1
HEALTH SERVICES DELIVERY
1.3
NATIONAL QUALITY ASSUARANCE PROGRAMME
1.3.1
Improved Quality of Patient Care Services (as of March 2008)
A Focal Point
B Implementing Agencies
C Target Areas & Beneficiaries
DDG/MS
Ministry of Health
The whole population
of country
Project Summary:
The project of improving quality of Patient Care Services is designed with the objective of
developing standard, protocol on best practices & also upgrading facilities at OPD & IPD to
improve systems & process of care. This also includes diagnostic services & establishment of a
medical audit system which will ensure high quality of care. In view of achieving this objective
various activities such as organizing hospitals & health systems, quality improvement
programmes, developing policies, treatment protocols & standards, regulatory frame work for
medical audit, logistical plan for each institution and establishment of an information network
will be taken up.
1.
Justification:
Sri Lanka is known to the world for the provision of reasonably satisfied cost effective health
care free of direct cost to the people. However our health system suffers of inadequacies in
responsiveness & higher level of quality mostly in the curative sector. Quality is the degree to
which health services for individual & population increase the likelihood of desired health
outcomes and are consistent with the current professional knowledge. Improvement of systems at
service levels & building positive attitudes & professional standards of health sector employees
will enhance quality of care.
However Sri Lanka do not have an organized programme for improving quality of care. Neither
the Ministry of Health nor the service institutions or hospitals have a system to monitor the
quality of care given to patients. During the next two decades Sri Lanka needs to focus on
customer oriented responsive health service provision at all levels. Improving quality of care at
all levels of institutions not only prevents bypassing, but also reduce preventable deaths &
complications arising from medical procedures and ensure safety in patent care.
2.
Important Assumptions/Risks/Conditions:
Improving quality of work environment & quality of work life & performance appraisal will
change the behaviour of employees to provide responsive health service.
3.
Project Objective:
Objective
To
develop
standards,
protocols on best practices
and upgrading facilities at
OPD and IPD to improve
structure & process of care
including
diagnostic
services & establishments
of a medical audit system
through which ensure high
quality of care.
4.
Means of Verification
Hospital reports & records

Project Output/Product:
Outputs
Quality Secretariat for the
Ministry of Health is
established.
Quality Management units
are established in all Tertiary
care hospitals.
Performance appraisal
system is developed at
National/Provincial &
Institutional level.
Manuals and Protocols are
developed for best practices
& responsive health service.
Human Resource
development plan focusing
on Health work force to
provide responsive health
services & safety care.
5.
Indicators

% of hospitals, protocols
& Procedures implemented

% of institutional
facilities are upgraded

% of hospitals with
appropriate diagnostic
facilities

% of hospitals medical
audit system is in place

% of hospitals, standards
are implemented.
Indicators

No of functions
established/quarter
No of quality management
units established per year

Means of Verification
Quarterly review

Quarterly review


Quarterly return
Annual report

No of articles developed in
respective specialty / year

Published data
Developing Human
Resource

Development action plan
annually.

Reviews



No. of reviews / year
Related Projects:
Project No.
Project Title
Upgrading Base Hospitals & establishing a District General
Hospitals in each district.
6.
Relevant Agencies to be Coordinated:
Productivity Secretariat Ministry of Labour & Employee Relations.
Sri Lanka Standards Institution
World Health Organization, World Bank. JICA
Colleges and associations of Medical Professionals.
7.
Monitoring & Evaluation:
To be reviewed every quarter, Mid Term evaluations.
8.
Activities:
Activities
1
2
3
4
5
6
7
8
Expected Results
Organize the Quality Secretariat of the To
establish
a
MOH.
mechanism
to
co-ordinate
&
monitor the Quality
Assurance
programme
Establish Quality Management Units in Productivity
&
Tertiary care Hospitals, Base hospitals Quality culture is
and DPDHs offices
created in hospitals
Organization development & improve Hospitals
become
quality of work environment in Health environment friendly
Institutions
& safer to patients.
Training of Trainers in NQAP in all Resource workforce
districts.
in
quality
improvement
is
organized
Periodical Performance Reviews.
Performance
of
different
hospitals
are
assessed
at
central level.
Develop Institutional frame work for Quality
of
all
Primary care functions & referral hospitals
are
Systems among different levels of improved & patients
hospitals
receive
responsive
health care.
Develop guidelines on best practices
Safety in patient care
services.
Develop clinical practice guidelines for Clinical guidelines
MS of common clinical conditions.
developed
Process Indicators
Review meetings
Annual report
do
do
do
do
do
Quality
indicators
process management
Identify
working
group
Develop guidelines
Pilot test