E 3 E I E EJ E 1 L1 Oo E T ETE TE ea GL ea Ee EJ EJ 0 0 0 0 0 0 0 0 0 0 LIEGE EST EE EST SES OO000000000000000000000000000000 58 OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOOOOOOOOOOOGA 2051 D T 0 D D Routine to Research 2004 OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOCOOOOOOOOOO
45. OOOO StrengthO 0 0 0 Weakness 0000000 110 Opportunity OO O00 Threat JI JJ UID 75 1 01 0 1 5 OO000000000000 0 Manager Planning and Development MPD 5 5 101 0 2 0000 0 0 5 11
46. Ooo ogag oo ogag ogag ogag oo oo oo oo oo 3 os oo oo oo oo oo oo De oo Eley oo oo oo oo oo oo oo oo 11 3 oo E13 64 L3 oa oa 9 OOo EYES ESI 96 A ccomplishment 5896 396 1596 ec 1 13 Sentrong Sigla Certified Facilities 1999 2004 T otal Certified 1375 390 97 Quality Framework of Quality in Health Program Traditional Healers 50 Other Professional Providers Suppliers 6 2 Clinics to 9 L x Licensing to ensure basic safety Providers Accreditation to stimulate continuous quality improvement Total Number 2 385 13 540 631 RESEARCH and TRAINING Initial Phase Externally enforced regulations and standards with periodic evaluation of compliance Later Phases self regulation and self determination Facility Rural Health Units Health Centers Barangay Health Stations 3 Hospitals Laboratories ande Diagnostic Clinics Do d Lo 4 e Devolved Hospitals 0 DOHO 2005 4 rira OD Barangay Health Stations
47. N 1110001000 1241 ELT ELE ESL E Ez EHE E53 ET ESI E ESI EZ El E 37 ESTY L1 L1 L1 E L1 L1 L1 L1 L1 L1 L1 E L1 L1 L1 L1 L1 MESE EY GL EST P E 0 111101 111111 11111111 1 01 10 0 0 0 11101111111411 0110111101 191111111 0110411111 47 00 0 HNQA Network Quality Management Training Program Quality E Periodic Network Service Internal Specification Service Provision Standard a Basic skill review 00 0 HNQA Network Quality Standard Network Round Audit 48 UIDDUDUDUDBDDUDUDUDUDUDUDUDBDBDUDUDUDUDUDUDGuDUUDUDUDUDUDLDL UUDDUDDDUUDDDBDUDUDUDBUDUDUDUUUDUDUDUDDUDUDUGUDBDUDUDUDUuUD UUDUDUDUDUDBDDUDUDUDUDUDUDUDBDBDUDUDUUDUDDBUDGUDU
48. 1 0 0 0 6 HI EET BC BEC 1110111 111111 11 gga DUUIDDUDDDUDUDUUDUDDUDUDBDDBDUUDUDUUUUDUGuDUUDUDUDUDUDUDUDU uDnLU EE HE EPI EI EIE EFE HE 1111 OOD 1 1411 BEBE ee POE
49. 13 19991 O Quality OOOO DOH 1101010000 20040 0000 20010 Improvement Health Program QIHP PHIC O 2780000 1 DDUUDU Sentrong Sigla DOOD 0 0 0000090900 8 QAPO 55 D D DU ePHICQOOOOOOOOOOOOOOOOO ess 13j 0 2001j0000000000000000 National Center for Health Facilities Development 111111 111011 1 5 65 14 Chronological Development of Quality Improvement Efforts in the Philippines Non Govemment Organization PCAHO QAP SSM QIHP RA7875 Benchbook Standards RA 4226 Hospital Licensure Act RA 9165 DOH AOs on Health facility 1965 1975 1985 1995 2005 Licensing PCAHOQG Philippine Council on Accreditation of Health Care Organizations PSQua Philippine Society for Quality in Health Care Inc
