Making quality improvement a way of life

Ms Purindri Maharani Suksesono, Head of Quality at EMC Sentul Hospital shares how she ensures quality management is a continuous process

Hospital quality management requires participation and commitment from all hospital departments, and can never be achieved just by the Quality department alone.

As such, building up staff awareness of hospital quality management – the importance of quality indicators, and what they each need to do in their individual roles to contribute towards overall hospital quality – is a key priority for Ms Purindri Maharani Suksesono, Head of Quality at EMC Sentul Hospital.

She shares that every month, each hospital unit reports their performance against a set list of quality indicators or KPIs. These indicators are set by Indonesia’s Ministry of Health (MOH), while some units also set additional indicators for themselves.

This process is especially important as the hospital prepares for its national accreditation exercise by MOH later this year. It also has plans to seek international accreditations moving forward.

However, Ms Purindri emphasises the need for quality improvement to be a continuous, consistent process – not one that receives focus only during preparation for accreditation surveys, but incorporated within the day-to-day work.

For one, regular monitoring and evaluation by the Quality department will be crucial to keeping quality top of mind for everyone. The hospital has also organised contests to encourage staff to identify problems or pain points in their daily work, and come up with ideas or projects that can solve these.

“For continuous improvement, we need our staff to come together to think about their daily care processes and workflows. It should be a bottom up process,” says Ms Purindri. “Through the contests, we reward staff who come up with the best ideas, providing them with budgets to implement their solutions.”

With rapid digitalisation in healthcare, digital tools that can aid with hospital quality management are now widely available. For example, EMR systems which collect digitised data can be tapped upon to pull together relevant datapoints to be studied, and areas of improvement identified. The EMC Healthcare group – which runs six hospitals in Indonesia – is planning to set up an integrated EMR system that will allow interoperability across the hospitals. This would allow data to be collated and analysed at the group level.

Besides quality management, Ms Purindri is also closely involved in patient safety. This involves tracking and following up on patient safety incidents, and education of staff and patients on relevant safety protocols. She raises the example of a medication alert system which the hospital is currently using. This digital system reads through the prescriptions ordered by the physician, and triggers an alert when it detects any errors or potential adverse drug reactions – thus mitigating the risk of errors and safeguarding patient safety.

Strengthening hospital crisis and risk management

Hospital crisis and risk management is an area she will be placing more focus in 2022. “We have developed a risk register, tracking the different types of risks that the hospital is exposed to, and we constantly review it and update it with action recommendations to our directors. We also closely track the guidelines within the Hospital Safety Index, a checklist created by World Health Organization and Pan American Health Organization to assess the disaster preparedness level of hospitals during disaster events,” she said.

The COVID-19 pandemic has driven home the importance of comprehensive, detailed crisis management plans. Indeed, the past two years have been a learning experience in adapting to a fast-changing pandemic situation and operating environment.

The hospital has had to quickly set up isolation facilities as well as semi-permanent clinics in container units dedicated for COVID cases. Telemedicine, drive-thru services and home monitoring were planned and offered to patients in quick succession when movement restrictions were in place.

In terms of staff management, the hospital has also adopted a flexible staffing model – putting in regular testing regimes and contingency plans for when staff test positive for the virus – and also conducted necessary training so staff are properly equipped to manage patients in a safe manner, such as in PPE protocol (what types of PPEs to be worn in which situations).

Though COVID-19 has subsided in the country, she is confident that the hospital can switch back to ‘pandemic mode’ if need be.

“We now have resources ready, for example our supply chain of key items such as medications, PPEs and masks is stabilised. We have also set up isolation and ICU wards, which can be switched to normal wards once the pandemic is over, and vice versa.”

The Ministry of Health of the Republic of Indonesia, in collaboration with Hospital Management Asia (HMA) and Indonesia Hospital Association (Perhimpunan Rumah Sakit Seluruh Indonesia/PERSI), will be holding a conference entitled “Digitise Healthcare Indonesia 2022” on July 6-7. This will showcase digitalisation best practices from local and overseas hospitals. To find out more and register, click here.

Leading up to the event, HMA will be holding a webinar on May 17, titled “Why Indonesia healthcare is ripe for a digital revolution”. Officials from MOH and PERSI will share about the key pillars of transformation planned for Indonesian hospitals. To register, click here.

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