PRIMARY HEALTH CARE CORPORATION - Together for a healthier Community
www.phcc.qa
Contents
5 ............ Managing Directors Note 6
Welcome to Primary Health Care ................................. Corporation
8
PHCC, Patients and ..................................Community
12
2
Contents
Ensuring Safe and ................High quality Services
16 Our Workforce .................. 32 Our Achievements ............
How PHCC runs its business: Corporate Governance and Committee Structure ............
37
Financial Results and Financial Governance............
41
Our initiatives and Future Plans...................
46 Contents
3
Dr Mariam Ali Abdulmalik Managing Director, PHCC
Managing Director’s Message
Introducing 2014-15 Annual Report It is a privilege to introduce the 2014/2015 Primary Health Care Corporation’ annual report; I do believe that readers whether on PHCC level or National/International Stakeholders Level will find interesting information that will offer a brief about our corporate achievements and indicate few parameters of the future that we are moving toward. Since we launched the Primary Health Care National Strategy on 2013, we defined our vision to be the “First Point of Contact” for Health Care in the state of Qatar. We believed that Health Care is a right for every human being and it’s our responsibility to cover all areas that may enhance the population wellness based on our capacity, investing our resources in the best way possible to achieve optimal results. The Primary Care is a key priority as indicated by the World Health Organization (WHO) and the development of this concept is a Qatar National priority aiming to shift the balance of care from secondary/ curative model toward a preventive and community based model that is delivered across Primary Health Care Centers. This aim inspired us to develop plans and take real actions by establishing programs and launching projects to fulfil our mission and our pledges. We were committed to create what is called “family medicine model of care” that is delivered by qualified family medicine consultants/physicians to work comprehensively with multidisciplinary team approach & support, screen for common diseases, and monitor health issues before they emerge; we launched the concept of wellness and projects shall follow soon. Furthermore we reached out our community through schools, social events, media campaigns, etc… to empower healthy lifestyles and raise public & individual awareness; we actually commenced the implementation of 8 new models of care; we have expanded geographically on facilities level and we have also expanded our scope and quality of services, we have extended our operating hours and incorporated systems of insurance and electronic medical records to be always ready to meet the population needs and patients
requirements and many other initiatives that turns into real projects and then to accomplished objectives. This annual report summarizes the progress made with the implementation of National Primary Health Care Strategy. It provides an opportunity to share with our patients, public and other stakeholders the journey of our efforts and hard work. Indeed, 2014/2015 has been another significant year for PHCC as several deliverables and achievements have been carried out. As always, I would like to appreciate the PHCC leaders & staff’ commitment and dedication to work as none of these changes could be placed without their efforts. I have been genuinely impressed by as they have been striven to maintain and enhance the quality of business and coping the speed of changes with their performance and environmental professional attitude. I continue to see great examples of staff using new technologies and innovating with new models of care and new methodology of workforce development. This gives me confidence as we move into another busy year 2015-2016 through which we will achieve new objectives, continue to deliver qualified services, ensure patient safety and world class care for everyone. Innovation will be always our inspiration to look forward to another year and more achievement to report about.
Chapter 1. Managing Directors Message
5
02
Welcome to PRimary Health care Corporation
Who we are The Primary Health Care Corporation (PHCC) is the state owned Primary Healthcare Provider. Established as an independent Corporation with its own independent budget by Emiri Decree in 2012. Currently, the Primary Health Care Corporation is operating through 21 primary health care centers distributed into three regions, namely Central, Western, and Northern. Thirteen of these centers are located in Doha city, while the rest are located in populated areas in all parts of the country. In 2014 PHCC served 5.2 million visitors. In order to provide excellent access to Qatar’s growing population, PHCC is expanding the number of Primary Health Care Centers and by 2019 we will have commissioned 12 new health centers and replaced 7 existing Health Centers with new modern facilities. We are also strengthening our home care service; and expanding the hours of operation of some of our services. This means that we are also increasing staffing from our current 4,500 staff in line with the expansion of facilities and services.
6
Chapter 2.Welcome to Primary Health Care Corporation
What We do PHCC is the main provider of primary health care services in Qatar. Primary healthcare refers to health care services that are delivered outside of the hospital, in the community, and offer the first point of contact in the health care system. We provide a wide variety of different types of health care services based on the location and population needs of each area. We focus on promoting the health of our population, and prevention from diseases, in addition to patient diagnosis and treatment, and the provision of a long-term and constant support to patients and their families from infants to elderly, children, adults, married couples, and mothers. We aim to meet the following goals in everything we do:• Excellence in Health Services, facilities and infrastructure – by being the first and continuous point of contact for high quality, accessible and safe primary health care services. • Excellence in Workforce – By developing and expanding a skilled and motivated workforce to deliver better health outcomes for the public. • Excellence in Organizational Learning and Development- By ensuring the organization as a whole has the culture and systems in place which enable it to core objectives • Excellence in Customer Services - By ensuring that our services, staff and facilities are centered on our customers’ needs • Excellence in Partnerships - Establishing effective relationships with all partners to deliver high quality primary care services
Mission Vision and Values PHCC’s Mission Our mission is “To advance health and well-being through primary health care services which are comprehensive, integrated, person-centered and affordable.”
PHCC’s Vision Our vision is “To be Qatar’s primary health care provider of choice.”
Our Values At PHCC we have developed our values through extensive consultation with PHCC staff and stakeholders. Below are our core values: • Teamwork- We work together for the benefit of our patients • Quality – We provide a high quality care that is safe, effective and focused on patient experience • Commitment to Community - We believe that our first commitment is to the community we serve to ensure the provision of high quality health care in the most effective setting to promote ease of access. • Mutual Respect - Engage, listen to and value the contribution of others • Compassion - Demonstrate our commitment to world-class care by providing a caring and supportive environment for our patients, patients’ families and fellow caregivers.
What We Offer The table below gives a broad overview of the services that we provide (our website www.phcc.qa provides full details per Health Center).
Family Physician
School health Service
Home Visits Services
Dental
Mental Health
Laboratory Services
Vaccination Services
ENT
Health Promoting Schools
Pharmacy Services
Patient Management
Social Worker Services
Radiology Services
Antenatal care & Ultrasound Services
Ophthalmology
Medical Commission Services
Health education
Screening services
Chapter 2.Welcome to Primary Health Care Corporation
7
03
PHCC, Patients
and Community
Our patients are important to us At PHCC we recognize the importance of not just providing excellent clinical services but of ensuring a positive overall experience for the patient. The following are our current Patient Experience management steps
107
The First Step
The Establishment of the Complaint Service: Complaints are vital for organizations to improve their service. At PHCC we strive to provide the best service but we understand that we can always learn and improve. Therefore we have an established complaints process to ensure that if we receive a complaint it is acknowledged, acted upon quickly and lessons are learnt.
The Second Step
Customer Service: We support a culture of customer service throughout PHCC by providing awareness and training to staff that work directly with our patients and introducing a Hayyak team at Health Centers to attend directly to patients’ concerns and provide timely information, support and advice to patients and their families to support them in accessing the care they need and resolve any concerns.
{
8
Chapter 3. PHCC, Patients and Community
The Third Step
Customer Service Management: We proactively seek patients’ views on our services so that we may continually improve and increase our patients’ satisfaction. The Hayyak staff provide a contact point within Health Centers whereby patients can express their feedback to us, we can also be contacted via the 107 telephone line. By not just focussing on complaints but also encouraging comments; concerns and compliments we can get a better picture of where we need to focus our attention and share good practice across all our Health Centers..
We continue to develop and improve our Patient Experience management and our services.
}
Patient Feedback We are actively encouraging visitors to our Health Centers to tell us about their experience so we can focus on the things that matter most to our patients. Between 1st April 2014 and 31st March 2015 we collected patient feedback responses from 5661 visitors. As can be seen from the chart below, the majority expressed satisfaction with our services. Where patients identify areas for improvement we address them locally or include them in our Health Center improvement projects for example queues and waiting times within the Health Center have been reduced by reviewing the patient flow, increasing the use of appointments, triage and faster more efficient electronic systems (further details can be found in the achievements section)
Patient H e al t h C e nt e r pat i e n t s a t i s f a ct i o n f e e d b a ck
Satisfied
45%
45%
Very Satisfied
12%
Dissatisfied
Chapter 3. PHCC, Patients and Community
9
Analysis of complaints received by Customer Service This year we had over 5.2 million visitors to our Health Centers and whilst the majorities are extremely satisfied with the service received, occasionally we do receive formal notice of dissatisfaction. This year 394 complaints were logged onto our electronic system, and every complaint received is taken very seriously and if the issue cannot be resolved at Health Center level our Customer services department facilitate and co-ordinate an investigation into the facts and work with the complainant until a satisfactory resolution cannot be found. The majority of complaints we received have come through the Governmental Health Communication Center (Labaeih). These complaints are fully investigated but we are also improving our arrangements for addressing concerns at Health Center level with the HAYYAK team being available at each Health Center to address any problems immediately at a local level.
Source of complaints recieved 01/04/2014 to 31/03/2015
Comments 300
Email
200
In Person In Waiting
100
Labaieh
0
Telephone Comments
Email
In person
In Labaieh Telephone waiting
All complaints received within the year have been reviewed and closed. However, as well as looking at the individual complaint we also try to identify common areas across our services and this information has been used to inform many of the Health Center Improvement Initiatives described later in this report
HAYYAK Helpline In June 2014 we launched the 107 helpline, a service allowing people to contact and acquire information, provide feedback about the service they received and to make an appointment. We have dealt with 269 different types of feedback as detailed in chart below:-
21% Information
22% Compliment
17% Comment
7% Advice
Feedback by Type from Launch to 31/03/2015
26% Concern
2% Help
10 Chapter 3. PHCC, Patients and Community
4% Request
1%
In the final quarter of the year PHCC reached agreement with ictQATAR Government Contact Center provider, to work together in establishing a Nationwide call center and Hayyak helpline called 107. Close collaboration between the two government bodies meant the contact center was established within a month at ictQatar head-quarters in Al Nassr Tower on the Doha Corniche. The center provides facilities to take calls from the public and patients for both general enquiries, appointment booking and reminder services.
107
Developing partnerships and community participation
PHCC aims to strengthen the relationship with the community by using their contribution to the decision-making process that supports PHCC’s vision in raising the awareness of a various services, campaigns and events. In addition, PHCC is working collaboratively with different partners in various areas whether related to its core operation or adding value to the community. The Corporation answers questions and to respond to inquiries from the public and other entities through its participation in conferences, career fairs and media. Furthermore, by holding sessions to encourage constructive dialogue which contributes to the development of the Corporation and how to improve the services to the public. We have 3 of these sessions this year with the first introducing PHCC and educating the community about the Corporation’s task of developing the relations with the community. A second session followed to discuss the implementation of new systems and execution of projects in addition to keeping abreast of the recent developments; and a third session was conducted to discuss the EMR-file system, triage and patient classification, patient appointments and the consequent pros and cons. These sessions are considered important because they reflect the voice of society and its views that are vital in visualizing the impact on the public opinion and pave the way for better achievements.
