Delivery of Effective Care Through Better Global Governance Mike Farrar - Moderator
Chief Executive, NHS Confederation, United Kingdom
Carissa Etienne
Assistant Director-General Health
Systems and Services,
World Health Organization (WHO), Geneva
Dr. Carissa F. Etienne assumed the role of Assistant Director-General for Health Systems and Services in February 2008. Prior to that, she was the Assistant Director of the Pan American Health Organization(PAHO). As Assistant Director in PAHO from July 2003 she directed five technical areas - health systems and services; technology and health services delivery; health surveillance and disease management; family and community health; and usstainable development and environmental health.
A national of Dominica, Dr Etienne began her career as a medical officer at the Princess Margaret Hospital in her country, where she eventually became the Chief Medical Officer. Other high-level posts she has held include the Coordinator of Dominica's National AIDS Programme, Disaster Coordinator for the Ministry of Health of Dominica, Chairperson for the National Advisory Council for HIV/AIDS and the Director of Primary Health Care for Dominica.
Dr. Etienne received her MBBS degree fromt the University of the West Indies, Jamaica, and her M.Sc. degree in community health in developing countries from the University of London.
Summary of Presentations:
In this exclusive session, the moderator and three panelists will discuss major, successful quality improvement strategies occurring both nationally in the United States and in two health systems. The session will highlight the results and lessons learned from national improvement initiatives to reduce infections and hospital improvement projects in chronic disease management, health information technology and patient safety. The session will focus on clinical and operational best practices, practical tools, and novel ways for leaders to learn from each other regarding major health care quality and safety issues. Examples will include how to effectively and efficiently spread clinical improvement, such as reducing health care associated infections, across an entire country and innovative ways to reduce patient falls, pressure ulcers and medication errors in hospitals. At the end of the session, participants will have learned proven strategies to accelerate quality improvement in their own hospitals and country.
Rich Umbdenstock
President and CEO, American Hospital Association
John W. Bluford
President and CEO Truman Medical Centers, AHA Board Chair
Thomas M. Priselac
President and CEO, Cedars-Sinai Health System, AHA Past Board Chair
Maulik S. Joshi
President, Health Research & Educational Trust and Senior Vice President of Research,
American Hospital Association
2
Private Public Partnership: Dubai Health Authority Experience
Dubai Health Authority Ibtesam Al Bastaki
Head of health strategy and performance at prime minister office
Takes care of the Health Sector for the Prime Ministers Office and looks after the Health Strategy and Policies at the Federal Level for the Government of UAE
The Director of Business development of Hospital Sector provides essential support to the vision and long term business strategy including all aspects of planning, project, revenue and innovation customized for Hospital sector across DHA.
To function as the official advisor in all functions of healthcare business, to hospital management within the Dubai Health Authority (DHA) network, so as to maximize cost efficiency and revenue streams, as well as to institute business strategies and frameworks, in line with the policy thrusts of the DHA and Government of Dubai.
The purpose is to lead different projects in collaboration with other external stakeholders and to activate the concept of PPP in health sector which allowed building a portfolio of health business delivering a long term performance in the Market.
Achievable projects:
Tie up DHA with various Insurance companies
Cost cutting and saving at DHA at different projects
Tie up with various corporate companies with DHA for medical services.
Involve in various projects at DHA such as Rehab centre, Trauma Jabel Ali, Screening centre, Dubai Diabetes Centre and Dubai Gyn. & Fertility centre..
Improve the financial budget and revenue within Hospital Service Sector.
Awards and appreciations:
Dubai police in cooperation with UNICEF for my participation in HIV project and as first initiative for Voluntary test under supervision of infection unit DOHMS
Initiative of Al Hajj Campaign across the governmental sectors in Dubai by offering free vaccinations, First Aid Kits and health awareness brochures.
Excellency Award as Family Physician 2005 by PHC.
First initiative of Traveler health awareness at Dubai International Airport.
Appreciation by Dubai Civil Aviation in the air Shaw participation 2007, 2009.
Appreciation by DOHMS for DHA stage II design 2008.
Appreciation by Emirates Airlines for catering their passengers at Dubai International Airport.
Shk. Rashid Scientific excellence Award for Arab Board in family medicine May 2008.
