Transcript Diapositive 1

Royaume du Maroc
Ministère de la Santé
Assessment of the process and its effects on
maternal and child health services
The expert talk
Eschborn 4th of December 2012
Dr Nejoua BELKAAB
Responsible for the Quality Unit
Hospitals Direction and ambulatory cares-MH-Morocco
How to assess the
quality of health
services?
Processus de
management
Eléments
d’entrée
Processus de
réalisation
Elements
of output
Processus
support
Dr Nejoua BELKAAB-The expert talk-Eschborn 4 Dec 12
RESULTS
FACTORS
Results of
Personnel
Staff
Leader-ship
Policy &
Strategy
Partnership
and Resources
Process
Results of
customers
Community
results
INNOVATION AND LEARNING
Dr Nejoua BELKAAB-The expert
talk-Eschborn 4 Dec 12
Key
Performan
ce
Results
Hospital
Health center
Provincial health dept
Maternity hospital




Creation of a dynamic in the system.
 Effect system,
 Annual appointment of all professionals;
A step ahead in the process of governance:
accountability, transparency and recognition of
efforts;
It became a political instrument which can include
the priorities of every strategy of the Ministry of
Health;
Better performance after several editions.
Dr Nejoua BELKAAB-The expert
talk-Eschborn 4 Dec 12
Strengths




Challenges
The responsible managers are
informed on conduct of CQ, the
evaluation criteria;
Awareness raising to reach
highest numbers of different
structures to join the process and
to plan and implement changes
according to the criteria of CQ;


Concrete actions to improve;
Development of partnerships:
Supporting representatives of
the communities


No predetermined schedule
that is shared with all
structures / lots of hazards,
unstable financing .....>
difficulty of planning;
No circulation of
information following the
meetings;
No technical support, to
execute changes "If we
know or can do it, we had
done! Without CQ “
Non harmonized actions
Dr Nejoua BELKAAB-The expert
talk-Eschborn 4 Dec 12
Strengths

Open questioning of
some processes;
Challenges



Time for change and
search
recommendations for
it.



Small team that fills the
guidebook;
Teams do not have the same
level of understanding;
No visibility on the horizons of
expectation;
Lack of support during this
phase;
Feels as a burden instead of
being an opportunity for
change.
Dr Nejoua BELKAAB-The expert
talk-Eschborn 4 Dec 12
Strengths

Results that reflect the
effort of the structure
and level of
involvement in the
process.
Challenges


Scoring very subjective,
answers and horizons
of expectation not
detailed;
Questionable since all
structures shall be
subject to audit.
Dr Nejoua BELKAAB-The expert
talk-Eschborn 4 Dec 12
Strengths


External evaluation;
Challenges

Preparing the structure
for this visit;



Structured diagnostic;
Confirmed areas for
improvement in the
majority of cases by the
team;



Results more credible.
Time: 1 day, not
sufficient for some
structures;
Warned structures /
situation not real;
Assessment according
to one process
description;
Results remain auditdependent.
Dr Nejoua BELKAAB-The expert
talk-Eschborn 4 Dec 12
Strengths



Improvement Plan is the
subject of a specific
assessment for the next
edition;
Improvement actions
oriented at the processes;
Realization of training by
the central level, following
the analysis of
Improvement Plan in several
domains.
Challenges


Improvement Plan is
not always included in
the Annual Action Plan
of the structure;
Sometimes
implemented to meet
the requirements of
CQ;
Dr Nejoua BELKAAB-The expert
talk-Eschborn 4 Dec 12
Strengths




Diagnostic of the entire
system in real time and
based on only one tool;
Challenges

◦
◦

Official ceremony;
Recognition and distinction
in presence of the Minister
of Health;
Mediatization.
Double classification:



Better performance in CQ
Better productivity performance
Transverse data bank not
available;
No substantial prices;
When they exist (study trip or
training ) for managers only;
Teams are not valued
sufficiently.
Dr Nejoua BELKAAB-The expert
talk-Eschborn 4 Dec 12
Strengths

Responsibility of the
team to develop its
own Improvement
Plan;
Challenges



Research
partnership to
concretize the
Improvement Plan;

Duplication of efforts: Lack of
coordination with other
structures in the province
(delegation, hospital and
health centers);
Lack of support in the
implementation of
Improvement Plan;
The resources are not
oriented at implementing
corrective actions.
Dr Nejoua BELKAAB-The expert
talk-Eschborn 4 Dec 12
Key factors of success
Challenges
Enlists in line with the strategy of the 
Ministry of Health for the reduction
of maternal and infant mortality;
Viability fragile, noninstitutionalized approach;

Conditionality in the program
program of EU support (20112014);

Monotony felt by professionals;

To date provided funding for the
organization of CQ:


◦ 2006-2010: GTZ- global fund-OMS-MH
◦ 2011-2012: MH

Two evaluations stressed improtance
of continuity;

Debate on CQ for the first time in

Difficulties of measuring the
contribution to the impact;
Implementation of other
approaches more fashionable
(accreditation) or current tools
(RAMED)
Moroccan parliament
Dr Nejoua BELKAAB-The expert
talk-Eschborn 4 Dec 12
1.
Linking prices of CQ to technical support and / or
financial:(Contracts, Assuring tutoring…);
2.
CQ-SQI better synchronize with other approaches to quality
management;
3.
Develop a legal and administrative framework;
4.
Promote an overall development framework with interfaces
between health, education, economy and environment based on
the same tool;
5.
Maximize the values ​of SQI by maintaining a long-term vision.
SQI an instrument of creation of value
Dr Nejoua BELKAAB-The expert
talk-Eschborn 4 Dec 12