Chapter 3. PHCC, Patients and Community
11
04
Ensuring safe, high quality services
Patient Safety and Quality PHCC is committed to safety and continuous Quality improvement. All employees from the Executive Team to front-line staff are constantly striving to provide safe and high quality care. Senior management lead a just culture that empowers all staff to report incidents and identify risks to patient safety. PHCC is committed to the Qatar National Patient Safety Standards aligned with the WHO Program and to the Accreditation Canada International Patient Safety Standards.
Risk Management Risk Management is an integral element of ensuring safety and preserving PHCC assets, the focus in 2014/2015 and the coming years is to reduce uncertainty, optimize opportunities, create value and enhance learning. An Enterprise Risk Management system is used to proactively and reactively manage all incidents and risks. This provides the organization with the capacity to learn and improve continuously.
12
Chapter 4. Ensuring Patient Safety and Quality
We run regular safety awareness campaigns to ensure all of our staff are aware of and maintain appropriate standards of care. For example in May this year we joined the World Health Organization’s (WHO) global annual hand hygiene campaign ‘Clean care is safer care’ which aimed to ensure that infection control is acknowledged universally as a solid and essential basis towards patient safety and supports the reduction of health care-associated infections and their conse-quences. Compliance levels are regularly audited across our Health Centers with compliance rates consistently rising. In October we participated, together with the global community, in the annual campaign for Infection, Prevention and Control and in January we took part in Patient Safety week where we delivered training and worked to raise awareness. In January PHCC joined the national efforts and organized a campaign with the theme ‘Speak Up: Safety can’t wait’. During this campaign, PHCC aimed to encourage patients and their relatives to take a role in preventing health care errors by being active, engaged and involved in their own treatment. The second purpose of this campaign was to encourage staff to speak up, report any risks or errors and implement solutions to prevent harm to themselves, their colleagues and patients.
Accreditation Canada International (ACI). As we reported last year, we achieved the platinum level status with Accreditation Canada International (ACI). This recognizes our dedication to safety and continuous quality improvement in line with highest international quality standards. Accreditation offers PHCC a framework to assess and improve the quality and safety of services. It is a tool that is aimed at enhancing effectiveness and efficiency of PHCC services ensuring patient and staff safety and putting patients and families at the center of our services. The accreditation of PHCC by ACI provides the organization and our public with assurance that the healthcare services provided by PHCC are in line with international quality standards. PHCC is setting plans to exceed the “Platinum” level and achieve “Diamond“ status within the coming two years. This will be attained through the commitment and dedication of all staff to continuous improvement.
Chapter 4. Ensuring Patient Safety and Quality
13
Development of evidence based clinical guidelines It is one of the key strategic initiatives of PHCC to embed evidence based medicine in routine clinical practices. In doing so PHCC has taken significant initiatives by establishing PHCC Guideline Review Committee, to review and ratify internally available best practice guidelines for local use within PHCC. 26 clinical guidelines on different clinical conditions mostly Non Communicable Diseases (NCD) have been reviewed and ratified and are available for use to guide physicians in making clinical decisions at point of care.
Clinical Audits Re-audit
Select Topic
Implement Change
Agree Standards if Best Pracice
Make recommen -dations
Define Methodolgy
Analysis and Reporting
Pilot and Data Collection
Clinical Audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change. Aspects of structure, processes and outcomes of care are selected and systematically evaluated against explicit criteria. Where indicated changes are implemented at an individual level, team or service level and further monitoring is used to confirm improvement in healthcare delivery. Clinical Audit has become one of the recommended tools to assure the quality of clinical care across the organization. It helps to ensure that patients and service users at PHCC facilities receive the right treatment from the right person in the right way. It does this by measuring the care and services provided against evidence based standards and narrowing the gap between existing practice and what is known to be best practice.
Working Towards A “Culture of Data” To Improve Data Collection and Performance Measurement To ensure that we are meeting our objectives and continue to improve the quality of healthcare services we need to monitor and measure our performance. KPIs or Key Performance Indicators are a short and selected list of Indicators that show the activity, quality and performance of the department or organization. They reflect our goals and help to define and measure progress towards these goals. We have established KPI’s for all health centers and they currently cover the areas of Laboratory,Radiology, Pharmacy, Clinics, Nursing and there are also general health center KPIs. We have also introduced procedures to enable staff to manage and collect data to demonstrate progress against these KPI’s. This process is in its infancy but when fully implemented health center managers and in-charges will have a better overview of the performance of their health centers and each section and a new monthly report is being developed which will be circulated to all staff so that they are aware of the areas they need to further develop. In addition to the internal KPI’s the Supreme Council of Health (SCH) is working with PHCC and other healthcare providers to develop and implement the Health Service Performance Agreements (HSPAs). HSPAs are a key requirement for achieving Goal 2 of the NHS “Integrated Health Care” and project 2.1 “Quality Improvement” (NHS 2011- 2016).
14 Chapter 4. Ensuring Patient Safety and Quality
The purpose of implementing HSPAs between the SCH and providers is to: • Enable providers to use a common framework for measurement and assessment for the accurate and regular collection of data. • Improve the quality of healthcare services, monitor and measure the overall performance of the health system, and strengthen transparency in the health system, which would help achieve the ultimate outcome of enhanced health status for the population of Qatar.
As part of the HSPA, PHCC is reporting 15 indicators to the SCH across 6 dimensions, which are: 1. Processes, Appropriateness, and Outcomes To ensure that providers appropriately and competently deliver clinical care services and achieve desired outcomes. 2. Access and Responsiveness To ensure that providers are responsive to community needs, ensure access, continuity, and coordination of care, and promote health. 3. Safety (Patients and Staff) To ensure providers have the appropriate structure, and use care delivery processes that measurably prevent or reduce harm or risk to patients, healthcare providers and the environment. 4. Health workforce To ensure that providers are qualified to deliver patient care, have the opportunity for continued learning and training, and work in positively enabling conditions. 5. Satisfaction/ Experience (Patients and Staff) To ensure that patients are satisfied with their care and staff are satisfied with their work. 6. Performance and Efficiency To ensure that providers make optimal use of inputs to yield maximal outputs given the available resources. We anticipate that we will be able to share the results of some of these performance in our next Annual report.
Chapter 4. Ensuring Patient Safety and Quality
15
05
Our Achivements
PHCC is working towards delivering comprehensive, integrated, person-centered and affordable primary health care services to advance the health and well-being of the population. We are not only improving access to our services but focusing on expanding the range of services by adding new services to meet the diverse needs of our population. Through ensuring that services meet population needs, and that clinical quality and safety is strengthened, monitored and maintained, we will meet our strategic objectives as set out in the National Primary Health Care Strategy 20132018. To achieve this we need to ensure that the clinical services and staff are supported by a strong high quality workforce training program including a strong health education foundation, effective human resources and IT. Last year we embarked upon the Health Center Improvement program which involved identifying areas to improve the patient experience and quality of service (not specifically identified within the National Primary Health Care Strategy).
Phase
Pha s e 1 o f t h e n on - clin ical w h i c h i n v o l v e d in tr od u cin g the HA YYAK t eam , r e d u cing p a t i e n t w aitin g tim e s w it h i n t h e He a lth Ce n te r by o r g a n i z i n g p atie n t f low and e l i mi n a t i n g ar e as of con g e s t i o n w i t h ou r qu e u e m an a g e me n t syste m an d im p r o v i n g r e c e p tion se rvice s t h r o ug h s tr e am lin in g w o r k p r o c e s s e s an d staf f development.
16 Chapter 5. Our Achievements
Phase 2 of the program for 2014 has rolled-out proven improvements from phase one and expanded the program further to include clinical space pathways.
Phase
Phase
expansion and strategy implementation are projects that are on-going for existing services and new HCs and these include projects such as; General Appointment System, Hayyak 107 Helpline, School Health, Triage, laboratory and radiology improvements and Communicable Disease Clinic (CDC). A number of these projects relate directly to patient pledges and recommendations in the strategy.
This section highlights some of our achievements in delivering our goals in these areas in 2014-15.
Patient services PHCC aims to provide high quality care that is integrated, coordinated and which places the patient and family at the center. In order to do this we are focussing on the needs of our population and expanding our range of services to provide equal emphasis on health promotion, prevention and early detection, as well as the treatment of acute and chronic conditions.
Prevention and early detection Health promotion activities are one of the most important responsibilities led by the World Health Organization which focus on the prevention of illnesses such as cancer and heart disease through the reduction of risk factors that include smoking, unhealthy food, sedentary life and environmental pollution. Therefore, improving lifestyle is the ideal solution to avoid ailments and complications. We, as Primary Health Care Corporation, a part of the health system, and the main provider of primary health care services in Qatar should focus first on preventing diseases and health promotion.
Expansion of smoking cessation services Health promotion activities are one of the most important responsibilities led by the World Health Organization which focus on the prevention of illnesses such as cancer and heart disease through the reduction of risk factors that include smoking, unhealthy food, sedentary life and environmental pollution. Therefore, improving lifestyle is the ideal solution to avoid ailments and complications. We, as Primary Health Care Corporation, a part of the health system, and the main provider of primary health care services in Qatar should focus first on preventing diseases and health promotion.
Mental Health Screening Mental health issues encountered in primary care in Qatar are relatively common. One in five people will be affected by a mental illness at any given point in time. Additionally, three of the top five causes of disability in Qatar are related to mental health issues (Qatar National Mental Health Strategy, 2013). Unmet treatment need is a global challenge, many people with mental disorders around the world are still not receiving the treatment they need.
The main reasons for this are:• continuing stigma and lack of understanding; • treatment generally being offered in hospitals rather than in community settings as well • a lack of mental health trained staff; • inadequate physical facilities; and • a lack of financial investment. The National Primary Health Care Strategy (2013) explicitly states that primary health care in Qatar will play a stronger role in tackling mental disorders and will form the foundation of the mental health service delivery system. A new mental health service, whereby physicians identify, assess and manage mild to moderate mental health problems within PHCC has been piloted in Abu Bakr Siddiq; Umm Slal and West Bay Health Centers and will be rolled out across remaining Health Centers by 2016. To facilitate this PHCC rolled out mental health foundation training to all physicians last year and 61 physicians attended Advanced Mental Health Training. Chapter 5. Our Achievements 17
Autism Spectrum Disorder (ASD) Screening at Well-Baby Clinics Autism Spectrum Disorder (ASD) is a general term for a group of complex disorders of brain development that affects social interaction and verbal and non-verbal communication skills. It is very important that autism spectrum disorder is diagnosed early in children. Studies show that the early intensive behavioural intervention improves learning, communication and social skills in young children with autism spectrum disorders. To facilitate early diagnosis of ASD, currently, all children are screened at the 18 months well-baby clinic visit. ASD screening involves the completion of a questionnaire by the well-baby clinic physician through interview with the child’s parent or guardian. The parent or guardian is asked a number of questions related to the behaviour of the child in order to identify any indication that the child may have ASD. When ASD is suspected, the child is referred to the Child Rehabilitation Clinic at the Child Development Center in Rumailah Hospital for further assessment, diagnosis and treatment, if necessary. To further improve early diagnosis, PHCC has introduced an additional well-baby clinic appointment at 30 months where ASD screening will be repeated for the child. This additional visit has been piloted in 3 health centers (West Bay, Madinat Khalifa and Abu Nakhla) and after this will be rolled out across all health centers.
