Vision
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Mission
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Background
Although the medical and health sciences advances rapidly, when it comes to addressing patient needs and satisfaction, ensuring patient safety and efficiency, the current healthcare system can be strengthened to perform at an optimal level. Our medical environment and healthcare system require deliberate redesigning for reliability, cost-effectiveness and safety.
The National Health Policy 2017 focuses on quality in healthcare. To implement this concept, the Ministry of Health (MoH) established a Quality Assurance and Standardization (QASD) Division in MoH and quality assurance focal persons in all hospitals. The QASD adopted Bhutan Healthcare Standards for Quality Assurance (BHSQA) and rolled out the standard in the majority of healthcare facilities across the country. It also monitors the implementation and disseminates the findings as Annual Report on MOH website.
One of the most important pillars of BHSQA is Continuous Quality Improvement (CQI). “Quality improvement (QI)” is defined as the application of a systematic and scientific approach that uses specific techniques to improve quality. It emphasizes the importance of the data and coordination by the team to improve health outcomes and processes for patients and population at large. Healthcare organizations monitor, assess and improve the standards of healthcare quality by quality assurance mechanism and multiple QI projects/initiatives at the point of care are the driving force to bring organizational change. QI also makes scholarly activities easier for the busy clinicians in their workplace as QI works are publishable in the scientific journals and side-by-side patient care and outcome will also be improved without compromising the service. QI competencies are also considered as the essential competencies of various categories of healthcare professionals in the competency based framework defined by the Royal Civil Service Commission (RCSC). It is a powerful tool and the same principles can be applied even for organizational and personal development.
In Bhutan, the Point of Care Quality Improvement (POCQI) training module, which was developed by SEARO-WHO, was introduced and scaled up by the Reproductive Maternal and Newborn Health (RMNH) program, MoH in 2017. However, its implementation was limited only among MCH care providers and nurses although it can be applied to any disciplines and processes.
To scale up this QI training beyond boundaries, with the support of WHO, Technical Working Group members from JDWNRH and KGUMSB developed and contextualized a generalized blended learning (Online and in-person) course titled “Total Quality Management in Healthcare” which integrate QI and QA in 2021. Despite COVID-19 pandemic, we managed to conduct training using virtual platforms over 80 doctors, nurses and allied healthcare professionals from 18 departments in JDWNRH and more than 30 QI projects in various departments have been completed so far with measurable outcomes and several projects are ongoing. Significant number of QI projects have been and will be conducted by KGUMSB faculties and students year by year as Faculty of Postgraduate Medicine (FoPGM) and Faculty of Nursing and Public Health (FNPH) initiated to integrate QI in their respective postgraduate and pre-service curriculum in 2018. Now, JDWNRH is on-track to institutionalise the QI program and we are planning to do the same in CRRH and ERRH this year with the support of WHO. This unique and latest approach of Bhutan has been showcased in the region through SEARO-WHO.
To promote and enhance quality culture, it is very important to develop a Community of Practice to connect experienced and inexperienced QI practitioners together to promote peer learning and mentoring. That is why many countries have developed such platforms and India developed the Nationwide Quality of Care Network (NQOCN: https://www.nqocncop.org/). NQOCN is a voluntary non-profitable network formed by teams working on quality improvement initiatives across India. It has an unique online Community of Practice catering to Quality Improvement teams across India & South-East Asia. Bhutan has been a part of it since 2021. However, there is a pressing need of having a local platform to connect local people considering the local context to promote QI in Bhutan.