50. 0 0 51 01 SERI SEE SERT EST Ez 521 u El 15121 ET ey 523 ET EST El EE 0 0 0 0 0 0 0 0 62 Accreditation of Healthcare Organization PCAHO B H E H D D Philippine 11111 1111111111 Uu 8 L Uu OOOOOOOOGO 1 100100 OOOOOOOOOO 11 1000 OOOOOOOOOOOOOOOOOOOOOOOOOOOOCOOOOOOOOO 01 11 1011111 01 0111 0111 011110111109 1101091111101111111111 9111 111111 0 D 0 Quality Assurance and Policy Development Group QARPDGT iety for Quality
51. 0 0000000 HA HA Thai HA Thai B B i B Ll U Hospital Accreditationgg D U Health Promotion B dH HH BH D Foundation of Health Promotion 00000000000000 cl 1 o o 010000000000 Dr 5 1 111111 1 1 0 0000008038 1 000 0 0000000080 9 0 0 00000000 8 0 0 OO0000000000000 80 080 08 08 080 00 8 08 0 1
52. Quality Assurance Program 1998 Sentrong Sigla Movement 1999 Quality in Health Program 2003 Republic Act 7875 National Health Insurance Law as A mended Republic Act 9165 Dangerous Drugs Act of 2002 Different Administrative Orders include AO 147 s2004 amended by AO 0029 s2005 2001 and 726520 PHIC Benchbook 2003 0 00000 0100 10010101010000000 0 11 1 00 2006 0 0000000000000 2 0 5 5251 11 1 101 0111010 10010101010 55 55 1111010100
53. Clinical Pathway Guidelind 0o 0 1 10 008 08 0 80 00 80 000800 00 0010000000 HB EE EE 1111 11111 0111011111 11111 BEBE Be ECCLE 1111111111 1 0 0 00000 Department of Health DOH Philippine Health Insurance Corporation PHIC E H E H E HB E HE 1 Philippine Council on Oo E L3 r3 L3
54. E E ees SE GOES 0 0 0000 OOOOOOOOOOOOCOOOOOOOOOOCOOOOOOOOOOOO EI 521 TU E EST EL Es L1 L1 oO L1 L1 L1 L1 L1 L1 L1 E L1 L1 E L1 L1 L1 L1 L1 L1 L1 L1 EJ L1 L1 L1 L1 L1 L1 L1 L1 L1 L1 L1 L1 L1 74 0 1 21 11 ET Es E EST ESI E 3 RF 3 1 1 TE gt E E SERT EST ESSE E Ez ESSI E 1 r3 sspe EW ES eb EZ E l TEE E D E 051 EST r3 E SES 3 EST E ESSE TEE E E ESSE EST E E 3 0 1 Ed EST H H E ed CEST EST E ESI 811221 E E m 6 Heath CenteQOOOOU00d OOOOOOOOOOOO
55. OOO 6 0000000000000000000 0000000 00800 00000 D 0557 OO 350 000000000000 Quality Standard System 57000000000 1300 D U C C U D 8 Quality Management Representative Elements 0 0 0000000000000000 9 00000000000 3000000000 8 1998 000000 0000 0 0 1998 D DI D JU Sentrong Sigla Movement SSMO 11110000000000808 1 0 0000090 80 90 eg Information Education and Communication IEC D E E E EL DE EE HI LU 1090000000 OOOOOCOOOOOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOOOG GEE ooo oog oog oog oog Oon
56. OOOOOOOOOOOOOOOOOOOOCOOOOOOOCOOOOOOOOO oOo Ek EST EST Ea L ea ESI Ee eas Ea L Ea r3 rH g 55 U uuu D uu O Respiratory Carel OO 0 0 RCQT Respiratory Care Quality Team OOOO DU Uu OOo r3 0 D uuu DUBDUU DU D Uu OO OOO D uuu DDUUDU 1 0 0 Community Hospital OOO 119808 CAID D D D D Healthy Thailand OOOOOOOOOOOOOOOOOOO HA OU cori LU Human Resource Management for Productivity Institute Dr oO nm LEE EISE 5 1 0 1 TE E E pepe OU OU OU OU BF E 51 11 11 E RF Eg EJ
