Overcoming adversity to deliver quality care in Myanmar

The COVID-19 pandemic has added significant challenge and complexity to hospital operations management, for example in allocating resources, building capacity and managing staff. These are no easy tasks for even […]

The COVID-19 pandemic has added significant challenge and complexity to hospital operations management, for example in allocating resources, building capacity and managing staff. These are no easy tasks for even the most experienced healthcare executives.

For Dr Thiri Aung, who stepped up to head operations at Myanmar’s Pun Hlaing  Hospital in May 2020 – in the thick of the first pandemic wave – it has been a steep learning curve. This was more so when she was promoted to Interim Chief Operations Officer a year later, during a time of social and political instability in Myanmar.

For someone who had just joined the hospital as a graduate six years ago, she is frank about the pressures that come along her expanded portfolio and responsibilities. She is now responsible for day-to-day operations at the 160-bedded flagship hospital in Yangon as well as three other clinics in the area. Her work scope covers customer experience and patient journey, business growth and revenue performance, as well as management of some 500 staff.

“Looking back at when I first took over the role, I felt that the role was a little too big for me, especially in terms of managing the complex dynamics in this situation,” says Dr Aung. “But luckily, I had support from my team and senior members of management to help manage the pressure.”

Overcoming a double whammy

The pressure arose from the double crisis of COVID-19 and social upheaval – meaning the hospital’s key goal was ensuring operations kept running smoothly, and healthcare services remained available to everyone that needed them.

Over the past year, the hospital has treated over  1,300 COVID patients, conducted over 60,000 COVID tests and administrated close to 200,000 vaccinations, relieving pressure on the country’s public hospitals.

With co-management of both COVID and non-COVID patients in the facility, it was critical to implement strict infection control. The hospital ensures that the 4S – space, staff, supplies and system – are catered separately for COVID patients versus the rest. With lower COVID-19 case numbers at the moment (as of start March 2022, Myanmar is reporting around 2,000 cases daily, as compared to 6,000 cases during the Delta surge), Dr Aung estimates that hospital resources are being split 50-50 for COVID and non-COVID patients. However, the hospital remains ready to ramp up COVID capacity if needed.

The surge in cases also meant that large numbers of hospital workers were infected. Around half of the staff have tested positive for COVID at some point, said Dr Aung. The need to safeguard staff safety and welfare became a top priority.

“We got one of our facilities within our hospital compound approved by the government to be a quarantine centre for our staff, so they do not have to go to a government facility. We made sure we have beds for staff and their family members who needed them, with treatment and medications provided for free for all our staff.”

“We want to ensure our staff feel emotionally and physically secure while working with us. At the end of the day, they are risking their personal safety to take care of our patients.”

On the other hand, the social and political turmoil has impacted access to public healthcare in Myanmar, while at the same affecting many locals financially, with some losing their jobs or facing salary cuts.

Dr Aung notes the hospital’s commitment throughout the difficult period to keep all their staff on employment without any cuts to salary: “To keep our staff morale high and motivated, we pledged to survive, protect and contribute to them, to our patients and to our stakeholders, over this once in a lifetime tumultuous and uncertain phase we are experiencing.”

Pun Hlaing also created more affordable private healthcare packages to cater to those who are financially tight yet unable to access public care.

“We have just recently introduced a new haemodialysis package which is priced 15% lower to alleviate the financial burden on patients. Also, we collaborated with a NGO to provide maternity services for patients who would normally have gone to public hospitals,” Dr Aung elaborates.

Vision for the future of Myanmar healthcare

Looking ahead, Dr Aung identifies a key challenge would lie in gaining public trust in local healthcare. With Pun Hlaing being Myanmar’s first and only JCI-accredited hospital, Dr Aung is well aware of the importance of advancing care standards and quality.

“People normally don’t trust the healthcare in our country. Before the pandemic we have around 500 people flying out daily to neighboring cities, such as Bangkok and Singapore, for medical services. The main reason we did JCI accreditation was to gain trust from our own people that we can provide quality care and good patient experience.”

She is optimistic about the future growth for Myanmar healthcare and Pun Hlaing. Indeed, the Pun Hlaing group has big plans for scaling up its operations and expanding the breadth and depth of its services. The goal is to establish 10 hospitals and 15 primary care clinics in the next decade, Dr Aung shares, along with more affordable and accessible services for its people.

In line with this, the hospital has invested heavily in its digital capabilities. A full EMR system was implemented in 2018, allowing the whole patient journey to be integrated digitally, across all hospitals and clinics in its group.

A mobile app is in the works, which would allow patients and care providers to conveniently access medical records, history, billings and so on .

Dr Aung concludes: “We will strive towards holistic care throughout our network of hospitals and clinics, and continue to implement our vision of building a better Myanmar for its people.”