Health Promotion and education The promotion of healthy life behaviours is one of the basic principles of the Primary Health Care Corporation and therefore has increased its promotion and education activities over the last year. PHCC participated in a number of activities and events aimed at raising awareness among the community and highlighting the importance of healthy life behaviours including sports and physical exercise as this can lead to prevention or early detection of many diseases especially those such as overweight and obesity, and other associated diseases including high blood pressure, cholesterol and diabetes.
Sport and exercise PHCC has participated (often in collaboration with other organizations) in a number of sporting events such as the National Sports Day and H.H. the Emir 24th International Equestrian Sword Festival by providing biometrics tests, nutrition advices and medical counselling related to the benefits of the physical activity and the importance of sports .
PHCC celebrates the National Day with the Qatari community PHCC has participated (often in collaboration with other organizations) in a number of sporting events such as the National Sports Day and H.H. the Emir 24th International Equestrian Sword Festival by providing biometrics tests, nutrition advices and medical counselling related to the benefits of the physical activity and the importance of sports.
18 Chapter 5. Our Achievements
Doha International Book Fair The Corporation set a booth under the theme ‘Read on Health’, where the Corporation offered health and awareness services and a workshop for mothers and children. During the event, PHCC provided blood pressure and diabetes check-ups and distributed educational brochures among the attendees, distributed ‘Rashid’s Family’ booklets, which explained the methods of prevention and treatment of chronic diseases, and organized colouring workshops that reflect and promote healthy behaviour and lifestyle. In addition, PHCC promoted the concept of reading by linking it with good mental health through several messages in Arabic and English.
Health-promoting schools PHCC is sponsoring health promoting schools initiative because it aims at enhancing students’ health. This is one of the World Health Organization strategies to intensify the capacities at schools, in order to provide a suitable environment and enhance the health among students and employees. This will enable them to take an active role in promoting community’s health. This year, the program included 105 schools and PHCC strives to include many more schools.
Further examples of Community Involvement are provided in Table 1 below:
EVENT
LOCATION
1
Ramadan events (19-20 June 2014)
2
Back to School (Mid Ramadan 2014)
3
Closing ceremony for “ Ramadan, Ajr wa A’afya” initiative (End of Ramadan 2014)
4
Qatar National Day (18-Dec 8-20 Dec 2014)
5
Cultural Entertainment Reading Festival (28 Feb -1 March 214)
6
First Social Participation Exhibition (10-17 Mar 2014)
7
Fifth CGG oral health week (25-31 Mar 2014
8
Honoring participants in awareness initiatives (Jun-2014)
Umm Salal Municipality
9
Career Fair (2-3 Dec 2014)
The community college
10
Career Fair 7-17 Jan 2015
11
Qatar Foundation Health Day (Jan 2015)
Qatar Foundation
12
College of medicine orientation session (Feb 2015)
Qatar University
13
“Healthy nutrition” awareness lectures (Feb 2015)
Umm Salam School
14
HH The Emir International Equestrian Sword Festival (19-26 Feb 2015)
Qatar Racing & Equestrian Club
15
The medical gathering (Mar 2015)
Al Bayan Educational Complex
16
“Oral Health “ awareness lectures (26 Jan- 6 Feb2015)
Hayat Plaza / Izdan Mall
Darb AL Sa’ee Islamic Art museum park
Health Centers
QNCC
8th health camp
Chapter 5. Our Achievements 19
Utilizing the media to provide health education The Corporation set a booth under the theme ‘Read on Health’, where the Corporation offered health and awareness services and a workshop for mothers and children. During the event, PHCC provided blood pressure and diabetes check-ups and distributed educational brochures among the attendees, distributed ‘Rashid’s Family’ booklets, which explained the methods of prevention and treatment of chronic diseases, and organized colouring workshops that reflect and promote healthy behaviour and lifestyle. In addition, PHCC promoted the concept of reading by linking it with good mental health through several messages in Arabic and English.
Distrubution of PHCC’s appearance in the news throughout 2014-2015
Apr-14
Oct-14
May-14
Nov-14
June-14
Dec-14
Jul-14
Jan-14
Aug-14
Feb-14
Sep -14
Mar-14
The same applies to TV and radio interviews. PHCC has presented audio and video interviews with several official bodies, like Qatar Radio Qatar TV, Al Rayyan TV, Oryx Radio, and Holy Quran Radio. The TV interviews were broadcast on the “Medicine and life” Program, Qatar News, Taraheeb program, Al Eid and sport day on Al Rayyan channel, as for Qatar radio the interview was broadcasted in Doha evening program, and in the “kaif Asbaht” program. Al Rayan TV had the largest share from interviews where it had 20 interviews from 45 interviews during 2014-2015. The topics was varied from medicine and sport, and introducing new systems such CIS.
36% Al Watan
25% Al Raya
11% Al Sharq
DIstrubution of PHCC’s appearance in the news throughout 2014-2015
25% Al Arab 20 Chapter 5. Our Achievements
3% Comment
PHCC is expanding its services Enhanced Home Healthcare Service Home health care is considered to be an integral part of patient recovery and skilled multidisciplinary care delivered in the patient’s home which may prevent forestall or limit re-admission to an inpatient setting. This year we have implemented a new model of home health service to ensure more comprehensive cover provided by a dedicated, multi-disciplinary healthcare team. Following the initial pilot phase which showed 100% patient satisfaction feedback the new enhanced service was rolled out and has now been established across all 21 Health Centers. Currently the service is available for Qatari patients and provides wound care; medication administration and review; and supporting patient self-management, however we hope to extend the service further in the coming year.
Enhanced Antenatal care services The updated ante-natal package of care aims to ensure early detection of pregnancy-related complications, provide an opportunity for health promotion and education and appropriately refer cases to a higher level of care, when necessary. For low risk mothers the updated Antenatal Care service will involve a set of 6 structured visits which will each provide opportunities for health education with the Maternal and Child Health counsellor. An improved screening package will also be provided, including HIV screening. Evidence based best practice clinical guidelines have also been developed to support Ante Natal Care teams in providing care to all clients receiving ante-natal services. Finally, the pregnancy notebook has also been updated following feedback received and this will be rolled out across all health centers.
Continuous Improvement of the services we deliver Long Term Conditions PHCC offer ongoing treatment and support to patients with long term conditions such as Asthma, Diabetes, Dyslipidaemia and Hypertension through our NCD (Chronic Non Communicable Diseases) Clinics which are now available in all of our Health Centers. The delivery of care in NCD clinics is based on the evidence based Chronic Care Model and this year we have reviewed a number of our clinical guidelines and provided additional training to our teams on these guidelines to ensure that every patient receives consistent care based on international best practice. We have also implemented a diabetes registry across 15 of our Health Centers (with the registry being rolled into other Health Centers in the coming months), this supports individual disease management for these patients enabling the clinician to track their progress whenever they attend our health facilities or other Healthcare providers such as HMC. Moving forward we will transition to the family medicine model in the near future, whereby patients with NCD’s will not need to go to a separate clinic but will be seen by their own GP of Family Physician.
Triage
As part of Primary Health Care Corporation (PHCC) strategy which aims at improving the health of the community in the State of Qatar, PHCC have launched the Patient Triage System in 11 Health Centers (Madinat Khalifa; Abu Nakhla, Al Gharafa, OBK; Al Daayen, West Bay, Al Sheehaniya, Messaimer, Al Rayyan, Al Wakra and Al Shamal Health Centers and this will be incrementally rolled out to all PHCC health centers by the end of 2015. Under the Triage System, patients who attend the health center without a prior appointment will be assessed by well trained and professional nurses who will ‘sort’ the patients according to clinical need. Those who, based on their assessment, need to be treated by a physician as a priority will be seen first. The remaining patients, with more routine needs, will be allocated an appointment on the same day or at a later date. Patients can book an appointment directly at the Health Center reception or through the Appointment Helpline (107). Those who have booked an appointment will be directed to the required clinic/service without any delay. Chapter 5. Our Achievements 21
Before the introduction of the triage system, there were varied waiting times that could sometimes be excessive. In the old system, priority to see the doctor was on the basis of first come first serve regardless of the urgency of the case. Thanks to the introduction of this service, patients with more urgent and critical needs are given preference ensuring safe and efficient health care to patients. PHCC is committed to improving the experience of patients’ visiting our health centers. In health centers where triage has already been implemented, the majority of patients (91%) are reporting shorter waiting times and are benefiting from the new appointment system that is implemented alongside the Triage System.
Laboratory service improvements The Internalization and centralization of lab tests and expansion of lab service hours at 11 health centers has been introduced to improve patient access and turnaround time for test results. 11 health centers now have also extended blood collection hours from 7-9 to 7-11 this has resulted in reduced patient waiting times and improve patient experience of lab services. Patient satisfaction with lab services over the last year shows that 96% of patients rated the lab service as very good or fairly good. without any delay. Laboratory Statistics measuring Improvements achieved: • • • •
100% of STAT tests done withing 100% of lab tests done 92% of panic results reported 94% of patients waiting less than
Radiology service improvements Extensive work has been undertaken this year which lay the foundations to revolutionise the way PHCC delivers its diagnostic imagery service; to support increasing demand on services and ensure best practice standards are utilised. We have recruited additional radiologists and collaborated with SIDRA to ensure more radiologists are available to review images and provide expert opinion to the family physicians to provide the very best care for our patients; we have initiated the procurement process for a radiology information system (RIS) and picture archiving and communications system (PACS). These systems will result in more robust patient tracking and scheduling, result reporting and image tracking capabilities which will speed up the process for patients but also ensure that there is a streamlined, co-ordinated and safe process in place for patients moving between healthcare providers. We have also supported our Ultrasound technicians as they have undertaken additional practical and theoretical training to enhance their practice.
