through the Pharmaceutical Leadership Development Program (PLDP) Lindile Mabuya 28 August 2014

Transcription

1 Health Gail Systems Mkele, Sue Strengthening Putter through the Pharmaceutical Leadership Development Program (PLDP) Lindile Mabuya 28 August 2014

2 Mission Saving lives and improving the health of the world s poorest and most vulnerable people by closing the gap between knowledge and action in public health.

3 Journey - History of Pharmaceutical Leadership Development Programme - Overview of the PLDP - Approach taken to achieve measurable results - Examples/Case Study - Acknowledgements

4 History of the PLDP Committee of Heads of Pharmaceutical Services requested support to build leadership and management capacity (2008) WHO Building Blocks Health System Strengthening SPS/SIAPS adapted the MSH leadership development program (LDP) developed in Aswan, Egypt in 2000 Modules added to meet the needs of pharmacists PLDP piloted in Gauteng (March August 2011) Rolled out in Free State/Northern Cape, Eastern Cape, Kwa-Zulu Natal, Western Cape, North West and Limpopo*

5 Leading and Managing for Results Model When applied consistently, good leading and managing practices strengthen organisational capacity and result in higher-quality services and sustained improvements in health.

6 PLDP Workshop Schedule Workshop 1 (5 days) Workshop 2 (5 days) Workshop 3 (5 days) Workshop 4 (5 days) Workshop 5 (2 days) Final Presentation Introduction to Leading and Managing Practices Strengthening Health Systems Planning M & E concepts and frameworks* Introduction to the Challenge Model Identify a team challenge and develop team challenge model Developing an M&E Plan Developing indicators Data sources and data quality Legislative Framework Financial Management in Pharmaceutical Services* Advanced Medicine Supply Management* Human Resource Management* Good governance in pharmaceutical services* Ethics in Pharmacy Teams work on challenge Preparing the abstract, poster and presentation Final preparation Presentation to Stakeholders Coaching Visits PLDP facilitators meet with teams to encourage and monitor progress on the leadership challenges as well as help teams reflect on their commitments

7 Technical Modules Monitoring and Evaluation Legislation, Governance and Ethics Financial management for pharmaceutical services Advanced Medicine Supply Management Human Resource Management

8 Monitoring and Evaluation M&E concepts and frameworks are introduced early in the process A rigorous process of developing the measurable result, indicators and an M&E plan is followed Teams identify possible data sources, data quality issues which may occur and ways to mitigate these

9 Legislation, Governance and Ethics Provide an overview of South African legislation which may impact on pharmaceutical services Introduce characteristics of good governance Explore potential governance related problems that can affect delivery of pharmaceutical services Strategies to improve governance Explore ethics and ethical dilemmas

10 Financial management for pharmaceutical services Understanding and interpreting the Public Finance Management Act and Treasury Regulations Empowering participants to plan and budget Financial risk management Strategies to mitigate risk Financial reporting Understanding the auditing process

11 How can the pharmaceutical management framework be applied when Advanced Medicine managing medicine Supply supply? Management Analysing and controlling pharmaceutical expenditure Analysing and controlling pharmaceutical expenditure Leadership & Management Quantification Inventory Management Pharmaceutical Management Framework

12 Human Resource Management Legislation and directives that govern employees in public service Explore pillars of HR management Case studies and role play on conflict management, grievance and disciplinary procedures Strategies for improving work climate and motivating staff

13 The PLDP approach The PLDP uses a novel approach that combines pharmaceutical management knowledge and sound leadership practices Working in teams, participants tackle a workplace challenge by applying the challenge model

14 Mission Vision Measurable Result Priority actions Root causes Current situation Challenge statement

15 Using the Challenge Model Create a shared mission and vision Assess the current situation Scanning the environment SWOT analysis Conceptual Framework Stakeholder Analysis

16 Using the Challenge Model (cont d) Focus on one challenge in the workplace Define one measurable result Develop an M&E plan Identify obstacles and root causes Five Why s

