The challenges include access and waiting times, primary health reform, human resources, chronic disease management, infectious disease, the role of public and private sectors, insurance, new technology and costs.
Leaders need to respond to the quality challenge, said Frank. There should be senior staff responsible for risk, quality and patient safety. He noted that SKMC’s Chief Quality officer reports to the CEO office.There should be improved processes, e.g. checklists, hand hygiene. Technology can also assist, e.g. electronic medical records and computerised physician order entry (CPOE). As important is increased reporting on quality both to funders and the public. At another level there need to be accreditation standards and the establishment of quality improvement organisations.
Characteristics of Leaders
Leaders should scan the environment, set the direction, inspire a vision, do leadership rounds unannounced, ask patient family members what the hospital can do better, align resources to the strategic direction and motivate and enable others, he advised.
Great organisations have successfully answered three questions: what are we deeply passionate about? what can we be the best at? what drives our engine?
High performing health systems are safe, effective, patient-centred, accessible, efficient, equitable, integrated and have appropriate resources focused on population health.
Frank had this advice for leaders to promote quality:
- Make quality visible
- What gets measured gets done
- Institutional and system-wide reporting is a good thing
- Have a strategic plan - vision, mission, values and priorities
- One of those priorities is quality and safety
- Develop and review quality indicators on a regular basis
- Communicate and celebrate success (best catch/ near miss award). For example, SKMC has a safety award for someone who catches something before it happens.
Culture eats strategy for breakfast, concluded Frank. The culture has to be changed from top of the organisation. Make sure you discuss at your leadership team - how do we enhance a culture that promotes patient safety?