Clinical Information System – Streamlined and co-ordinated services We have continued implementation of the Clinical Information System (CIS), with 4 Health Centers (Al Daayan; West Bay; Al Gharafa; and OBK) going live on Electronic Health Records in the period between 1st April 2014 and 31st March 2015. The rollout into all Health Centers is anticipated to be complete in 2016. CIS supports the advancements of providing the best medical services worldwide ensuring the patient receives an integrated service. With the participation of Hamad Medical Corporation (HMC) and under the supervision of Supreme Council of Health (SCH), PHCC has begun transferring patients’ healthcare information from paper files to the newly implemented electronic medical record (CIS). CIS allows electronic connectivity between health centers and one personal record across PHCC & HMC allowing the treating physician access to a full medical and medication history and lab/ radiology results within seconds. We have also been installing new sophisticated digital vital signs machines and digital weighing scales which along with our laboratory analysers have been interfaced with CIS, reducing the need for manual data entry. This reduces the likelihood of error and greatly enhances patient safety therefore ensuring that all people in the State of Qatar have access to the most effective and safest medical services.
22 Chapter 5. Our Achievements
National Health Insurance (SEHA) During the year 2014-15 PHCC joined the National Health Insurance Scheme, SEHA, as a provider of services for the SEHA eligible population – Qatari and similar status patients . Five health centers joined the scheme between September 2014 and April 2015, and are now providing SEHA services to patients and important claim submission data to the National Health Insurance Company (NHIC). PHCC continues to be a fully engaged partner, committed to a collaborative relationship with SEHA and NHIC to deliver “social health insurance establishment” in line with the goals of the National Health Strategy. One example of this is the piloting of the Annual Health Check, a service that will be covered by the basic benefits package of SEHA, and which is also an important deliverable in the National Primary Health Care Strategy, and one of the ten “PHCC Pledges” to improve primary health care services. At health center level SEHA will be implemented as part of the clinical information system (Cerner) roll-out, and we look forward to a further nine health centers joining the scheme by the end of 2015. In the future, PHCC will be funded by NHIC and is therefore undertaking a financial costing project of all services. Until then PHCC is still funded through the State budgeting system, but is submitting claims data to NHIC in ‘shadow billing’ format, ensuring that we are gathering important information about how our services will be funded in the future.
Improving access to our services PHCC has achieved significant progress in improving access to its services and operations. This progress is core to the delivery of the wider primary health care strategy implementation. The planned and ongoing renovation of current health centers along with the addition of 20 new health centers is one of the fundamental ways to improve access to our primary care services. This is in addition to the improvement program for health care services across PHCC service portfolio. This includes delivery of better services through enhanced health center governance, more efficient patient time management by introducing triage services and enhanced appointment booking system , better front office services at health centers and a clear focus on customer services through Hayyak Customer Services program.
Appointment systems As at March 2015 the helpline was receiving approximately 15,000 calls per month, approximately 9000 of which were to book, cancel or reschedule appointments. The initial phase supported appointment booking for up to 8 health centers with plans to expand the service to cover all 21 existing PHCC Health Centers as the clinical triage program expands and appointments become the norm. The contact center will expand further during 2016 in line with PHCC’s plans to increase the number of Health Centers via its impressive New Build program. The contact center has plans to increase dramatically and accommodate a shift from the current 5 days to a full 7 day a week, year round service, capable of supporting the whole of Qatar’s population for Primary Health care.
Extended hours of operation PHCC has extended working hours in selected health centers including pharmacy and lab services. This will lead to more flexibility and convenience for the public in reaching our services.
Home care service
We even aimed to take our services to the doors of those who need home- care service, all this to make sure that our services are accessible by as many as possible and enhance our patient’s experience.
Chapter 5. Our Achievements 23
24 Chapter 5. Our Achievements
New Health Care facilities: PHCC recognizes that the current facilities of Primary Care have outgrown and outstretched their capabilities due to the unsurpassed population growth in the country in the last few years. For this reason, in accordance to National Primary Health Care Strategy pledges for services that are provided in a safe and clean environment that meets patients’ expectations and enhances clinical practice; PHCC has developed Corporate Priorities which a number of them is pertinent to physical environment. Twenty (20) new Health Centers are planned to be built at Metropolitan area of Doha (where the most significant increase in population was recorded) and the all over the country including recognition of need in the outskirts of Doha the rapidly growing demand of health services for the community of the State of Qatar. These facilities are planned to be delivered between years -2015 2019.
Chapter 5. Our Achievements 25
Twenty (20) new Health Centers are planned to be built at Metropolitan area of Doha (where the most significant increase in population was recorded) and the all over the country including recognition of need in the outskirts of Doha the rapidly growing demand of health services for the community of the State of Qatar. These facilities are planned to be delivered between years 2015-2019. All new Health Centers are bigger in size than existing ones with a wide range of clinical services in accordance to the vision of the country for enhancement of a healthy and productive society where self-care and awareness become priority is community’s conscience and are designed to cater clinical services in parallel to empowering relations with the community for long-term solutions and life style promotion. This vision is achieved by integrating Wellness features such as pool, gymnasium, ante-natal classes, weight management and other new services in many of them. Primary Care Walk-in-clinics, expanded Diagnostic Imaging Services as well as Family Medicine and Specialized Medical services are also provisioned aligned with PHCC strategy”. The objective of the New Health Centers is to create facilities that are of outstanding architectural merit and will become clinical centers of excellence, supporting patients and their families as well as the clinical staff. PHCC strives for venues that will be Evidence-based, Purpose-built, Patient-centered, Family-oriented, Respectful to Culture, Supportive to clinical practice, safe, reliable and sustainable. Public Works Authority (PWA) is executing these New Projects and six (6) New Health Centers are due for completion and commissioning within year 2015:
Al Karaana
Rawdat Al Khail
Umm Slal
Dental
Mental Health
Laboratory Services
New Facilities Plan and Status PHCC Center
Type
Remarks
2012
2014
2015
Expected Delivery
1
Al Karaana
A
Replacement
Design
Construction
Construction
2015
2
Leghuwairiya
A
Replacement
Design
Construction
Construction
2015
3
Al Thumama
B
New
Design
Construction
Construction
2015
4
Rawdat Al Khail
C
New
Design
Construction
Construction
2015
5
Leabaib
C
New
Design
Construction
Construction
2015
6
Umm Slal
Special
Replacement
Design
Construction
Construction
2015
7
Al Waab
B
New
Design
Design
Construction
2016
8
Al Jamaa
B
New
Design
Design
Construction
2016
9
Al Wajba
C
New
Design
Design
Construction
2016
10
Muaither
C
New
Design
Design
Construction
2016
11
South Wakra
A
New
Planning
Design
Design
2017
12
Al Mashaf
B
New
Planning
Design
Design
2017
13
Umm Al Seneem
B
New
Planning
Design
Design
2017
14
Al Khor
C
Replacement
Planning
Design
Design
2017
15
Madinat Al Shamal
C
Replacement
Planning
Design
Design
2017
26 Chapter 5. Our Achievements
16
Al Sadd
Special
New
planning
Design
Design
2017
17
Al Hilal (Nuaija)
Special
New
planning
planning
DCSC in procurement
2019
18
Bani Hajer (Al Themaid)
Special
New
planning
planning
DCSC in procurement
2019
19
Madinat Khalifa
Special
Replacement
planning
planning
DCSC in procurement
2019
20
Umm Ghuwailina
Special
Replacement
N/A
N/A
Upload in Mowazana
2019
Year PHCC Centers
2013
2014
2015
2016
2017
2018
2019
21
21
24
28
32
32
34
Capital Projects – Facilities Management Capital investment projects relevant to sustainability, safe and sound operation and amelioration of current facilities in terms of safety, applicable standards, codes and statutory regulations have been completed or are on-going: Selected Major Projects 2014 – 2015:
Project
Benefit
1
Installation & Commissioning of Fire Alarm at Twenty One (21) Health Centers.
Enhancement of safety.
2
Refurbishment & Upgrade of Four (4) Health Centers (Mesaimeer, Al Rayyan, Gharaffat Al Rayyan & West Bay): Package 1.
Installation & Commissioning of CCTV system in Thirteen (13) Health Centers.
3
Refurbishment & Upgrade of Four (4) Health Centers including Extension Buildings (Al Muntazah, Umm Ghuwailina, Abu Baker Al Siddiq & Airport): Package 2 (* on –going).
Increase clinical capacity / response to increased demand for services / Patient experience and amelioration.
4
Construction of West Bay Extension Building (* on –going).
Increase clinical capacity / response to increased demand for services.
5
Installation & Commissioning of Generators in Five (5) Health Centers.
Back-up Power sustainability / continuity of care.
6
Installation & Commissioning of CCTV system in Thirteen (13) Health Centers.
Compliance to Qatar Law / MOI (20% coverage). * Note: additional scope required per MOI specifications (80% coverage).
7
Installation & Commissioning of Internal Light fittings in Eight (8) Health Centers.
Reduce risk of fire due to old and outdated light fixtures.
8
Installation & Commissioning of Centralised UPS in Ten (10) Health Centers.
Back-up Power sustainability of critical medical equipment & ICT assets / continuity of care.
9
100% Fresh Air conditioning & ventilating system for dirty Utilities in Fifteen (15) Health Centers.
Accreditation & IPAC requirements.
Chapter 5. Our Achievements 27
10
Construction and Commissioning of Parking shades at Thirteen (13) Health Centers (100% coverage).
Patient comfort and experience.
11
Consultancy Services for Fire Fighting system at Fifteen (15) Health Centers (* on –going).
Improve Safety (suppress fire).
12
Consultancy Services for Life Safety and QCDD Codes Assessment of Compliance and QCDD Certification of Eighteen (18) Health Centers (* on –going).
QCDD Compliance.
13
Multiple Minor Works (required by Accreditation standards, e-cash rooms, triage rooms, additional storage facilities, replacement of ceilings, “air-curtains”, HVAC filters, pharmacy counters for CERNER project etc.) completed.
Response to End-User / Accreditation / IPAC requirements & improve sustainability of facilities.
Since 1st June 2014, Primary Health Care Corporation assumed responsibility on the Facilities Maintenance Management and all below core functions: • Planned Preventive Maintenance • Response and Resolution of Corrective Actions, Urgent and Emergency Calls • Supply, Testing and Commissioning of Spare parts, Materials, Systems, Non-medical equipment and Building Fabric items. • Landscape Maintenance • Computerized Maintenance Management System (CMMS) • Call Center • Potable Water Testing & measures required for water enhancement • Key management • Support Services / Planning & Procurement
BIOMEDICAL ENGINEERING SERVICES Since 1st April 2015 Primary Health Care Corporation assumed responsibility on the Bio-medical Engineering Services. A full-fledged completely functional independent biomedical engineering department has been set up within the Facilities & Engineering Directorate. The department is highly resourced and established with competent staff to cater for: • • • • • • • •
Management of Medical Equipment within PHCC Portfolio Planned Preventive Maintenance of Medical Equipment Response and Resolution of Corrective Actions, Urgent and Emergency Calls Medical Equipment Planning, Budgeting & Procurement Medical Equipment Supply, Installation, Testing & Commissioning Medical Equipment Recalls Medical Equipment Inventory Audit Medical Equipment Training
Within the year 2014 – 2015, old medical equipment in the health centers have been replaced with to date and sophisticated medical equipment to cater to the growing needs of PHCC. One Thousand Two hundred Ninety (1,290) equipment in total have been installed across all Health Centers, (25% of total capacity). This has essentially improved the diagnostic capabilities of clinical staff and has contributed significantly in improving patient waiting times. Biomedical Engineering Department has played a vital role in medical equipment supply pertaining to various programs that have been rolled out by PHCC for Triage, Antenatal & Well Baby Clinic, NCD Clinics, Home Health Care Service and Smoking Cessation Clinics. 28 Chapter 5. Our Achievements
Within year 2015; the department aims to replace additional 40% of all old equipment to maintain the quality and patient safety standards. Special emphasis has been given on procuring equipment that improves the infection control practices and newer diagnostic solutions.