57. EISE 0 0 0 0 111111111111111 111 111 1 111 0 0 0 L1 L1 EJ L1 E a L1 L1 L1 L1 L1 L1 L1 L1 L1 Q O EJ EE 5 1 a 1 E E p L ESTER CEST E l EST Ez EI Fe A 21 EZ po EST ES EST End Lady Ridgeway Hablock Hospital S000 2000004000000 0 0000000000000000 200 0000000000 Dr Pannilaj O 20050 00000000 5 N L1 m L1 LJ L3 r3 D 41 1 OOo OG 1 OOo Ooo ESETEI D D D D D D D D D 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 C3 C3 0 0 0 0 0 0 0 8 MSE Medical
58. es E p p TESI 51121 L1 L1 Lr Exp iE Ti EI 0 0 0 0 se Es E 0 0 0 E DOBUDUuu 3 L1 L1 EFT EST ESI 020000000000000 PHICOOOOOOOOOOOOOOOOOOOOOOOOOOOSSOO 0 LU DODGE EO Oe Oe eo 8 1 0 15 Status of Sentrong Sigla Certification and PhilHealth Accreditation Programs for Rural Health Units and Health Centers HCs September 2005 T otal Number of RHUs HCs 2835 Total Number of SS Certified RHUs HCs 1375 Total Number of Non SS Certified RHUs HCs 1 010 Total Number of PHIC Accredited RHUs HCs 841 SS Certified Facilities with PHIC Accreditation 660 SS Non certified F acilities with PHIC Accreditation 181 OO 0 DOH 2005 70 OOOOGOCGOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOCOOOOOOOOOOCOOOOOOOOOCOOOOOOOOOOOOOO PHICO Benchboog 00000
59. in Health Care PSQua 000000 oo D 0000000000000 0000000000000 D nm 4 qq E L3 L3 L3 L3 E3 E3 E3 E E E E E 3 EST IET E E 3 E 3 E I GS E E EEE ESI TE l 5 17 EE SES ES Re E E E l UU U uuu D uuu DU uu 0 Lr oo 2 3 IT EHI 0 3 LLL OOOOOOOOCOOCOOOOOOOOOCOOOOOOOOOGO naaRPogoogooogogoloooooooooooooolooln EJ E 5742 OOOO OHH OOO In 5 gt Soc oO nm OU OU 0 6
60. 11111 1 1 1 0 0 00000 0900 0 0 0 0 6 BEDS oOo BEI EFE EGET EF EIL 1888 1111111888 8 111111 111111141111111111111111 1111111111 oe oO 0 Uu enggugaugngpnaupnana
61. 5 19960 Administration OOOOOOOOOOOOOOOOOOOOSOTOMOOOOOOOOOOO OOOOOOOOOOOOOOOGO ooooooooooogsLioagroMOOOoOoloocooocoooloocoooocag District Medical Office OO BIB ECHTE B OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOGO 5 10000 0800 0800008000000008005000000000000 9 OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOCOOCOOOOOOOGO 0 0 um
62. 9 ODO ee ey ey ES Ez E C F EJ ESI 5 3 nm Pe Ea p 1121 ET E E 1 E 5 E L3 L3 Lr rr L I L1 E L1 L1 E L1 L1 L1 E L1 L1 L1 E L1 L1 L1 E L1 L1 L1 E L1 E L1 L1 L1 E L1 L1 L1 E L1 L1 L1 E L1 L1 E ET ER ES ESI Ig SES EET 3 EJ L1 E E L1 L1 L1 E E L1 L1 E L1 E L1 E L1 L1 L1 E L1 E L1 E L1 L1 L1 L1 E L1 L1 E L1 L1 L1 L1 L1 EJ L1 E L1 L1 L1 L1 L1 L1 E L1 L1 L1 L1 E L1 L1 L1 L1 L1 L1 L1 L1 L1 L1 E L1 L1 L1 L1 L1 L1 L1 L1 L1
63. DUDUDUDUDuUL 1100 0 0000000000 D 0 LD Clinical Pathway OOOO Patients Department of Medicine 1 1111001010000000000000000 OD0000000000000000000000 200000000000000 OOOOOCGOOCOOOOOOOOOOOOOBOOOOOOOOOO OOOOGOOOOOOOOOOOOOCOOCOOOOOOOCOOCOOOOOOO OOGOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO 1 i E 5 1 EE Fy E 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 mg 3 ESI Spes E 21 OT EST 19 1 ESSE EJE EI 2 2 O E E 2 21 cess ES EE SEE TT ETT Bees A Es Ea EZ a EO EL O gt 2 o
