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Systemic Quality Improvement Approach Quality Concours Morocco

Royaume du Maroc Ministère de la Santé. Systemic Quality Improvement Approach Quality Concours Morocco. Assessment of the process and its effects on maternal and child health services. The expert talk Eschborn 4th of December 2012. Dr Nejoua BELKAAB

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Systemic Quality Improvement Approach Quality Concours Morocco

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  1. Royaume du Maroc Ministère de la Santé SystemicQualityImprovementApproachQualityConcours Morocco Assessment of the process and its effects on maternal and child health services • The expert talkEschborn 4th of December 2012 Dr Nejoua BELKAAB Responsible for the Quality UnitHospitals Direction and ambulatory cares-MH-Morocco

  2. Processapproach Modelgenericused How to assess the quality of health services? Elements of output Eléments d’entrée Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

  3. F A C T O R S R E S U L T S Results ofPersonnel Staff Key Performance Results Policy & Strategy Results of customers Leader-ship Process Communityresults Partnershipand Resources INNOVATION AND LEARNING The Excellence Model- EFQM(European Foundation for Quality Management) Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

  4. Steps of the SQI Hospital Health center Provincial health dept Maternity hospital

  5. General benefits of SQI • Creation of a dynamic in the system. • Effect system, • Annual appointment of all professionals; • A step ahead in the process of governance: accountability, transparency and recognition of efforts; • It became a political instrument which can include the priorities of every strategy of the Ministry of Health; • Better performance after several editions. Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

  6. Step 1: Preparation of structures • The responsible managers are informed on conduct of CQ, the evaluation criteria; • Awareness raising to reach highest numbers of different structures to join the process and to plan and implement changes according to the criteria of CQ; • Concrete actions to improve; • Development of partnerships: Supporting representatives of the communities • No predetermined schedule that is shared with all structures / lots of hazards, unstable financing .....> difficulty of planning; • No circulation of information following the meetings; • No technical support, to execute changes "If we know or can do it, we had done! Without CQ“ • Non harmonized actions Strengths Challenges Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

  7. Step2: Self-assessment • Open questioning of some processes; • Time for change and search recommendations for it. • Small team that fills the guidebook; • Teams do not have the same level of understanding; • No visibility on the horizons of expectation; • Lack of support during this phase; • Feels as a burden instead of being an opportunity for change. Strengths Challenges Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

  8. Step3: Analysis of self assessment • Results that reflect the effort of the structure and level of involvement in the process. • Scoring very subjective, answers and horizons of expectation not detailed; • Questionable since all structures shall be subject to audit. Strengths Challenges Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

  9. Step4: Audit & feed-back • External evaluation; • Preparing the structure for this visit; • Structured diagnostic; • Confirmed areas for improvement in the majority of cases by the team; • Results more credible. • Time: 1 day, not sufficient for some structures; • Warned structures / situation not real; • Assessment according to one process description; • Results remain audit-dependent. Strengths Challenges Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

  10. Step 5: Participatory improvement plan • Improvement Plan is the subject of a specific assessment for the next edition; • Improvement actions oriented at the processes; • Realization of training by the central level, following the analysis of Improvement Plan in several domains. • Improvement Plan is not always included in the Annual Action Plan of the structure; • Sometimes implemented to meet the requirements of CQ; Strengths Challenges Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

  11. Step6: Result announcement and price rewards • Diagnostic of the entire system in real time and based on only one tool; • Official ceremony; • Recognition and distinction in presence of the Minister of Health; • Mediatization. • Double classification: • Betterperformance in CQ • Betterproductivityperformance • Transverse data bank not available; • No substantialprices; • When they exist (study trip or training ) for managers only; • Teams are not valued sufficiently. Strengths Challenges Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

  12. Step 7: Improvement support Strengths Challenges • Responsibility of the team to develop its own Improvement Plan; • Research partnership to concretize the Improvement Plan; • Duplication of efforts: Lack of coordination with other structures in the province (delegation, hospital and health centers); • Lack of support in the implementation of Improvement Plan; • The resources are not oriented at implementing corrective actions. Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

  13. Stepn: sustainability • Enlists in line with the strategy of the Ministry of Health for the reduction of maternal and infant mortality; • Conditionalityin the program program of EU support (2011-2014); • To date provided funding for the organization of CQ: • 2006-2010: GTZ- global fund-OMS-MH • 2011-2012: MH • Two evaluations stressed improtance of continuity; • Debate on CQ for the first time in Moroccanparliament • Viability fragile, non-institutionalizedapproach; • Monotonyfelt by professionals; • Difficulties of measuring the contribution to the impact; • Implementation of other approaches more fashionable (accreditation) or current tools (RAMED) Key factorsof success Challenges Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

  14. Perspectives • Linking prices of CQ to technical support and / or financial:(Contracts, Assuring tutoring…); • CQ-SQI better synchronize with other approaches to quality management; • Develop a legal and administrative framework; • Promote an overall development framework with interfaces between health, education, economy and environment based on the same tool; • Maximize the values ​​of SQI by maintaining a long-term vision. SQIan instrument of creation of value Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12

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