Medical Devices Integration The department has played a noteworthy responsibility in providing medical equipment for the Hospital Information System (HIS) program that has been embarked upon by providing equipment which adheres to Healthcare Insurance, Portability & Accountability Act (HIPAA) & Medical Device Integration act (MDI).
Medical Device Training for Clinical Staff Biomedical Engineering has actively boosted the confidence in Clinical staff in health centers by engaging them in Medical Devices training to ensure a faster productive time and improve capability. This has been done with competency assessments by highly specialized and trained equipment specific Applications Specialist from Original Equipment Manufacturers.
Medical Equipment Maintenance A total of 5,514 pieces of equipment within different health centers are under the maintenance by highly competent staff. The department is proud to have advanced test and measuring instruments for calibration and safety analysis to ensure that the equipment adhere to international patient safety standards. Additionally, 24 x 7 hrs. uninterrupted support is provided to ensure that the clinical workflow continues, with minimum response time for attending breakdown calls.
Health Center Wise Equipment Installation Chart 105 83
59
Wakra
31 Ummgwalina
Sheehaniya
Rayyan
OBK
22 Shamal
12 Kaaban
14
MK
35
Jumailiya
Gharaffa
Al Khor
Airport
Abu Nakhla
ABS
Daayen
41 36
60
54
Muntaza
50
75
25
4
Ummsalal
60 M e sa i m e e r
56
71
West Bay
76
Ummbab
4
6 Ghuwairiya
Karaana
Computerized Maintenance Management System A Computerized Maintenance Management System, Oracle EAM (Enterprise Asset Management) has been implemented to focus on achieving and maintaining the department’s Key performance Indicators (KPI). The system identifies tracks and monitors the Planned Preventive Maintenance and Corrective Maintenance within every health center.
Future Prospects In the long road ahead, we aim to standardize all the medical equipment within all the health centers ensuring maximum efficiency within clinical settings and patient satisfaction along with setting high standards of Quality & Infection Control practices
Chapter 5. Our Achievements 29
Public Health Matters PHCC has developed a stronger public health surveillance program to raise awareness and ensure appropriate arrangements are in place to manage public diseases, such as Ebola and MERS_COV. Improve access to patients by extending CDC and Travel Clinics to 17 health centers across Qatar.
Immunization and vaccine campaign Primary Health Care Corporation’s (PHCC) aim is to contribute to the prevention of common communicable diseases. Immunizations and vaccines protect the community from serious diseases and prevent the spread of those diseases to others. The risk of contagious and infectious diseases that can spread through personal contact is increased when an individual is in close proximity with large masses of people. This year PHCC continued its Vaccination Campaign against meningitis, pneumonia and seasonal influenza between May 25th and the beginning of October.
PHCC and MERS-CoV Campaign Primary Health Care Corporation (PHCC), in cooperation with the Supreme Council of Health (SCH), joined MERS-CoV campaign to raise awareness about this large family of viruses that may cause a range of illnesses in humans and animals from the common cold to acute respiratory infection. Middle East Respiratory Syndrome (MERS) is a viral respiratory disease caused by a novel coronavirus (MERSCoV) that was first identified in Saudi Arabia in 2012. This campaign aimed to raise awareness amongst the community about preventive measures in their day to day life.
Emergency Preparedness Primary Health Care Corporation (PHCC) Health Services are an essential part of planning and responding to emergency arrangements within Qatar ensure a consistent and integrated approach from responding agencies, whatever the emergency. The PHCC Emergency Plan has been developed to provide guidance to organizational personnel in addressing the specific needs and demands arising from a disaster and forms the foundation of the integrated corporate response of PHCC, along with allied organizations to ensure an immediate, effective and optimal response to major emergencies. 30 Chapter 5. Our Achievements
In 2014-2015 PHCC completed a number of Internal Emergency drills in line with the rollout of the Emergency Plan and also participated in a planned National emergency exercise on Feb 18th 2015. This was the first time that PHCC participated in a National exercise with so many other stakeholders and we were very proud of the successful outcome and the feedback from the other stakeholders involved. All or part of the PHCC Disaster and Emergency Plan may be implemented at any time, and during any phase of an emergency, to provide primary medical care to the victims of major catastrophic incidents that may occur in the State of Qatar. The drill involved many emergency response organizations in Qatar such as Qatar Airways,Hamad Medical Corporation, Qatar Civil Aviation Authority, Ministry of Interior (MOI), Qatar Emiri Air Force, Qatar Armed Forces, the State of Qatar Police, Civil Defense, the Supreme Council of Health, National Command Center, Ministry of Defense, Air Customs and other support services and organizations. Patients requiring secondary care treatment were sent to HMC and others to the PHCC Airport Health Center. The objectives of the exercise included assessing the adequacy of plans and facilities during a major incident at the airport, including the communications, partner response, management of the site, casualty registration and transportation logistics. Other emergency preparedness drills completed in 2015 included a Pandemic Drill at Al Sheehaniya Health Center and a Head Quarters Corporate drill for the Corporation.
Chapter 5. Our Achievements 31
06
Our Workforce
Our Staff Possibly the most critical factor in a providing a high quality primary healthcare service is having a motivated, appropriately skilled and experienced team, that work collaboratively with the ultimate goal of improving health outcomes for the patient and PHCC recognize the importance of this. Broadly speaking we can divide this into three categories- recruiting new and different staff; training and developing existing staff; and promoting the Health and Safety of all our staff.
32 Chapter 6. Our Workforce
Recruitment During 2014-2015 we continued the intense program of recruitment that we started in 2013 ensuring the recruitment of the most appropriate candidates. We have recruited most of the key roles, many of which are for providing the clinical services including specialist doctors from a varied range of backgrounds, ensuring that our patients receive the best possible care available. We are proud and pleased to have successfully recruited staff that are committed and passionate in delivering health care services to the patient population of Qatar. Building upon this success, we are in the process of designing a Workforce Planning Model for PHCC and developing a Medium Term Workforce Plan. This will integrate Workforce Planning into Service specification development and Manpower Budgeting. Further, this will also ensure that we continue to recruit to meet the needs of an evolving model of Primary Care services and is linked to the National Workforce Plan of the State of Qatar.
PHCC Workforce
PHCC STAFF AS OF 31 MARCH 2015
1
Number of Physicians
483
2
Number of Dentists
115
3
Number of Nurses & Dental Assistants
1279
4
Number of Pharmacists & Assistant Pharmacists
290
5
Number of Allied Health Professionals
339
6
Number of Non-Clinical
2033
7
Number of Workforce
4532
Total
Workforce Learning and Development We are committed to further strengthening the workforce of PHCC and understand the value of continuous learning and development of our workforce. The PHCC workforce development plan focuses on how the existing workforce can deliver work in new ways, provide more services and develop new skills.
Patient pledge 6 PHCC will provide high quality services that the people of Qatar can trust through the ongoing development of competent teams of health professionals
A dedicated workforce training and development team is in place to support the organization in identifying training needs and establishing high quality training and development opportunities. The focus of PHCC Workforce Training Department is to deliver ‘Excellence in Workforce’. By improving knowledge, skills, competence and embedding a learning culture; PHCC will ultimately enhance patient experience through development of emerging services and new roles to provide high quality primary health care. The development approach has been to triangulate learning requirements with the strategic direction, professional standards, service and organizational priorities. This is to ensure a comprehensive assessment for training needs across the organization.
There have been significant achievements over the past year, supporting the National Primary Health Care Strategy (2013-2018) and national priorities for the State of Qatar. In summary, these include: • PHCC International Training Center accreditation from American Heart Association (AHA) for resuscitation courses. • Accreditation of CPD as an approved provider by Qatar Council for Healthcare Practitioners (QCHP) – Supreme Council of Health • Strategy Implementation training preparation for all 8 emerging service models • Development of e-learning strategy and implementation plans, including access to the best practice international health care resources • Approved development plans for Management and Leadership programs for PHCC senior leaders • Strengthening academic partnership with national and international educational establishments • Ensuring that PHCC meets the Annual Practicing License for health care professionals • The Pediatric Competencies of our Physicians and Nurses have been assessed and we have developed curriculum based training modules (6 modules) and delivered training in collaboration with SickKids and St Michael Hospital Canada. Chapter 6. Our Workforce
33
Summary of Training Delivered – 1st April 2014 to 31st March 2015 No. of Trainings / Conferences
Clinical Trainings
No. of Attendees
1
Resuscitation Trainings
70
1480
2
Job Specific Orientation
11
307
3
CME for Physicians
12
1079
4
CME for Dentists
3
147
5
CPD for Pharmacists
22
2162
6
CNE for Nurses
15
870
7
CPD Inter professional - Evening
41
2889
8
Strategy Implementation Training
65
2315
9
International Sponsored
Scientific
Conferences
-
PHCC
74
116
10
International Scientific Company Sponsored
Conferences
-
Drug
22
133
11
Official Mission (training or Conferences nominated MD)
19
68
12
E-Learning (BMJ)
1068
1975
13
Clinical Trainings - Miscellaneous
25
780
Non-Clinical Trainings
No. of Trainings / Conferences
No. of Attendees
1
Fire Safety & Environmental Safety
9
2344
2
Corporate Orientation
12
439
3
Customized Training (Bespoke training specific vendors for specific groups)
with
9
152
4
External Training – Reward ( Compliment for 2 – 3 Qatari Staffs from each directorate for their outstanding performance during 2014)
18
24
5
Career Plan with Ministry of Administrative Development
44
254
6
Official Mission (training or Conferences nominated MD)
15
35
7
Non Clinical Training - Miscellaneous
61
789
e-Learning BMJ Learning & Best Practice ICT e-Learning Pilot Project (6 Months)
34 Chapter 6. Our Workforce
No. of Courses/ Modules Completed
No. of Users
2537
454
120
32
Arab Board Graduation As a result of both residency programs, PHCC has: a)Three Community Medicine graduated (Qataris ) passed the Arab Board specialization exam in 2014 and other 2 Qataris passed the first part. b)Ten (10) Family Medicine Residents successfully passed the Arab Board Specialization exam. All of them are now on board at different health centers across PHCC.
