The growing role of digitalisation in hospital quality improvement

Unit Head of Sustainability & Quality Management at ParkCity Medical Centre, Ms Mageswari, shares the hospital’s quality improvement strategy and how new digital tools are set to support quality management

Between battling the demands of the COVID-19 pandemic, it is a common challenge faced by hospitals to also commit to rigorous accreditation exercises which require extensive review of processes and quality across all departments of the hospital.

ParkCity Medical Centre (PMC) in Kuala Lumpur, Malaysia, managed to do so, clinching the well-sought Joint Commission International (JCI) accreditation in November 2020, after undergoing the first-ever virtual accreditation process by the JCI amidst the severe pandemic situation at that time.

“We connected with the JCI surveyors via our laptops and mobile devices so they can view and assess our facilities and practices,” says Ms Mageswari Veloo, Unit Head of Sustainability & Quality Management. “It was definitely a fresh learning experience for us, after being used to physical accreditation surveys over the years.”

Echoing the views of her fellow hospital quality managers, she emphasises the need to maintain a continuous focus on quality management, even in between accreditation cycles.

PMC is embarking on benchmarking clinical indicators against Australian Council on Healthcare Standards (ACHS). The six-month data submissions are analysed, and results are delivered in the form of general and peer-comparative reports. The aim is to keep a consistent and valuable way of measuring, benchmarking, and tracking performance.

It has also made it easy for staff and patients to provide feedback. QR codes can be found around the hospital – around staff areas, QR codes for staff to scan to submit incident reports or near-miss reports as well as to raise work orders for facility job requests, as and when they happen; and around patient areas, for patients to access the patient experience survey form. There are QR codes in every public toilet to provide feedback opportunities, with cleaners receiving real-time notifications to attend to cleaning and hygiene requests.

Constant training also plays a big role. Her department conducts regular courses for staff on quality improvement models and tools, such as the “Plan-Do-Study-Act” model, she shares.

“Staff can use this model to not just identify problems, but also be able to justify their observations or ideas by presenting data. So it is not just doing something for the sake of doing so, but making changes that are really backed up by evidence.”

For projects that have demonstrated value, the Quality department comes in as an advisor to guide planning and implementation.

Quality improvement projects don’t have to be complicated to achieve good results, she emphasises. Winning projects from PMC’s annual contest for top quality improvement ideas are often simple – for example, simply purchasing a better innovation solution.

Last year’s winning submissions included one which suggested purchasing a new type of brush, based on staff and doctors’ feedback on pap smear test samples. They had observed that pap smear test samples were sometimes of inadequate quality, and patients had to be called back to redo their tests. This was not ideal for patient experience and was unproductive. However, this was overcome by simply purchasing better brushes which produced better test samples.

For Ms Mageswari and the quality team, this constant exercise to identify pain points and solutions is essential to hospital business sustainability, for the organisation to keep up with changing industry trends and retain their customers.

Towards the goal of becoming a smart hospital

Digitalisation has been a clear direction for the hospital since day one. Its Electronic Medical Record (EMR) system was implemented when it first opened its doors in 2012. The team is now working to enhance it with an encrypted text message service that will allow clinicians to share medical data (lab reports, photos, etc) with each other in a fast and secure manner; ensuring easy accessibility to information while also keeping compliance to personal data protection regulations.

Digital initiatives and tools are now being deployed in different areas of the hospital. In boosting patient safety, the hospital is now trialling AI-powered cameras that can monitor patient movements in the wards – with the aim of preventing patient falls, particularly in elderly or frail patients. If the camera detects patients trying to get up from the bed on their own or missing from the bed for certain time periods, it will send a notification to nurses to alert them. The hospital plans to install the cameras in the Medical Surgical wards this year as the results are satisfactory.

With a more digital-savvy population, smart wards are in the pipeline, where patients are given a smart device at bedside that allows them to – among other things – check doctor schedules, medication schedules, daily treatment plans, request for meals, or enable smart control of air-conditioning, curtains, lighting and movement sensor lighting in the toilets.

Self-service smart queue kiosks will be available in outpatient services where patients can scan a QR code for virtual queue, and check in to multiple touchpoints using one queue number. With the impact of COVID-19, the smart queue system will minimise contact touchpoints, as patients will be informed on the estimated waiting time at each touchpoint, and receive real-time notification via SMS or WhatsApp when their number is called.

All in all, digitalisation will be increasingly embedded along the patient journey. This means more and more data and insights will be available for the quality department and relevant stakeholders to work with, manage, analyse and to implement areas of improvement. While this is great news, this also means there is an ever-growing volume of data the team has to wade through, as a lot of the data extraction work is being done manually right now. Ms Mageswari notes that the next step will be to work with the IT team on the best ways to digitalise healthcare and patient records through an effective data management system.

Indeed, going forward, the key to hospital quality may very well lie in the ability to leverage on digital transformation and the data that comes with it, creating a more streamlined information exchange that enhances patient experience and service without comprising on data protection and security.