BUILDING WORLD-CLASS ALLIANCES IN HEALTHCARE A Bridge to Better Healthcare Services Ahmed Ghali MD Assistant General Manager Dar Al Fouad Hosp.

BUILDING WORLD-CLASS BUILDING WORLD-CLASS ALLIANCESALLIANCESIN HEALTHCAREIN HEALTHCARE

A Bridge to Better A Bridge to Better Healthcare ServicesHealthcare Services

Ahmed Ghali MDAhmed Ghali MD

Assistant General Assistant General ManagerManager

Dar Al Fouad Hosp.Dar Al Fouad Hosp.

Dar Al Fouad Hospital

Dar Al Fouad Hospital is a private Dar Al Fouad Hospital is a private healthcare facility located in 6healthcare facility located in 6thth of of October City, West of Cairo, 32 km’s October City, West of Cairo, 32 km’s away from down town.away from down town.

The total area of the hospital is The total area of the hospital is 42,000 meters, with the premises 42,000 meters, with the premises occupying 24,000 meters. occupying 24,000 meters.

The premises are comprised of a The premises are comprised of a ground floor, beside two levels on ground floor, beside two levels on top. top.

The current capacity of the hospital The current capacity of the hospital is 144 beds qualified with all is 144 beds qualified with all necessary medical an nursing necessary medical an nursing requirements. requirements.

MissionMission

Our mission is to serve the Our mission is to serve the community through community through providing high quality providing high quality medical services at an medical services at an affordable price.affordable price.

VisionVision

Our vision is to Our vision is to GROWGROW In-house: In-house: by inaugurating a new by inaugurating a new

building in 6building in 6thth Oct main campus. Oct main campus. Locally: Locally: by acquisition of the new by acquisition of the new

East Cairo Dar ALfouad Hospital East Cairo Dar ALfouad Hospital (2015).(2015).

Regionally: Regionally: byby opening satellites opening satellites in the Gulf region, north Africa and in the Gulf region, north Africa and sub-Saharan Africa. Kuwait branch is sub-Saharan Africa. Kuwait branch is functioning.functioning.

DRIVING FORCES:DRIVING FORCES:

CardiologyCardiology Cardiothoracic SurgeryCardiothoracic Surgery Liver TransplantLiver Transplant OncologyOncology Orthopedic Surgery Orthopedic Surgery

Collaboration with Collaboration with Cleveland Clinic Cleveland Clinic FoundationFoundation

In 1990’s the concept and vision of DAF owners was to In 1990’s the concept and vision of DAF owners was to establish a world class service for the cardiac and establish a world class service for the cardiac and cardiothoracic surgeries for Egypt and Middle East region cardiothoracic surgeries for Egypt and Middle East region

For more than 15 years, Cleveland Clinic For more than 15 years, Cleveland Clinic Foundation (CCF) has been ranked as the first Foundation (CCF) has been ranked as the first hospital in the USA in the fields of Cardiology and hospital in the USA in the fields of Cardiology and Cardiothoracic Surgery.Cardiothoracic Surgery.

In 1999, a collaboration agreement was signed In 1999, a collaboration agreement was signed between DAFH and CCF. This agreement ensures between DAFH and CCF. This agreement ensures continuous technical, medical, and administrative continuous technical, medical, and administrative support to be provided by the CCF as well as support to be provided by the CCF as well as exchange programs for physicians and personnel exchange programs for physicians and personnel for training. It also allowed CCF to have a Board for training. It also allowed CCF to have a Board seat in DAFH.seat in DAFH.

This was the first affiliation contract done by CCF This was the first affiliation contract done by CCF outside the states and in the middle East Regionoutside the states and in the middle East Region

Collaboration with Collaboration with Cleveland Clinic FoundationCleveland Clinic Foundation

In 2006, the collaboration In 2006, the collaboration agreement was revalidated agreement was revalidated between DAFH and CCF for 10 between DAFH and CCF for 10 years including the new extension years including the new extension in east Cairo.in east Cairo.

Partenership with CCFPartenership with CCF

Benefits:Benefits: Guided Daf in setting a world class system Guided Daf in setting a world class system

for work in all hospital departments for work in all hospital departments Continuous staff development and training Continuous staff development and training Continuous audit on the outcome of care Continuous audit on the outcome of care

considering CCF as the benchmark .considering CCF as the benchmark . This helps our hospital in continuous This helps our hospital in continuous

improvementimprovement

Liver Transplant Liver Transplant agreement with KYOTO agreement with KYOTO UniversityUniversity In 2001, an agreement was signed In 2001, an agreement was signed

with with KYOTO University, Japan for KYOTO University, Japan for collaboration in liver transplant.collaboration in liver transplant.

Several surgeons were invited to Several surgeons were invited to Kyoto to attend this program Kyoto to attend this program

Japanese team were involved in Japanese team were involved in our first cases of the program in our first cases of the program in Dar Al-Fouad.Dar Al-Fouad.

Building a team for Building a team for accreditationaccreditation

What does quality mean in What does quality mean in healthcare?healthcare?

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Quality is doing the right things Quality is doing the right things right, first time and every time right, first time and every time

To ensure:To ensure:1-The best possible outcome for patients1-The best possible outcome for patients

2-Satisfaction for all our many customers2-Satisfaction for all our many customers

3-Retentions of talented staff3-Retentions of talented staff

4-Sound financial performance4-Sound financial performance

Why did DAF seek for Why did DAF seek for Accreditation? Accreditation?

