Ayman Sabae - Citizens-monitored health service quality indicators to evaluate health service providers

Transcription

1 Ayman Sabae - Citizens-monitored health service quality indicators to evaluate health service providers Quality indicators and an information platform on health care quality in Egypt Name Ayman Sabae Date of Birth 15/01/1984 Gender Male Nationality Egyptian Occupation Partner - Shamseya for Community Health Solutions Country of Residence Egypt Why I fight corruption In Egypt, resources - that are limited to begin with us - are continuously drained due to a significant fail in the good governance mechanisms that govern all sectors, the public sector in particular. Public funds are wasted in unmonitored expenses that fail to remotely meet the basic requirements of acceptable service quality to the general population in many sectors. Any needed reform in this sector, will have to begin through citizens tools that could eventually boost Egypt s rank in good governance indicators from its current position in the 10th to 25th percentiles in voice and accountability indicators, falling behind Malaysia and India, government effectiveness", behind Cuba and India and control of corruption behind Rowanda according to the World Bank s 2011 Good Governance Indicators. This is particularly true in the health services sector where the 72% of expenditures are from outof-pocket payments of families who rather spend their resources on private service providers which also very often fail to provide access to quality services. Your experience Our organisation is working through participatory community solutions aiming at improving access to quality services to individuals and families that have limited resources and therefore, need to make calculated decisions about their expenses on health services. Our team is made of multidisciplinary young researchers, field workers and experts in the fields of health systems management, participatory development, and quality of healthcare.

2 I personally come from a medical background followed by a diploma in total quality management of healthcare services from the American University in Cairo and a masters degree in International Health Systems Management from the Management Centre Innsbruck in Austria. I have been working in this field as a project manager, right to health researcher and consultant for the past 2 years. Title Citizens-monitored health service quality indicators to evaluate health service providers Brief description The project tackles citizens' voices and enhanced service providers accountability through the creation of service quality indicators and measures that are patient-centered, conceived by citizens, validated by experts and that can be monitored through community audits. These indicators will enable citizens to hold service providers in the public and private sectors accountable and will provide other consumers with a continuing assessment of the service quality provided in different facilities, enabling them a more enlightened choice of providers, exposing governments and service providers and making them accountable in front of their customers and constituencies through a scientifically-measured, yet, user-friendly set of quality indicators and measures that are available to all and regularly updated. Context The healthcare providers market in Egypt is a fragmented network of in-patient and out-patient facilities, owned by the Ministry of Health in addition to public sector facilities operated by the Health Insurance Organization, the Curative Care Organization, Universities, Teaching Hospitals and Institutes as well as exclusive facilities managed and owned by the police and the military. There is also a heavy reliance on a growing private market of hospitals, outpatient clinics, pharmacies, and traditional healers. In most cases, patients do not have any initial assessment of the quality of service each health facility provides prior to their visit. If they have this luxury, they rely on word of mouth or previous experiences when making their choices about service providers. If the services provided are of poor quality, they may complain or decide not to visit this facility again, but this does not hold the provider accountable nor does this give the consumer any voice that would make the low service quality provided in this facility, visible to other consumers. Target The quality indicators will be created through an initial set of workshops combining quality experts and patients representatives. The patients being the target audience of this project, will be coached into the formulation of quality standards that cover all aspects of quality of services in health service facilities. Standards and measures will be formulated through the eyes of the consumers and validated by the quality experts. These standards will then be used to audit and evaluate different service providers and the collected data will be publicly available. Patient groups, patients in university clinics and public hospitals will be mobilised to participate in these sets of workshops aiming at reaching out for a diverse range of socio-economic levels, occupations, habitats, ages and genders. Who will benefit? 1. Users of health service facilities wanting to make an enlightened choice of providers. 2. Managers of public and private hospitals and service providers aiming at improving the service quality they present to their customers. 3. Public servants and decision makers as a tool to track the performance of service providers. 2

