View
151
Download
0
Category
Preview:
Citation preview
Uganda Protestant Medical Bureau
Health Systems Strengthening through Faith, Innovation and Vigilance
30th CCIH Annual Conference 2016
Baltimore, Maryland 19TH June 2016
Dr. Tonny Tumwesigye
EXECUTIVE DIRECTOR
www.upmb.co.ug Health in Totality
• UPMB Founded in 1957,
• National PNFP Coordinating body for Protestant health services in Uganda.
• Network of 290 Health Institutions in Uganda
• Approximately 80% of the member institutions are located in rural and poor communities across Uganda.
• PNFP Network covers about 40% of Hospital Beds in and 60% of Nursing Training in Uganda
• UPMB covers about 40% of the PNFP services
www.upmb.co.ug Health in Totality
PNFP Facilities across Uganda (DHIS2 – GIS – Over 70 facilities missing from this map)
www.upmb.co.ug Health in Totality
Contribute to all health system building blocks and levels of care
www.upmb.co.ug Health in Totality
Change Model
• Based on partnership work • Based on 6-step process-Successes
and Challenges
www.upmb.co.ug Health in Totality
www.upmb.co.ug Health in Totality
• Situational Analysis (SA) conducted WHO-APPS tool used – Long Form (For this presentation-only four areas identified for action are discussed)
• Patient safety team formation stimulated through the SA
www.upmb.co.ug Health in Totality
Healthcare Associated Infections
• No clear structures and mechanisms for infection prevention and control (IPC)
• No human resources designated for IPC activities
• No written policies and or guidelines in all areas of IPC
• No methods to assess compliance
• No system in place to conduct health worker training
• No hand hygiene system in place
www.upmb.co.ug Health in Totality
www.upmb.co.ug Health in Totality
Healthcare Waste Management
• A lack of total systems thinking for waste management.
• Nonexistent hospital policy on health care waste management.
• Some guidance on waste segregation, transport and disposal, but no capacity to handle toxic, chemical and radiation waste.
• No facilities for appropriate temporary storage of waste.
• No protocol on environmental cleaning communicated to cleaning and supervisory staff.
• Very limited training in health care waste management.
www.upmb.co.ug Health in Totality
www.upmb.co.ug Health in Totality
www.upmb.co.ug Health in Totality
Key Steps
• Situational analysis findings were discussed at the Hospital Management Committee (HMC).
• Identified the four priority areas for action following examination of all situational analysis findings.
• Concentrated on how best to tackle the gaps identified in the situational analysis
• Community engagement
• Appointed an APPS team (Kisiizi APPS team).
• Discussions held across the partnership.
• Launched the Program
www.upmb.co.ug Health in Totality
• Action Plan formulated and agreed
• Done through face to face meetings, teleconference and email
• Action Plan approved by the Hospital Management Committee & BOD
• Action Plan approved by WHO APPS.
www.upmb.co.ug Health in Totality
Innovation-Kisiizi vs WHO Surgical Checklist
www.upmb.co.ug Health in Totality
www.upmb.co.ug Health in Totality
www.upmb.co.ug Health in Totality
www.upmb.co.ug Health in Totality
www.upmb.co.ug Health in Totality
Health Care Waste Management
www.upmb.co.ug Health in Totality
• Identification of Lead Professional
• Appointed a Drugs And Therapeutics Committee
• Training Programme on Medication Safety
• Introduction of Prescribing Standards Document
• Surgical Antibiotic Prophylaxis Policy
• Audit tool – Prescribing Guidelines
• Emergency Red Drug Boxes - Wards/Departments
• Computer based medicines management system.
Medication Safety
www.upmb.co.ug Health in Totality
Evaluation
• Program now sustained and in Budget
• Scale up to other Hospitals
• New Partnerships have been developed-AIPJHM
www.upmb.co.ug Health in Totality
Challenges
• Culture differences • Initial fear of change • Lack of Chester teams knowledge and experience
of working in a developing country • Communication/maintaining relationships • Maintaining momentum • Significant differences in facilities/equipment • High expectations/Goal setting • Sustainability
www.upmb.co.ug Health in Totality
• Keeping of old “Prestigious” traditions
• Knowledge gap
• High expectations of partners
• Lack of facilities/equipment
• Sustainability-Local production at hospital of ABHRs
• Soap stolen
• Cold weather with no air conditioning
www.upmb.co.ug Health in Totality
Key lessons
• Involve the entire Hospital and ensure early and visible Executive support
• Consider utilizing a mutually beneficial partnership approach for capacity building
• Involve and listen to patients and the community
• Focus on Knowledge and skills that are applicable
• Modify the approach to suit local culture
• Ensure a multidisciplinary approach
www.upmb.co.ug Health in Totality
Key lessons
• Resourcefulness is key as resources will always be limited
• Harness individual passion for change! • Change is possible in an African Hospital • Systematic planning is critical • Programme can be replicated • Document everything-Good & Bad • Alignment with both Institutional and
National Strategy
www.upmb.co.ug Health in Totality
• I have learned to believe in the philosophy of “Learning as we do”
• This appeared as theory but it’s now practice…
www.upmb.co.ug Health in Totality
The future is bright…
www.upmb.co.ug Health in Totality
THANK YOU 39
Recommended