Reclaiming Lost Glory of Medical Institutions
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Reclaiming Lost Glory of Medical Institutions

Unlock the Hidden Potential; become the Healthcare Leader you were destined to be

Post by DR. FIAZ MAQBOOL FAZILI on Monday, October 16, 2023

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In the ever-evolving landscape of healthcare, medical institutions play a pivotal role in shaping patient care standards and adopting the pursuit of excellence as an ideal in health care, health education and health research will ultimately generate innovations in care and better health outcomes. Taking proactive initiatives to demonstrate progress and improvement is a strategic approach to influence authorities; the key is to consistently demonstrate the positive impact of your efforts to improve through tangible improvements and data-backed results. By showcasing your commitment to progress through KPIs, you'll increase your chances of convincing authorities to review and potentially revise old decisions on transferring of power. Remember, representation must be prepared professionally, well researched, convincing, and focused towards the positive impact on patient care as an independent, autonomous organization, and potential consequences of losing that status.


Strategies for Overcoming Setbacks and Learning to Fly Again

In pursuit of excellence using SWOT (strength, weakness, obstacles, threats) analysis on the challenges of my alma mater have some suggestions for current or forthcoming CEOs of medical Institutes. Healthcare is a collaborative effort that involves various disciplines working together, and the Director must be visionary, encouraging teamwork, interdisciplinary collaboration, empathy, and a positive and patient-centric culture among healthcare professionals. Implementing change in organizational culture and functioning of medical institutions can be a complex and challenging process that requires careful consideration, professional expertise, and cooperation of all stakeholders. I must have approached at least five previous CEOS with a helping hand; sadly the response was not encouraging. Let's break down the certain key areas which can have an impact on improving the functioning of this institution. Defining and identifying Institutional goals and objectives is paramount to progress includes prioritizing improving patient outcomes, enhancing patient care and satisfaction, optimizing resource utilization, ensuring regulatory compliance etc.


Small changes that can make a big difference

There could be several key areas within the Institution, where focusing on improvement is to be prioritized can bring reasons that Institution is able to deliver optimally and expectantly makes a strong case for reclaiming previous status. To help with our improvement efforts identify Key departments & engage stakeholders using QI tools like FOCUS-PDSA, a common quality improvement approach can be applied to the management of any process. Each of its nine steps stand for the following actions’ ; Find a problem, Organize a team, Clarify the problem, Understand a problem/’s , Select an intervention, Plan, Do, Study, Act. Simple data collection and reporting tools improves the process to monitor results over time, the FOCUS-PDSA model works well in many areas of improvement and requires only the formation of an interdisciplinary team.


What is not measured can’t be managed well, improvement must be measurable. Creating a comprehensive and effective action plan for measuring performance in various departments involves setting key performance indicators (KPIs) that align with the institutional goals and objectives. These KPIs should be specific, measurable, achievable, relevant, and time-bound (SMART). For each department, and its managers develop qualitative KPIs that provide insight into their performance. Assigning ownership of each KPI to specific individuals or teams within the respective departments ensures accountability for tracking and improving performance. Promote meritocracy through a meritocratic approach in healthcare promotes fairness and encourages the recognition and advancement of healthcare professionals based on their skills, dedication, and performance.


Many previous appointments, interviews have come under vigilance lenses, implementing transparent performance evaluation systems, and providing opportunities for professional development can motivate staff to excel, ultimately benefiting patient care. Clear and transparent hiring processes ensure that qualified and competent individuals are hired for various roles. This promotes a culture of professionalism and reduces the risk of bias or nepotism affecting staff selection. Transparency in financial matters helps prevent mismanagement, dispel criticism of indulging in unethical practices. Patients and stakeholders should be able to understand where funds are allocated and how they are being used to improve healthcare services.


Holding individuals accountable for their actions and decisions is essential for maintaining high standards on QPS. When there are clear lines of responsibility, it encourages everyone to perform their duties diligently and ethically. Sadly, no documented well-defined hospital wide and departmental policies, job descriptions for all care provider positions and staff exist so it is difficult to fix responsibility in case of adverse events. Accountability mechanisms, such as regular performance reviews and audits, ensure that healthcare professionals adhere to the highest standards of practice and uphold their commitment to patient welfare. Improving patient centered care to elevate healthcare standards by establishing clinical guidelines, protocols and pathways based on the latest scientific research not only for the institute but for the whole State was one of the objectives of establishing SKIMS as a research institute.


Working with check lists, surgical safety forms, implementing international or National patient safety goals these protocols guide healthcare professionals in making well-informed decisions and help standardize care processes, reducing variations and errors in treatment ensures that healthcare is provided in an efficient, effective, safe, and patient centered way. Why go outside for treatment was the core message of SKIMS, for many years, now we have not seen any addition to its super specialties like liver or stem cell transplant, neuro-spinal reconstruction, Hospice, end of life care doctors in emerging medical specialties like, Gene therapy, Cancer immunologist, Nocturnist, Lifestyle medicine physician, Clinical informatics, Medical virtualist etc.


It's true that many referral hospitals and tertiary care medical institutions, often face issues related to being overburdened arising out of several causes like high patient volume, improper referral system and Queue management and in coordination or lack of E - medical grid with a single centralized operation room to see what suits best for which patient. Educating the public about appropriate use of emergency services and encouraging satellite units, outreach programs in peripheries, starting home care services, proper triage (visual or physical) or screening clinics by CTAS, AIIMS Triage Protocol at EDs, queue management tools and techniques can overcome problems leading to long wait times and potential delays in care. Electronic health records, telemedicine, and appointment scheduling systems can improve efficiency and patient management. The deficiencies of staff and lifesaving equipment like ventilators, administrators should be able to plead the case before the authorities how shortages affect patient care, satisfaction and ultimately the reputation of the institution.


Government support can play a role by providing necessary funding, policy support, and guidelines for managing patient overload in referral hospitals. We must choose carefully where to invest our time, energy, and money. But regardless of the choices, we must always strive for excellence. Selection of visionary leadership (Director) is the single most important factor which sets healthcare institution's direction, performance, and reputation. Traditionally our selection of CEOs is mostly on seniority bases, not all eligible clinicians can be visionary leaders, refreshing courses on finance management, healthcare quality improvement tools like, PDCA, SWOT, LEAN six sigma are useful for any Head of an organization. No one will ever have all the correct answers, and ultimately, you will make better decisions as a leader by having diverse people and views, team building, brainstorming in decision making is a trait of a visionary leader for unearthing the best solutions.


National Healthcare policies continues to provide Medical Institutions with the latest and greatest methods for how to improve patient-centred care; it is of the utmost importance for healthcare administrators and HCPs across the UT to stay on top of the newest Institutional improvement ideas that could solve some of their biggest pain points in how to improve patient care and progress even further. A professional suggestion is indeed a valuable form of feedback or intellectual brainstorming that is intended to contribute to improvement rather than to express objection. When one welcomes criticism, displays a willingness to learn and evolve, showing that they are on a path of continuous development and it’s important to recognize that solving these issues requires a combination of short-term strategies to alleviate immediate burdens and long-term strategies to build a sustainable healthcare system that can meet the needs of the population.


Improving Healthcare in Medical Institutions needs will, ideas, execution. You can do better by Identifying gaps in organizational culture, developing a framework or model of change for reforms and policy initiatives that guide towards the improvement.


(The author is a past alumnus of SKIMS, and an international expert on Healthcare standards, policy planning and reforms can be reached at:

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