17 Using the Challenge Model (cont d) Articulate their challenge Select priority actions Develop a detailed action plan Align and mobilise key stakeholders Implement the plan Monitor and evaluate progress towards achieving the desired result The Challenge model gave us a dynamic framework in which to practice our leadership skills, PLDP participant

18 Examples of quality improvement activities implemented

19 Salatchi 85 years old Nearest health facility GJ Crookes (20 km) 1 day each month dedicated to collecting her chronic medication $$$ on travel and long waiting times = her reality Naleeni Pharmacy manager at GJ Crookes Dedicated to ensuring that Salatchi s medicine was always available at the hospital Limited resources and high patient volumes = her reality

20 New reality - Stroll to the community centre around the corner, collect medicine and return home Also the new way of life for ~400 patients in her community for the past year I spend less than 30 minutes in a queue and within an hour, I would be back home resting (Joanna another patient) One of three community based collection points for chronic mediation established by GJ Crookes hospital

21 Examples of quality improvement activities implemented Priority Areas Some Challenge Addressed Waiting time Ensuring medicine accessibility Improving medicine supply management The average patient waiting time at the pharmacy at Kraaifontein Community Health Centre (CHC) in the Western Cape was reduced from 41 to 19 minutes over a 6 month period. Work of the Zenzele team in Ugu District in KwaZulu-Natal resulted in a 16% reduction in the number of parcels of chronic medicine which were not collected by patients at Umzinto Primary Healthcare Clinic (PHC). Development of a referral system in Camdeboo Sub-District, Eastern Cape facilitated delivery of chronic diseases medications supplied by Midlands Hospital to feeder clinics, thus enabling a more client s easier access to medications for chronic conditions. At Cecilia Makiwane Hospital in the Eastern Cape, implementation of a batch management system resulted in a 3.1% (3.8 to 0.7%) reduction in expired stock as a percentage of expenditure The value of expired stock was reduced from 3.4% to less than 0.5% of stock held in 6 of 11 clinics in Sisonke district, KwaZulu-Natal

22 Examples of quality improvement activities implemented (cont d) Priority Areas Ensuring compliance with standards Ensuring rational use of medicines Some Challenge Addressed In KwaZulu-Natal compliance of prescriptions with standard treatment guidelines for non-steroidal anti-inflammatory agents was improved from 57 to 94% and 60 to 68% at two hospitals and from 37 to 67% at a CHC In the North West pharmacists worked with 10 primary health care facilities on the development of SOPs, distribution of reference manuals, and building capacity in good pharmacy practice including medicine supply management, which increased compliance with national core standards from 33 to 77% The average number of patients initiated on isoniazid preventive therapy at the Joe Morolong Memorial Hospital in North West increased from three to eight per month (a 167% increase in enrolment of patients on IPT) Eight months after completion of the PLDP, 45% of the facilities in the Frances Baard District were reporting ADEs, up from 26% (a 73% increase in number of facilities reporting ADEs)

23 Some time in the near future Limpopo s journey has begun Workshop 1 held in June Western Cape Leadership Development Program pharmacist, facility manager & doctor at PHCs Kwa-Zulu Natal Sustaining PLDP projects Internal capacity to rollout workshops Incorporating approach within the organisation how we tackle our activities Sustainability Partnerships with universities Watch this space

24 MSH Remains True to its Founding Values:

25 Acknowledgements PLDP Team Senior Managers of the Department of Health Guest Facilitators Participants Yourselves References Management Sciences for Health, Managing access to medicines and other health technologies. Arlington, VA: Management Sciences for Health Management Sciences for Health, Health Systems in Action: An ehandbook for Leaders and Managers. Cambridge, MA: Management Sciences for Health.

26 ~160 pharmacists and facility managers that carried out quality improvement initiatives as part of the Pharmaceutical Leadership Development Program (PLDP)