FFHI – Solution with in Ajit Kumar Singh

1. FFHI – Solution with in Ajit Kumar Singh

2. Guess ….Name of the Place

3. 4th Century A D Hospital of Gupta period in India

4. Health facility

5. Health facility

6. Changes after intervention Before After

7. One color scheme

8. Labor room Before After Pakaridayal Block PHC – East Champaran district

9. Go to the people. Live with them. Learn from them. Love them. Start with what they know. Build with what they have. But with the best leaders, When the work is done, The task accomplished, The people will say ‘We have done this ourselves’. -Lao-tse in 7th century B.C. Philosophy of working

10. FFHI Progress Review Meeting in Chairman-ship of SDM Sherghti • .

11. Vision statement • ‘The vision of our hospital is to heartily welcome all the people who come as they provide us opportunity to serve them. Our hospital provides special facility/care to the pregnant mothers, children, people with disabilities and people from marginalized communities. It’s our privilege that we are a member/part of Sub-Divisional Hospital family which has determined to provide world-class quality services. ‘

12. Problem Bank

13. Third Phase • After formation of FFHI Stake Holders Committee, assessment of all department of the Facilities were done by Committee members in leadership of MOIC with the help of FFHI Tool kit from First week of Nov,2011 as per guidelines & finally identified 130 gaps from various departments of facilities. • All 130 gaps were divided in to three levels, out of which 84 facility level, 40 District level & rest 6 State level issues. • Regular weekly meeting of FFHI stake holder .

14. Progress Phase • FFHI Progress Review meeting is being held in every 15 days in FRU, Sherghati. • Three times review meeting has been held for progress status & next planning for progress in presence of SDM & DPM with line departments. • Total 40 gaps have been mitigated from 130 gaps with in month.

15. Minutes of Review Meeting

16. Transect walk and preparation of Facility map plan

17. Skill Mapping and training

18. Skill lab Dr.P. Padmanaban / Prasanth K S / A K Singh NHSRC, New Delhi, 20th February/AIIMS Skill Stations Skill lab in Guru Govind Singh Hospital ,Patna

19. Community Participation –Blood donation camp is the key of success

20. Store room Before AFTER Alauli Block PHC – Khagaria district

21. Public toilet in Sadar Hospital Aurangabad

22. Newly purchased Equipments and Instruments

23. Taking support from other government scheme Before after Alauli Block PHC – Khagaria district

24. Useful equipments available locally 3rd Phase NOW Pakaridayal Block PHC – East Champaran district

25. District support for procurement of equipments alauli block phc- khagaria district

26. Recognition of work

27. Monitoring by indictor

28. Change

29. 2. Process for QMS in hospital (as per FFH standards) Meeting by Hospital Quality Improvement Group • Team building . • Visioning Exercise & Problem Bank creation (Gap Analysis) . • Vision statement of health facility / Quality statement. • Action Plan Development with Time frame (Prioritizing the gaps, level at which gaps would be addressed, resources/FMR source, responsible person,etc) • Monthly Hospital Quality Improvement Group and RKS meetings for approval of work and associate line department. • Implementation of Plan according to activity plan. • Monitoring & check. • Apprise District QAC on the processes & progress. • Once facility is ready it may apply to DQAC for certification. Hospital staff Independent assessment and certification

30. 3. Certification Process: State Certification –cum-Audit Body Submit report with recommendation or non-recommendation for certification visit State Quality Assurance Cell,SHSB Conduct certification Visit & award quality certificate Submit final reports with recommendation or non-recommendation for audit Regional level Assessment team (RQAC + any nominated member) Check readiness of facility and request for 1st round assessment District Quality Assurance Committee (DQAC) Once ready, may apply for certification Public Health Facility

31. Type of quality certification –By Silver / Gold Star : • Benefits for the certified facility and working team ( System for motivation): • Certified institutions would be supported by providing additional HR and funds on priority basis especially if these institutions are located in the hard to reach areas. • The Gold FFH certified institutions may be given additional maintenance funds to sustain the quality standards. The norm of financing to the hospitals would be as below :- • Gold certified DH/SDH - Annual grant of Rs. 25 lakhs. • Gold certified FRU - Annual grant of Rs. 15 lakhs. • Gold certified PHC - Annual grant of Rs. 10 lakhs. • Gold certified APHC/HSC- Annual grant of Rs. 1 lakh. • (75% of the this additional fund granted to the hospital could be used for infrastructural strengthening whereas up to 25% could be used to pay incentives or welfare activities of all employees & staffs) • The DM/CMOs/Hospital Superintendents/MOIC/ DPM and all those service providers of the Gold FFH certified institutions may be given due recognition by the way of merit certificate or any other means from the Government.

32. First C-Section Thanks for Support

33. Process of FFHI In Facility • Vision statement • Problem Bank • Creative team building (As per Service ) • Transect walking • Gap analysis by tool • Colour coded activity ranking • Indicator development • Photographic monitoring • Weekly meeting of Creative team • RKS meeting for approval of work and associate line department • Presentation of Gap analysis and development at District level • District will start monitoring Colour Coded Activity ranking

35. Process to be followed in each Facility Meeting by Hospital Staff Hospital staff Independent assessment and certification