Accreditation is not an end in itself, Accreditation is not an end in itself, but rather it’s but rather it’s a a way to improve way to improve quality. quality.

It is a It is a tool tool to assist the hospitals in to assist the hospitals in improving the system framework of improving the system framework of all the hospital functions in an all the hospital functions in an integrated well organized manner integrated well organized manner

Accreditation is a strong marketing Accreditation is a strong marketing tooltool 16

Why Did we choose Why Did we choose JCI Accreditation? JCI Accreditation? ““JCI Accreditation is a well established JCI Accreditation is a well established

non profit organization that assess non profit organization that assess the level of performance in relation to the level of performance in relation to established standards established standards and to and to implement ways to continuously implement ways to continuously improve the healthcare system” improve the healthcare system”

JCI is considered one of the toughest JCI is considered one of the toughest accreditation agencies that stress on accreditation agencies that stress on patient safety and processes of carepatient safety and processes of care

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Essential elements of a successfulEssential elements of a successfulstrategystrategy

Include developing the Include developing the right cultureright culture,, attracting and retaining the attracting and retaining the right peopleright people, , devising and devising and updating the right in-house updating the right in-house

processesprocesses, and , and giving staff the giving staff the right tools right tools to do the job. to do the job.

External influencesExternal influences, such as local market , such as local market competition, and public or private health competition, and public or private health quality initiatives and standards also have an quality initiatives and standards also have an impact.impact.

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Quality team tasksQuality team tasks

ChallengesChallenges

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Key challenges Key challenges Before the First AccreditationBefore the First Accreditation

A- The main challenge was A- The main challenge was the staff the staff resistance to change resistance to change especially:especially:

1) To Teamwork: volleyball team not a golf 1) To Teamwork: volleyball team not a golf team.team.

2) To be System managers.2) To be System managers. 3) To Develop standard procedures.3) To Develop standard procedures. 4) To Deliver care as an integrated team.4) To Deliver care as an integrated team.

B.B. Change the Change the conceptconcept of physician of physician centered to patient centered care.centered to patient centered care.

C.C. Accepting the idea of continuous Accepting the idea of continuous performance evaluationperformance evaluation..

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D.D. Staff TurnoverStaff Turnover due to the fact: Preparing for due to the fact: Preparing for accreditation and delivering optimum quality accreditation and delivering optimum quality of care required more effort at workof care required more effort at work

E.E. Staff Communication Staff Communication especially among especially among physicians. It was noticed that patients physicians. It was noticed that patients managed by more than one specialty their managed by more than one specialty their steps of care could be inappropriate due to steps of care could be inappropriate due to lack of communication. lack of communication.

..

Key challenges Before Accreditation

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2005 - 2008 2008 -2011 2011- 2014

Accreditation RewardsAccreditation Rewards

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Clients are more satisfied Larger Clients are more satisfied Larger share of the marketshare of the market

Pride of the employees in their workplacePride of the employees in their workplace Retention of excellent human resourcesRetention of excellent human resources

Safer environment Less risk Safer environment Less risk less liability less liability

Quality culture Quality culture Continuous Continuous improvement improvement

Efficient operationsEfficient operations Cost savingsCost savings increased profitabilityincreased profitability

After the First After the First AccreditationAccreditation Before 2008 JCI accreditation, there were Before 2008 JCI accreditation, there were

challenges mainly in the form of reluctance challenges mainly in the form of reluctance of staff to comply fully to the standards. of staff to comply fully to the standards.

Action Taken By the hospitalAction Taken By the hospital Engaging and empowering the staff Engaging and empowering the staff Stressing on the importance of continuous Stressing on the importance of continuous

quality management quality management Regular Quality meetings for all the hospital Regular Quality meetings for all the hospital

staff demonstrating areas of good practice staff demonstrating areas of good practice and areas that require improvementand areas that require improvement

We found 10 Success Characteristics that We found 10 Success Characteristics that are associated with high performanceare associated with high performance

LEADERSHIP STAFF

PERFORMANCE PATIENTS

Ÿ LeadershipŸ Organizational

Support

Ÿ Staff FocusŸ Education and

TrainingŸ Interdependence

of Care Team

Ÿ Patient FocusŸ Community and

Market Focus

Ÿ PerformanceResults

Ÿ ProcessImprovement

Informationand

InformationTechnology

1. Strong Leadership

2. Great Organizational Support

3. Focus on Staff (Professionals)

4. Education and Training of Staff

5. Interdependence of Care Team

6. Performance Result Focused

7. Process Improvement Focused

8. Patient-Centered (Patient Focus)

9. Community and Market Focus

10. Information & Information Technology Orientation

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Take Home MessageTake Home Message

We learned over the 15 We learned over the 15 yearsyears

Keys to SuccessKeys to SuccessLeadership SupportLeadership SupportStart small; use several tests of changeStart small; use several tests of changeInvolve staff to obtain their buy-inInvolve staff to obtain their buy-inMake it a win-win situationMake it a win-win situationReward and recognize staff for their Reward and recognize staff for their inputinputProvide ongoing feedbackProvide ongoing feedbackAlways make patient safety the priority!Always make patient safety the priority!Never give up; there is no obstacle that Never give up; there is no obstacle that cannot be overcome!!!cannot be overcome!!!

Thank YouThank You