3 4. Insurance companies and contractors to make better decisions about the service providers they wish to contract with. Game Changing Factor This projects tackles corruption through providing a visible community-monitoring tool that allows citizens to voice their view on service quality, through an objective, scientifically accurate set of quality indicators that are user friendly and easy to use by others. Constituting an important step in promoting social accountability of service providers. The quality standards and measures are actually designed by the consumers. They are the ones who decide what matters most to them and how they perceive this indicator should be measured. This is a community-monitoring tool that is created by the communities and validated by experts. Its strength and capacity to grow and prevail relies on its community origins. Project partners Shamseya s team, patient groups, one pilot health facility (El Bostan Center), a web development company for the publishing platform. For more information about the Shamseya, the team and the organisation carrying out the project, visit Results 1. A set of specific patients-conceived quality indicators that cover all aspects of health service quality. 2. A set of quality measures that directly reflect patients perceptions of how they see quality of service according to the aforementioned indicators. 3. A pilot auditing of one health service facility following these indicators and measures. 4. A beta online platform where the results of these audits and the quality indicators and measures are published and explained. How will you know when you have achieved these results? 1. A list of quality indicators 2. A list of quality measures for each of these indicators 3. An audit report of the chosen health facility following the indicators and measures 4. A working pilot online platform where these indicators and measures are explained and where the results of at least the initial pilot audit are published. How do you want to achieve these results? See Planning Table below What challenges do you think you will face in implementing your project? Reluctance or refusal of the service providers to undergo the audits: A set of incentives are provided to them including a customised set of recommendations to improve the service quality in their facilities Achieving the needed level of reliability and neutrality of the auditing process: Close monitoring of the auditing process will take place through a designated team and facilities will be having the possibility to ask for repeating the review process through a different auditing team. 3

4 How do you plan to make your project results sustainable? The project provides the basic foundations for a sustainable community monitoring tool. Once the indicators and measures have been formulated through this project and the online platform has been created, community audits of health service providers will be regularly published on the platform, scaling up the reach and impact of this tool. Health service providers agreeing to undergo the audit will also receive a customised list of recommendations about what can be done to improve their results. Also, community groups, local NGOs and patients groups will be trained and coached in carrying out the audits following the indicators and using the measures to enable a growing scale for the listed service providers. Once the tool is operational, decision makers at the ministry of health will be contacted to include this community monitoring tool as part of their evaluation processes with the aim of the results influencing the accreditation process of the different facilities. What is the overall budget of your project in EUR? Euros Do you have other funding sources for your project? Will you seek other funding sources? Please explain. Yes, it has been agreed upon that the initial audit will be carried out as a paid coaching / consultancy to the first pilot health service provider (El Bostan centre). The organisation (Shamseya) has resources it will spend on the project and additional funds will be sought for the continuation and scaling up of the project. Would your project become a social business? Please explain. Yes, this is a community tool that works to provide the data citizens need to hold service providers accountable. Scaling up and the carrying out of additional service audits will be done as a paid service requested by the service providers at a minimal cost that covers the expenses of the project without bringing profits to individuals. Detailed budget proposal See Budget Table below 4

5 Planning Table #1 Stakeholders mapping, design of the workshops #2 Community workshops, to design and create the new quality indicators and measures #3 Review and validation of the set of quality indicators and measures #4 Conducting a pilot audit of a health facility using the quality indicators and measures Steps Justification/Explanation Proof Duration To ensure the chosen participants are diverse and representative of the target audience and that the workshops design achieves its target goals To ensure a truly participatory process for the creation of these quality standards To validate the scientific and practical aspects of the chosen indicators and measures To test run the quality indicators and ensure they work in the field A group of around 30 individuals representing different income levels, ages, habitats and genders have confirmed an interest to participate. at least 3 workshops have been carried out and documented A final list of quality indicators and measures that have been formulated by the patients, validated by the experts A pilot audit report according the quality indicators and measures Phase 1 Dec Feb 2015 #5 Development and testing of the beta online platform #6 Publishing of the pilot audit on the online platform To have a unified platform where the results of future audits are published and the indicators and measures are explained To have one real audit published, evaluating one health facility and therefore, have a precedent to use to be able to carry out additional audits and replicate the process A working beta version of the online platform Results of the pilot audit published on the online platform Phase 2 March - May 2015 Budget Table 5

6 Expenditure Type Description Total per expenditure type IACC SEI Grant Own fund 1. Internal Salaries Salaries for 3 part-time employees for a 6 months ,179 6,739 period (a 1 month salary average of 551 Euros) 2. Overheads 5% of salaries Materials None 3. Honoraria One quality consultant to review the formulated indicators and measures 4. Publication & PR Web development and design of the online platform, basic publications for the workshops ,414 2, Travel None TOTAL in EUR ,000 10,598 6