64. OOOOOOOOCOOOOOOOOOOOOOOOOOOOOO Oo unn 0 0 nm n d 100 2004 HIPC Heavily Indebted 200400000000000 oor Country Completion Point DuBgumuupbBpuupauupgunpuuupguupgugapgugpgdguuuuluu 9 1 000000000008008080 0800909089 8 0 8 199600000000 Central Board of Health CBoHQ OOOO cBeHi
65. TE BEBE B EPI BEL EI REIHE EET EHE EE H HEHELEBEBE BEBE EHE 00 12 Background and Performance of 5S Components of 5S Step of Procedure Committee Organization Chart Chart of Administration T asks Committee of Policy and Academic System Committee of Monitoring and Evaluation Committee of PR and Motivation Committee of Cooperation Zoning Charts and Activity Plan 00 0 000000 TQM AND DEVELOPMENT OF THE HOSPITAL QUALITY 57 DU Uu O30 000000 sirraj Hospital TOM 2400 000 0 00 0 1 1010 0 Ll Duty COTQMO 150
66. aou OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOOOOOOOOOOOGA OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOOOOOOOOOOOOG OOOOOOOOOOOOOCOOOOOOOOOOOOOOOOOOOOOOG g Epidemic Chang 0 UU 0 0 00000 10100 0 0 8 0 00 080 80080 80 000001000 36 SLIDA 5 1 1 0000000000000000 OOO
67. e Ed Oo UOOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOCOOOOOOOGO 6 UD 0 584 13710 4541 660 sMOOOOOOOOOOOOOOO 0 0 HI 0 5 551 55110 5000000 00 000000000 0 OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOOCOOOOOOOOOGA 0 0 Rural Health Unit RHUO OOOOOOOOOOOOOOOOOOOOCOOOOOOOOOOOOOOOOOOOG 3 E E nm
68. ent A ctivity T 00 0 0 00 0 D Service Internal Specification 000000 E Network Quality Standard E Service Provision Standard uu oo o CEST 4E 77 es ETE 0 0 0 0 0 0 LET EJ 1 1 L 1 Oo Eq a E Le Ey L1 OO l EJ FJ iE 21 29 EJ C FJ E p EF EI ESI OOOO ET LY E Ei 1 EI ESI SES EFT ES L1 L1 L1 L1 E oo D E TE 2 EST E E L ETT es ESI H H 3 ESE SET Ey E 3 3 EXE EE EE ESL E l TES res L1 ra H EI Up Tu usa 07 E AEST SERT Ea Es maq EST 3 L1 E L1 E nm HNQAQ 1 08 00 80 8000080080 800000000 0 0 0000009 Qc n dnb un du sp
69. ertiary care hospitals 00 0 IDA WB Health Services Project 2005 2010 Sri Lanka Health Sector Development Project Components Support to district health authorities to improve service delivery and outreach Support to central programmes and hospitals Support to policymaking budget formulation and monitoring and evaluation Project management Subcomponents Family health programme and nutrition Immunization G Non communicable diseases and mental health Hospital efficiency and quality 8 0 0 8 L 38 SLIDAQ 1
70. ion to NHI P Quality improvement Hospitals out patient clinics including ambulatory surgical clinic dialysis clinic maternity clinic anti T B DOT S centers rural health units PHIC Benchbook Desk review of document On site evaluation DOH BHFS Licensing Some accreditation Mandatory RA 4226 RA 9165 AO 0029 s2005 Ensure safety Permit to operate Quality improvement Licensing Hospitals and other health facilities excluding medical and dental dinics rural health units and Barangay Health Stations Accreditation drug testing laboratory confirmatory drug testing laboratory