ACGM-i Accreditation
The PHCC Family Medicine Residency program achieved ACGMEI in 2014.
Licensing and Revalidation In addition to these activities our Clinical Licensing team have been working with our clinical staff to ensure they all can obtain the Annual Practicing License for Clinical Staff from Qatar Council for Health Practitioner of Supreme Council of Health, Qatar. Having all Clinical staff go through the process provides assurance that all PHCC clinical staff are competent and appropriately qualified and a set of clinical competencies are being developed. The table opposite shows the current status of Clinical Licenses, remaining clinical staff are under the evaluation or licensing stage.
48% 60%
of Nurse Staff’s Licensed
68%
of Dental assistant’s Licensed
72%
of Dentist’s Licensed
of Radiology Staff’s Licensed
61%
1st April 2014 to 31st March 2015
of physicians Licensed
of Pharmacy Staff Licensed
60%
73%
of Laboratory Staff’s Licensed
Revalidation is the process by which all licensed doctors are required to demonstrate on a regular basis that they are up to date and fit to practice in their chosen field and able to provide a good level of care. PHCC Consultants and Senior Consultants participated in the revalidation project this year which was undertaken in partnership with Medical Validation Ireland. Each Consultants qualifications, training and experience were benchmarked against the international standards of the Irish Training Bodies (Irish College of General Practitioners, College of Psychiatrists, Royal College of Physicians of Ireland and the Royal College of Surgeons in Ireland). Consultants were scored in 6 categories: Qualifications and Training, Portfolio of Experience and Quality Improvement, Teaching and Training, Research and Enquiry, CME/CPD and Professional Attributes, assessors within the relevant specialty and training body in Ireland carried out inde-pendent assessments of assigned submissions. The results of these assessments were moderated by a training body clinical lead. The results exceeded the expectations since Consultants achieved the top category distinction. The revalidation process confirms that PHCC Consultants are qualified worldwide and experienced to practice in their speciality area meeting the highest international standards.
Chapter 6. Our Workforce
35
Healthy and Safe workforce Safety is a top priority for us at Primary Health Care Corporation. We strive to bring everyone, staff and patients, to work together to ensure safety for all. We recognise the importance of the wellbeing of our staff as well as our patients and have a dedicated team to ensure that Organizational Health & Safety standards are implemented and maintained in accordance with our policies. This year we have launched a number of key initiatives including: • Providing all dental staff with radiation measuring devices (TLDs) to ensure that they don’t get over exposed to harmful radiation (near conclusion); • And routinely carry out radiation levels assessments in all radiology areas; • Prevention of needlestick injuries project • Participation in the effort led by SCH to manage medical waste from all healthcare providers in the state of Qatar.
What our workforce say We also regularly check how we are doing with our workforce. Our latest staff survey was conducted from 10th till 27th November. The survey measured 37 traits of staff satisfaction under 12 sections. Whilst we still have some work to do overall our workforce are satisfied.
Satisfac t i o n Rat e :
3.6 / 5
12 areas of staff satisfaction Leadership
Management
Employee Satisfaction
Supervisory Issues
Qualtiy of Work
Responsibility
Job Security
Safety
Training Opportunities
Recognition
General Attitudes Salary & Benefits 36 Chapter 6. Our Workforce
07
How PHCC run its business: corporate governance and committee structure
The Senior Management Executive Team is accountable for Internal Control. The managing Director has ultimate responsibility for maintaining a sound system of internal control that supports the achievement of the organizations policies aims and objectives. The Managing Director is responsible for safeguarding the public funds and the organizations assets. The Executive team is collectively responsible for maintaining the systems of internal control and Executive Directors are accountable for ensuring effective governance arrangements in their individual areas of responsibility. The Executive Team is also responsible for leadership and setting the strategic direction of PHCC, and for monitoring the organization’s performance.
Committee Structure We undertook a wholesale review of our Committee Structure in 2013/14 and have spent 2014/15 embedding the new structure. We have kept the new structure under constant review so that we can ensure that it is optimal. As a result of this review the Strategy Implementation Group (SIG) has been formed as part of new measures to strengthen current PHCC Strategic Program Management arrangements and delivery of the National Primary Health Care Strategy. The group is responsible for oversight and management of the strategy, and this involves review of a number of different work stream deliverables. The SIG will report to the overarching Strategy Program Management Board (SPMB), which has also been configured to provide overall steerage, leadership and top level decision making for the program.
Strategy Program Management Board (SPMB)
SMEC
Workforce & HR
GTC & MTC
Finance Committee
Operation Committee
Research Committee
HIM Committee
Quality & Safety
Health Center Improvement
Estates & Facilities
Emergency Planning
SIG
Ethics Committee
Clinical Affairs Committee
Chapter 7. How Phcc Run its Business: Corporate Governance and Committee Structure 37
The Quality and Safety Committee The Quality and Safety Committee is part of PHCC’s governance framework with data and communication flows from the health centres to senior management. The committee monitors and manages risks, retrospective and prospective, within the scope of clinical risks, patient safety risks and patient experience risks and promote and support quality improvement activities. Significant risks reported to or identified by the Committee will be reviewed to consider the implementation of additional controls and quality improvements. Where these additional controls and quality improvements cannot be implemented in a timely manner the matter will be referred to SMEC for consideration of the resources or capital spend implications.
The Workforce and Human Resources Committee Workforce and Human Resource Committee (WHRC) oversees and supports the development, implementation and delivery of the PHCC strategies for workforce design, delivery, direction and development. It monitors, evaluates and makes recommendations to the SMEC related to the PHCC workforce strategies in line with PHCC Strategy, operational objectives and service development plans thereby developing and improving the human relation approach design to give emphasis to all employees related issues.
GTC & MTC The general tender committee (GTC) is responsible for reviewing and approving all types of Purchases over than QR 500,000 with the objective of ensuring that the total proceedings are in accordance with the rules prescribed in the law and therefore ensuring that purchases are obtained from those that have submitted the best bid. The minor tender committee (MTC) reviews and approves all types of purchases over than QR 50,000 and less than QR 500,000.
Operation Committee The key duties are to ensure that Operations Directorates takes action in response to PHCC controls assurance and risk assessments. Specifically, to review on a bi-monthly basis the delivery of patients services to a standard that meets all statutory duties; national and local standards, targets and to other obligations, and agree actions and responsibilities to address areas requiring improvement.
HIM Committee The role of the HIM Steering Committee is to set directions and an execution strategy for Health Information Management in PHCC. The Steering Committee is to take responsibility for introduction, management, monitoring, and the achievement of desired outcomes in relation to health information management across all PHCC facilities. Health Center Improvement Steering Group The Health Center Improvement Program began in January 2013, this program has includes all initiatives which involve changes to or introduction of new health Center provided services, excluding those which are covered by the Strategy Implementation Program. The Health Center Improvement Program focuses on a continuous cycle of improvement of existing health Center based services. Each project in the program looks at the following eight criteria: • • • • • • • •
Patient and System Flow Staffing and efficiency Resources Access Patient Experience Staff Experience Quality Evaluation and Sustainability
The Health Center Improvement Steering Group has been formed to provide management oversight to this work program.
38 Chapter 7. How Phcc Run its Business: Corporate Governance and Committee Structure
Ethics Committee The Ethics Framework seeks to address issues relating to Organizational Ethics, Business Ethics, Research Ethics and Clinical and Bio-Ethics. Introducing standards related to corporate ethics as a companion to the PHCC “Patient Bill of Rights and Responsibilities”1 will ensure that both PHCC clients (patients and their families) and its own employees are supported and protected by this framework when they are dealing with complex issues such as patient consent and confidentiality; and when staff are using organizational assets and complying with rules and regulations.
Finance Committee The FSC sets appropriate frameworks policies and procedures to support delivery of the organizational objectives from Finance perspective. Using the frameworks in place the FSC establishes, continually monitor and review the financial performance of the Corporation and advise corrective measures where necessary.
Research Committee PHCC’s goal is to be a leader in primary care research in Qatar and the GCC Region, producing high quality research outputs and providing useful clinical, epidemiological, operational and health systems data to guide national health policies and interventions. To achieve this goal, PHCC has established its research governance structures and developed a 5-year Research Strategy and Plans which set out our research priorities based on evidence from a needs assessment. To facilitate research and ensure good governance, the Research Committee (RC) was established. The purpose of the RC is to provide strategic leadership and technical direction for research strategy and the conduct of research within PHCC to support the Corporation’s over all vision; and to protect the rights and welfare of human subjects participating in biomedical research conducted at the PHCC’s areas of responsibility. The RC is responsible for the oversight of any research to assure that it meets the ethical principles established for human subjects’ research, and that it complies with Qatari and international law and regulations that pertain to human subject’s protection and any other pertinent regulations and guidance. The RC acts as part of an efficient, accountable and independent Research Service within the PHCC to protect the dignity, rights, safety and well-being of people who take part in research. Our staff are our greatest asset for reaching the goal of research scholarship and leadership. To support them, our RC also reviews and commissions good quality research and the Research Section has embarked upon a staff research training and capacity building program targeting 100 trained staff per annum with an emphasis on Good and Ethical Research Practice. Our staff are also engaged in a number of high quality externally funded collaborative research with our Academic Health System (AHS) partners, the results of which will help us improve the quality of patient care services and our health policies.
PHCC Guideline Review Committee (PGRC) The PHCC Guideline Review Committee (PGRC) is a multidisciplinary team of healthcare professionals from across Primary care, established to ensure that the PHCC clinical guidelines are of a high quality and are developed through a transparent, evidence-based decision-making process and the guideline development team has followed the procedures and policy for the development and adaption of best clinical practice guideline for local use within PHCC. The remit of this Committee to undertake comprehensive review of draft guidelines based on current available best practices and PHCC preferences and ratify and endorse for approval from executive director clinical affairs. 26 Clinical Practice Guideline have been ratified and approved so far. Estates & Facilities The committee is established as the necessary interface and coordination forum among relevant departments in regards to capital projects and corporate plans. The committee will streamline corporate projects, coordinate actions among involved departments for capital investments, identify risks, mitigate delays and effectively report to SMEC.
