Quality Assurance Program (QAP) Goal: To make DOH and LGUs active partners in providing quality health services Key Strategies: 1. Certification/Recognition Program - CRP 2. Continuous Quality Improvement - CQI Sentrong Sigla Movement Goal: Quality Health Objectives: Better and more effective collaboration between DOH and LGUs DOH: as provider of technical and financial assistance packages for health care LGU: prime developers of health systems and direct implementers of health programs Pillars: y y y y
quality assurance assurance grants and technical assistance awards health promotion
Phase
Period
Standards
I
1998-2000
Input
II
2001-2004
Process
III
2005-2010
Outcome or Impact
Achievements of Sentrong Sigla SS - Certified as of end of 2003 y y y y
53%
of health centers 15% of district and provincial hospital 3% of BHSs A dditional awards for several facilities
Positive Outcome of Sentrong Sigla y y y
y
y
y
created a quality service-orientation among public health service providers promoted interest and participation of LGUs in raising quality health services generated additional support from LCEs for health; channeled local resources to fund supplies, basic, equipment of facilities Improved quality of services in general'changed attitudes of service providers; perceived increased utilization of services effective tool to maitain DOH leadership in health that would ultimately redound to health impact serveral health centers received CQI training; some established quality circles
Valuable Lessons y
y y
realization to the need for total systems quality standards that combine simple yet basic input. process and output standards importance of careful selection of incentives the need for changin procedures to provide adequate time for crucial processes to take place and be internalized prior to the assessment
THE
SENTRONG SIGLA PH ASE II
Background/Framework y y
y
efforts to raise quality of health services to be intensified expansion of concern on quality beyond DOH-LGU interaction to the entire health sector to be coordinated by a mulit-sectoral Quality Health Care Commitee
Guiding Principles y y y
y
y y
recognition of achieving quality the main incentive in SS certification quality improvement is an unending process certification to focus on public health programs proven most cost-beneficial to the people roles and responsibilities including contributions must promote appropriate counterpart and reciprocity purposive DOH assistance involvement of non-DOH partners to ensure objectivity and broader perspective
Goals
Long Term: Institutionalize within the health sector the leadership, processes, knowledge, attitudes, skills and organizations to generate continuous quality improvement in health care Intermediate (2003-07): to improve quality of health care in outpatient health faciities, hospitals and public health services in the communities Specific: to improve the quality of outpatient health care (public and private and of public health service in communities) Objectives 1) To establish an efficient system of: y y y
providing technical and other forms of assistance to the LGUs assessing health services against established standards monitoring key indicators in the SS Certification process
2) To progressively raise the average quality of public health services through recognition of successful attainment of quality standards y
at least 50% of health centers successfully meet the revised SS-Phase II basic
y
Certification Standards (Level I) at least 20% of Level I certified health centers successfully meet SS-Phase II Specialty A ward (Level 2) standards for all core public health programs
3) To raise public health awareness of public support and demand for, and client participation in SS Certification of their health services and facilities
Level and Scope of the Certification Level Category
I
II
III
Description
Basic SS Certification
minimum input, processes and output standards for integrated public health services for 4 core programs, facility systems, regulatory functions and basic curative services
Specialty A ward
second level quality standards for selected core public health programs
A ward
for Excellence
Recognition
highest level quality standards for maintaining Level 2 standards for the 4 core public health programs and Level 2 facility systems for at lease 3 consecutive years
Scheme
Level Recognition
Given by
I
SS Seal, individual recognition
CHD
II
Specialty Banner, individual recognition others
CHD
III
SS trophy, individual National recognition, media exposure, others
Validity of Certification 1. facilities which did not progress to a higher level of certification but maintained current certification are: - given stickers to confirm the renewal of the validity of seal - no ther incentives given for mere renewal of SS status 2. facilities that slide back: seal will not be removed but not issued a SS sticker
Similarities y y
y y y y
ultimate aim - to improve quality of health services certification/recognition and continuous quality improvement remain as key strategies continue as a partnership with LGUs regions remain as overall in-charge of certification health facilities CHD T A Teams to provide assistance LGU participation is voluntary
Differences y y
y
y y y y y y y
standards include inputs, process, outcome standards cover health facility and systems, 4 core public health programs, basic curative services and regulatory function covers initially only RHUs/Health centers; to expand to BHSs, private clinics and community-based facilities; hospitals not covered minimal cash awards no prequalification based on inputs all standards, tolls in assessment to be transparent purposive T A to be provided T A Packages to be disseminated LGU self-assessment assited/facilitated by the DOH Reps training of T A Teams and A ssessors