hospitals conducting kidney transplantation OF W and Seafarer Medical Clinic AO 147 s2004 AO 0029 s2005 Desk review of document On site evaluation T ype of quality assurance improvement instrument Nature of quality assurance improvement program Legal policy Basis most recent amendment Purpose of QA QI instrument Target facilities References for QA QI Quality assurance improvement activities 0 0 NHIP National Health Insurance Program 5 OFW Overseas Filipino Workers 33 TA Technical Assistance L9 0 OOOOOOOODOOOOOOOLOOOOOOOOOOOOOOOOOOOOG
71. it 399 Uu OO3000000000000000000000 U uuu nm 0 0 EIE E p 60 57421 Ey EST EST EE E I D Uu EIE EP ES I EJ rE EET p E LzI EE E CE EM Ee ey Ei j EST EST EIE 0 EI p EST ETT E 3 EST EE EHE LETT LESE 0 LT ES EJ Ere 6 1 n n Va JI UJU E oO Oo es Ue E3 rapa ED oh ao a ESI ESL ron exe Fa 121 EST ror no cas es ET E F E EE ES EES ES l ra EI EJ Ee E ESTE oO 0 0 0 0100000000 Hospital Accreditation HA 45 43 Social
72. oo I Oooo Ewe r a Oooo oo E L3 EZ EI Er E se OH Ez3 ESTE E 1 E ET EZ EJ E C3 C3 C3 C3 C3 C3 ELE E OOOO ES EI Ez Bea ET E Ez T1 ET ET E C3 C3 C3 C3 9 Organize Hospitals PRODUCTIVITY CONCEPTS Improve efficiency 00 0 TQM 8 1 0 8 08 80 00 0080000 000000000 0 oa BEC RETE Pg md mg ggg ET EE BE 1 0 8 080000 80 00800 00 800000000 0 D Non medical Staff
73. partment of Health Service Support h 0 0 0 D 1 1 Primary Health Center PHCO O J Community Hospital 0 100 200 0 eneral Hospital 100 000000000000000 Regional Hospital Excellent Center nn naa a 1 11006 1 Teaching Hospital OOOOOOOOOOOOOOOOO Dr 8 OO 19900000000000 7000000 000000000000 00 300000 0 00000 2000 0 00000000000 0 20040 1 U uuu YS Hospital Network Quality Aud
74. pna agpnagagpnpuu 1 9 9 000000800 0 0080000000008000008 0 09 OOOOOGOOCOOOOOOOOOCOOOOOOOOOGO 5 3 FI Oo ELBE 1111 11 BE 1 11 8111111111 BE 1911111111 11101111 11111111111111411111111411111 114 D
75. urce Administration Development Level Risk Management System in Quality Hospital Clinical Quality and Safety IT and Quality Improvement Individual Patient Case Management Drug Dispensary System in Quality Hospital 00 11 Basic Intermediate 1 General Quality Development HA301 HA 100 HA 302 2 Being a Coach HA400 3 Inspection HA 401 4 Resource A dministration HA 1 5 Particular Development HA 303 HA 305 HA 601 HA 603 HA 604 HA 605 OOOOOOOOOOOOOOOOOOGO HA 100 HA 301 HA 302 HA 303 HA 305 HA 400 HA 401 HA 403 HA 501 HA 2 HA 601 HA 602 HA 603 HA 604 HA 605 0 LU U 0 0 0000000 TQM OU E 54 OOOO DU utu DU MD D U 0 D LU OU OU OU L1 OOOO OOOO OU 0 0 Q 0 0 0 0 0 0 0 m oo m EJ st ES l EIE ES LESE EIS E EJ ESI E L1 E L1 L1 LU UUIDDUDDUDBDDUDUDUDUDUDUDUDBDDUDDUDUDDUDUDGUDUDUDUDUDUUDLUL OOOOGOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOGOOOOOOOOOOOOOCOOCOOOOOOOCOOOOOOOOO EP EE 011 111111 11 1 11 1071111111 1111 11 1 911 111 111111 11 1 1 0800 80 0 0 080000 80 8000000 1
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