Emergency Planning This committee is established to oversee the development, maintenance and evaluation of the Primary Health Care Corporation (PHCC) Emergency and Disaster Management Plan that will be underpinned by policy and protocols, planning, performance targets and strategies that are necessary for responding effectively and timely to emergency events that pose an immediate danger to the health and safety of staff, patients, visitors, the community and the environment. Chapter 7. How Phcc Run its Business: Corporate Governance and Committee Structure 39
Clinical Affairs Committee As the main clinical committee of PHCC, this committee focuses on: 1) Ensuring effective clinical practice through: • A motivated clinical workforce • A competent clinical workforce • Evidence-Based care • Standardized care • Coordinated care 2) Ensuring that adequate and appropriate clinical governance structures, processes and controls are in place to: • promote safety and excellence in patient care; • identify, prioritize and manage risk arising from clinical care on a continuing basis; • ensure the effective and efficient use of resources through evidence-based clinical practice; • protect the Health & Safety of employees 3) Promote and deliver improvement in the quality of services for the population of Qatar ensuring clientcantered; Safe and reliable services and supporting and developing practitioners 4) Provide a strategic and advisory role on medicines management issues, along with development of polices and guidelines.
Key governance systems Corporate governance In support of PHCC meeting its objectives, the Corporate Governance function has developed processes and policies to support the transparency in decision making process including: a Corporate Governance Handbook and Code of Conduct, Gifts and Hospitality policy, Conflict of Interest Policy. The focus of the function is to ensure there are internal controls and mechanisms in place providing assurance on the delivery of PHCC’s corporate goals and objectives, facilitating and coordinating the information flow into the Senior Management team on each system that forms part of the governance framework and supporting the Senior management team in executing their governance role.
y t alit Qu emen g a n Ma
Environmental Management
Lea
der
Governance Framework
shi
p
Client Service Management
Community Engagement
Financial Management Workforce Management
Internal Control The Internal Audit function also provides consultancy services to the organization. It carries out various activities to determine whether the Corporation’s controls and governance processes are adequate and functioning in a manner to ensure that risks are appropriately identified and managed to an acceptable level, significant financial and operating information is accurate, reliable, and timely, policies, procedures, standards and applicable laws are complied with, resources are used efficiently and protected, objectives are achieved. 40 Chapter 7. How Phcc Run its Business: Corporate Governance and Committee Structure
08
Financial Results & Financial Governance
PHCC’s finance function has been stabilized recently after and moving forward two state-of-art software’s are being implemented in order to enhance and automate the processes and apply the best practices. Currently, PHCC adopted the cash basis of accounting method in compliance with Ministry of Finance guidelines; however, Accrual Basis of Accounting method will also be maintained in addition to cash basis from April 2015 onwards after the rollout of ERP system for efficient and effective decision making and reporting functions.
Chapter 8. Financial results 41
For the next two years we expect the organization’s budget requirements to continue to be funded by government, but starting from the year 2017 (tentatively) this mechanism may be changed as a result of the health insurance scheme implementation. Health Insurance mechanism may be challenging from a cash flow perspective considering the complexity for reimbursing insurance claims, but in time with familiarity about the system and the increase in efficiency of the operations staff, the organization will have an excellent opportunity to utilize its funds in a more effective way.
PHCC Net Expenditure For the Year 2014-15 Notes
FY 14-15 (Apr-Mar)
FY 13-14 (Apr-Mar)
Variation %
Staff Cost
1.1
1,121
764
47%
Drugs & Supplies
1.2
198
178
11%
Rent of Housing and Facilities
1.3
89
70
27%
General and Administrative
1.4
236
152
56%
1,644
1,644
41%
91
46
98%
Operating Expenses
Net Operating Expenses Capital Expenditures
1200
2.1
1,121
1000 800 764 600
FY 14-15
523
FY 13-14 400
400 200
91 Manpower
Opex
46
Capex
Staff Cost Staff Cost has been increased in 2014-15 around 47% as compared to 2013-14 due to the following reasons: (a) Introducing additional services across PHCC facilities. (b) Introduction of extended working hours/days in some health Centers. (C) New manpower required to operate the new Health Center.
Drugs & Supplies Drugs & Supplies has been increased in 2014-15 around 11% as compared to 2013-14. The reasons of this increment are hereunder. (a) Number of patients has been increased due to Increase in population of Qatar. (b) Prices of Medicines & Drugs have been increased due to purchase of latest researched medicines & drugs products and also due the impact of global inflation. 42 Chapter 8. Financial results
Rent of Housing & Facilities Rent of staff housing accommodations have been increased significantly in 2014-15 around 27% as compared to 2013-14 due to high number of skilled medical & non-medical expats who have been hired and provided with PHCC accommodation facilities.
Capital Expenditure Overall capital expenditure has been increased by 100% in 2014-15 as compared to 2013-14 due to the following reasons.
IT System & Infrastructure PHCC is implementing the sophisticated ERP system (Oracle) for Finance, HR, Procurement & Supply Chain Management etc., Hyperion for planning & budgeting and also the CIS (Clinical Information system) in order to equip its functions more competitive in modern era of hitech environment.
Furniture & Fixture For new PHCC Head Quarter, furniture & fixture cost has been incurred on higher side as compared to the previous year.
As per the latest strategy PHCC invest in hi-tech sophisticated medical equipment’s to be compatible with CIS requirements & for better treatment of patients in effective & efficient manner.
Medical Equipment
Potential Risks
There are potential risks that may have a financial impact on PHCC but cannot be quantified at the moment. They are as follows: • Changes in funding – PHCC is currently a fully funded government entity. Budgets are fully funded by the government. In the future (year 2017) onwards, there are initiatives that may change this process wherein government funding may be limited and major source of funding would be Health Insurance. • Private Health Care Operators – within the framework of the Health Insurance system, private health care service provider will be allowed to operate and will compete directly with PHCC.
Potential Opportunities & Challenges With these risks there are also opportunities. The possible changes in the budget funding scenario and the possibility of having direct competition in providing health care services, may provide the opportunity to focus on efficiency and cost savings to make the organization more effective in meeting its objectives and also feedback of patient satisfaction level will be very helpful to evaluate the performance and competency of PHCC services. Since, reliable, accurate and timely information is being the key factor in every business success, and as it’s based on the effectiveness of system in place of the organization, PHCC is focusing on the development of efficient Management Information System Strategy to mitigate the potential relevant risks which includes the implementation of Oracle ERP, My care System for billing, Hyperion for financial planning and other related enhancement in SOPs (Standard Operating Procedures) as well. After Successful implementation of MIS (Management Information System) , PHCC will be able to manage the benchmark exercises within the region and rest of world medical services providers for standardization of services within the framework of international practices and also able to develop strategy for cost reduction programs, which will ultimately make service more competitive and induces potential customers and Investors.
Chapter 8. Financial results 43
Gharrafat Al Rayyan
Northern Umm Salal Al Daayen
Al Ghuwairya Al Kaaban West Bay
Health Centers Central Airport
Al Wakra
Western
Al Karaana
Madinat Khalifa
Al Shamal
Al Khor
PHCC/ GTC/30/2014
PHCC Head Quarers
Al Jumailiya
Construction, Testing & Commissioning of Extension Building of West Bay Health Center
PHCC/ GTC/29/2014
Abu Nakhla
6 Construction, Testing & Commissioning of PHCC HQ’s Interior - Fit out, Furniture, Fitting and Equipment and Signage
SCH/GTC/ PHCC/74/2012
Mesaimeer
7
Renovation and Extension Buildings in Four (4) Health Centers (Package 2)
PHCC/ GTC/09/2014
Al Sheehaniya
8
Testing, and Commissioning of Parking Shades for Eleven (11) Health Centers
PHCC/ GTC/24/2014
Al Rayyan
9
Improvement of Plant Rooms in Fifteen (15) Health Centers including Supply, Installation and Commissioning of additional Water and Diesel Storage Tanks in five(5) Health Centers; Supply, Installation , Testing & Commissioning of Standby Storage tank for Generator Fuel in Five Health Centers including Civil Works for enclosure and safety; Providing Additional Domestic water storage tanks at 5 HCs.
PHCC/ GTC/21/2014
Abu Baker Siddiq
10
Consultancy Services for the AS-BUILT drawings preparation, Life Safety and QCDD Codes Assessment of Compliance and QCDD Certification for Eighteen (18) Health Centers
PHCC/ GTC/21/2014
Umm Ghuwailina
PHCC/ GTC/11/2013
11
Rehabilitation and Maintenance of Landscaping for Sixteen (16) Primary Health Care Centers for Three Years
ENG/ZAK 102012144/2013
Omar Bin Khattab
Design, Supply, Upgrade, Installation, Networking, Testing and Commissioning of Fire Alarm System for (21) PHCC’s SCH/GTC/ PHCC/50/2013
12
Potable Water Storage and distribution System Bacteriological and Chemical Testing Services (Existing 21 Health Centers)
SCH/GTC/ PHCC/33/2013
Al Muntaza
1 Modification and Upgrade of Four (4) PHCC Health Centers (Package 1) PHCC/ GTC/25/2013
Reference
2 Supply, Installation and Commissioning of Generators in (5) Five Health Centers: Mesaimeer, Abu Nakhla, Abu Baker Siddiq, Al Shahaniya and Al Jumailiya PHCC/ GTC/7/2013
S.no 3
Supply, Installation Testing and Commissioning and Training of Security CCTV System at Thirteen (13) PHCC Health Centers, With Maintenance and Warranty for Three (3) Years PHCC/ GTC/10/2014
Projects
4
Consultancy Services & Supervision until Handover to Client for Fire Fighting System in Fifteen (15) Health Centers (Design).
Completed Major Capital Investment Projects
5
13
Maintenance Contract for Civil, MEP and HVAC System for Eighteen (18) Existing Health Centers
On Going Major Capital Investment Projects
14
MAJOR CAPITAL INVESTMENT PROJECTS (Summary & Timeline) S.No
S.No
Completion Summary
In progress (Summary
1
Construction, Testing & Commissioning of Extension Building of West Bay Health Center
2
Construction, Testing & Commissioning of PHCC HQ’s Interior Fit out, Furniture, Fitting and Equipment and Signage
3
Construction, Testing, and Commissioning of Pedestrian Bridge at the PHCC HQ’s.
4
Renovation and Extension Buildings in Four (4) Health Centers (Package 2).
5
Design, Acquisition of Approvals and Construction of Fit-Out Works at Barwa Tower 2 within PHCC Occupancy.
6
Construction, Testing, and Commissioning of Parking Shades for Eleven (11) Health Centers.
1
Design, Supply, Upgrade, Installation, Networking, Testing and Commissioning of Fire Alarm System for (21) Health Centers.
2
Modification and Upgrade of four (4) PHCC Health Centers (Package 1).
3
Supply, Installation and Commissioning of Generators in (5) Five Health Centers.
4
Supply, Installation Testing and Commissioning and Training of Security CCTV System at Thirteen (13) PHCC Health Centers, With Maintenance and Warranty for Three (3) Years.
5
Installation, Test and Commissioning of all internal Light Fittings in Eight (8) Health centers.
6
Supply, Installation, Testing and Commissioning of Centralized UPS in Ten (10) Health Centers.
7
Construction of E-Cash at Eight (8) Health Centers.
8
Supply, Installation and Commissioning of Lift/Elevator for West Bay HC.
9
Supply and Installation of Porta Cabin (3x4) to be utilized as stores in selected HCs.
10
Supply, Installation, Testing and Commissioning of Light Fittings for the Roof and External Area in all the Health Centers.
11
Supply and Installation of Wall and Corner Guard.
12
Modification/ Replacement of Exterior Ceiling including exterior lighting Fixtures.
13
100% Fresh Air conditioning & Ventilating system for Dirty Utilities, including Air balancing and commissioning for 15 HCs.
14
Providing/ Replacing damaged Air Curtain to all Entrance & EXIT doors at HCs and interlocking the system with sliding doors.
60%
15
Provision for adding Bag Filters to existing HVAC units to assure indoor Air Quality.
40%
16
Supply of Oil Spill Kit for Fuel tank in Generator room for all the Health Centers, Maintenance Technicians Uniforms, PPE and Tools.
Improvement of Plant Rooms in Fifteen (15) Health Centers including Supply, Installation and Commissioning of additional Water and Diesel Storage Tanks in five(5) Health Centers; Supply, 7 Installation , Testing & Commissioning of Standby Storage tank for Generator Fuel in Five Health Centers including Civil Works for enclosure and safety; Providing Additional Domestic water storage tanks at 5 HCs. Design and Built Contract for Supply, Installation, Testing & 8 Commissioning of Normal and UPS Power outlets at Sixteen (16) PHCC Health Centers for Cerner Support. Renovation of Fourteen PHCC Guard-House accommodation, 9 One(1) Staff accommodation and Design, Supply, Installation and Commissioning of One (1) Pre-Fabricated Guard-House Accommodation. Addition of UV sterilizer system to Centralized Water Filtration for 8 HCs. 10 System SIC/ Replacement of Centralized water filtration system (1 working + 1 Standby) with UV sterilizer system. 70% 50%
60%Completed CAPEX Projects initiated within F.Y. 2014 - 2015
30% 20% 10%
S.No
Ongoing Major selected projects
40% In progress CAPEX Projects initiated within F.Y. 2014 - 2015
Reference
Timeline
1
Construction, Testing & Commissioning of Extension Building of West Bay Health Center
PHCC/GTC/30/2014
06-Jan-15 / 05-Sep-15
2
Construction, Testing & Commissioning of Extension Building of West Bay Health Center
PHCC/GTC/29/2014
29-Dec-14 / 30-Nov-15
SCH/GTC/PHCC/74/2012
20-May-14 / 07 - Oct -15
PHCC/GTC/09/2014
01-sep-14 / 30-Jun-15
3
Renovation and Extension Buildings in Four (4) Health Centers
4
Construction, Testing, and Commissioning of Parking Shades for Eleven (11) Health Centers
5
Improvement of Plant Rooms in Fifteen (15) Health Centers including Supply, Installation and Commissioning of additional Water and Diesel Storage Tanks in five(5) Health Centers; Supply, Installation , Testing & Commissioning of Standby Storage tank for Generator Fuel in Five Health Centers including Civil Works for enclosure and safety; Providing Additional Domestic water storage tanks at 5 HCs.
6
Consultancy Services & Supervision until Handover to Client for Fire Fighting System in Fifteen (15) Health Centers (Design).
7
Consultancy Services for the AS-BUILT drawings preparation, Life Safety and QCDD Codes Assessment of Compliance and QCDD Certification for Fifteen (15) Health Centers
PHCC/GTC/21/2014
11-Dec-14/ 01-Jul-15
8
Rehabilitation and Maintenance of Landscaping for Sixteen (16) Primary Health Care Centers for Three Years
SCH/GTC/PHCC/37/2012
25-Dec-12/ 31-Dec-15
9
Potable Water Storage and distribution System Bacteriological and Chemical Testing ENG/ZAK/102013144/2013 Services (Existing 21 Health Centers)
01-Aug-13/ 31-Aug-15
10
Maintenance Contract for Civil, MEP and HVAC System for all Existing Health Centers
01-Jun-14/ 31-May-17
PHCC/GTC/24/2014
PHCC/GTC/10/2014
PHCC/GTC/33/2013
18-Jan-15/ 31-Aug-15
16-Nov-14/ 01-Jun-15
Chapter 8. Financial results 45
09
Our initiatives & future plans
As Qatar continues to grow in the economic, social and cultural areas, we, in the healthcare sector, not only need to keep abreast of these developments and think and work positively and sincerely, but also to be among the leading Corporations in the developments and achievements attained on the path to realizing Qatar Vision 2030. The Corporation has worked hard since its establishment in February of 2012 to lay the foundation of an integrated health-care system, as part of the national strategy for primary health care framework of 2013 -2016, through which the Corporation paints the roadmap towards achieving short and long-term goals. The National Primary Health Care Strategy places primary health care as being the first point of contact for patients. Primary care and family medicine are going to become increasingly important for people as the first point of contact and access to the right care services at the right time.
46 Chapter 9. Our Initiatives & Future Plans
As Qatar continues to grow in the economic, social and cultural areas, we, in the healthcare sector, not only need to keep abreast of these developments and think and work positively and sincerely, but also to be among the leading Corporations in the developments and achievements attained on the path to realizing Qatar Vision 2030. The Corporation has worked hard since its establishment in February of 2012 to lay the foundation of an integrated health-care system, as part of the national strategy for primary health care framework of 2013 -2016, through which the Corporation paints the roadmap towards achieving short and long-term goals. The National Primary Health Care Strategy places primary health care as being the first point of contact for patients. Primary care and family medicine are going to become increasingly important for people as the first point of contact and access to the right care services at the right time. We are working towards a fully integrated Family Medicine Model of care – where service are integrated, focused on continuity of care, provided by an inter-professional team who have a clear relationship to the patient and family. This model has a number of core components as follows:• • • • •
Access to care and information Health center based care teams and services Co-ordinated care management Quality and safety Health information technology – Cerner implementation
In the Family Medicine Model, access to services will be facilitated through quick and efficient mechanisms to make appointments for the desired care at the right time, with the patient’s assigned and known primary care provider and team. We will also be introducing alternatives to face to face consultations to better manage demand and increase patient access to health care provider. Using an interdisciplinary team and inter-professional collaboration approach to patient care, with a family physician as the anchor enables patients to develop a continuous relationship and level of trust with their health care team. It will also improve management of workflow for provider within the health center. In 2015/16 PHCC is focused on Referral Management to manage all referrals for primary care along the patient pathway into secondary care and then on to continuing care if necessary but also back into primary care – a critical part of completing the circle of care. At present patients can get lost in the system so we believe it is important to operate a referral center that enables this transition to happen smoothly, enhancing the patient journey and helping them to positively navigate the health system. As part of the set-up of referral management PHCC wish to develop referral management guidelines (including prioritisation of referrals) and referral pathways for referrals within and between health centers and from health centers to secondary care. The development of guidelines from health centers to secondary care can only be achieved by PHCC and HMC working together. A number of clinical guidelines have already been jointly developed (diabetes) or are in development (mental health and cancer) which include robust referral guidelines. Some specialties have been identified as a potential starting point. These include referrals to the heart hospital, referral for diabetic care and referral for obstetric care. PHCC is also carrying out preliminary work to identify the most frequent referrals. This work would benefit by being carried out in conjunction with the HMC. The Corporation has already begun implementing the first steps both on the geographical distribution level and at the level of improving the quality and comprehensiveness of health services. Over the coming years we will continue to move forward with our developmental projects, in order to achieve the aspirations of the public and meet their needs. In total PHCC’s ambitious plans for Qatar will deliver 20 new Health Centers over the next 4 years, many coming on stream in the next 12 months. A number of the larger buildings will include a unique “Health and Wellness” center concept. These Wellness Centers will have additional focus on preventative health measures and feature elements which contribute to an individual’s overall wellness of mind and body rather than just their medical health. PHCC’s aim is to help keep Qatar’s population well by raising public awareness of broader healthcare issues, increasing physical activity and providing improved health education and advice. The larger Wellness centers will include facilities such as a swimming pool, massage room and gym to help Qatari people- especially children and families - live healthier lives. The first group of wellness centers, currently under construction are Leabaib, Umm Slal and Rawdat Al Khail.
Chapter 9. Our Initiatives & Future Plans 47
With support from HE the Minister of Public Health and HE the Prime Minister, Primary Health Care Corporation (PHCC) has successfully formed a strong partnership with an internationally recognized third party cancer screening specialist to launch two national cancer screening programs for Breast & Bowel Cancer. The goal is to identify early signs of the disease or indications that a person is more likely to develop the disease in the future. In most cases, early detection of cancer increases the chances of successful treatment. Cancer is a significant cause of death, therefore, recognizing possible warning signs of cancer early and taking prompt action for early diagnosis and treatment are essential to win the battle against cancer as early detection considerably increases the chances of successful treatment. PHCC will also raise awareness and educate people, to eliminate stigmas about Cancer and promote the general publics’ uptake of cancer screening services. Just as important is the need to increase training, education and awareness on the possible warning signs of cancer among medical and nursing staff when they come into contact with the general public to alleviate any concerns or fears. The cancer screening services will offer dedicated elegant units where mammography and bowel screening are co-located with a separate entrance to the unit and sensitive appointment scheduling to maintain patient privacy.
Location of Services: Mammography: Al Wakra
Leabaib
Mobile Screening Unit
Leabaib
Rawdat Al Khail
Bowel Screening: Al Wakra
The call and recall service will begin for Qatari residents from November 2015, expanding to all residents of Qatar from Q4 2016. In addition to the health center based services a self-contained mobile mammography unit will be available, which can be parked at health centers or in convenient public spaces eg: shopping malls and Souq Wakif to maximise convenient access for the public. PHCC will work with other health services in Qatar to increase cancer screening awareness and promotion of services via media, social media and advertising. Mobile apps will promote self-care and patient education. Email, SMS and online functionality will support convenient appointment booking and results notification. All of our services are subject to a process of continuous evaluation, improvement and development, in order to provide special, fast and easy services. PHCC has commenced implementation of a number of large scale projects and has commenced introducing the health insurance system, new electronic systems, as well as in capacity building and further development and training for the entire workforce in the Corporation, these initiatives will continue to be implemented. We have also enhanced or extended a number of services at Health Centers as part of the National Primary Health Care Strategy. These initiatives will be extended out across all of our Health Centers . PHCC will work with other health services in Qatar to increase cancer screening awareness and promotion of services via media, social media and advertising. Mobile apps will promote self-care and patient education. Email, SMS and online functionality will support convenient appointment booking and results notification. and a review of the Primary Health Care strategy will be undertaken from a PHCC perspective, which is due for completion by end of December 2015, to enable us to determine our next steps and priorities. We will be realigning our annual report to coincide with the new fiscal year and reporting to the Supreme Council of Health.
48 Chapter 9. Our Initiatives & Future Plans