Appreciation from Dubai Police at Dubai International Airport July 2009
Appreciation from DHA SSS sector regarding 2009 Dubai Air Shaw
Award by H.H. Shk. Mohammed Bin Rashid for the Excellence DHA employee for the year 2009-2010.
Appreciation from HRH princess Haya for special needs award
Saeed Al Shamsi
Director of Technical Affairs, Dubai Health Authority
ENGR. SAEED ALI IBRAHIM AL SHAMSI is the Director of Technical Operations at the Dubai Health Authority, with responsibility for all Technical Operations such as Bio-medical Engineering Services, I.T. Services, new Healthcare Projects, Facility Management & Environmental & Safety Management). Engr. Saeed holds a B.Sc. Degree in Bio-Medical Engineering and Masters Degree in Project Management, from the George Washington University, Washington D.C., U.S.A. Participated in Harvard Business School in HealthCare Delivery Program and Attended a HR Diploma Course, Australia.
He developed an interest in natural approaches to Healthcare and Imaging Science overseas, by participating in major Conferences in Europe (ECR) and U.S.A. (RSNA). He has undergone several Technical and Managerial trainings on site and abroad, with 20 years’ experience in the Health Care Sector. He started as Field Service Engineer before holding a Managerial post. He has extensive skills in managing Health Care Projects and wide network in this field. An accomplished Engineer, he won the Dubai Excellence Award in 2007, in the category ‘Excellent Employee’ for Department of Health & Medical services, Dubai, which has total strength of over 9500 employees. Engr. Saeed was a distinguished Speaker in the DUBAI – OSAKA economic FOURM, OSAKA, JAPAN, and several others. He also served as Vice Chairman and member of many projects at DHA, Trauma Centre, Rashid Hospital, Cord Blood Bank, PACS DOHMS Enterprise and others.
Laila Al Jassmi
CEO of Health Policy and Strategy sector at Dubai Health Authority
Ms Laila is the CEO of Health Policy and Strategy sector at Dubai Health Authority (DHA). She is responsible for the development of the policy and legislation for the health system in the Emirate of Dubai driven fromDubai Strategic Plan (DSP). Overseeing the implementation of the DHA Health strategy and conducting sector planning and forecasting. The sector will be involved in setting standards and policy for the healthcare across Dubai in incorporation with federal healh policy framework. This to assure that Dubai develops a world class health system, high quality Public Health and healthcare service provision.
Placing Dubai at the world health map is the main drivers for this sector. Having worked for the Dubai Health Authority, she has extensive knowledge of the healthcare systems, Health reforms, strategic direction, planning and delivery of healthcare services. Prior to this she was the CEO of the Clinical Support Services Sector, responsible for management and direction of the Clinical Support Services across the DHA. Laila is a strategic focus person who is prior to this post was the Transition Director for DHA were she was leading the proces of the health reform from Department of Health & Medical Services to Dubai Health Authority, prior to which she was responsible for overseeing the development of the Dubai Health Authority new heath funding model and it economic future projection. Laila is a graduate from the College of Allied Health Science and Nursing in Kuwait University and in 2007 secured her Masters n Executive Healthcare Administration from Zayed University in affiliation with Arizona State University, the University of Houston‐ Clear Lake and the University of Kentucky. Laila is a graduate of Sheikh Mohammed Bin Rashid leadership program 2003. She has been awarded Dubai Government Excellence Award (distinguish employee 2009) and the Sheikh Rashid Award for Scientific Outstanding (2008). Laila also being awarded the Feigenbaum Excellence leadership Award for women’s leaders 2011
Dr. Khaleghian is Director of the Policy and Strategy Department at the Dubai Health Authority. Formerly a Sector Leader in the World Bank’s Europe and Central Asia health practice, he has over 12 years experience leading strategic advisory and project finance assignments in Asia, Europe and the Middle East. An experienced specialist in emerging markets healthcare, Dr. Khaleghian has acted as a strategic advisor for investors, firms and governments looking to expand their footprint and improve their performance in high-potential markets; and as a PhD- trained health economist, he has extensive experience as an interlocutor between the public and private sectors on issues concerning healthcare investments, public-private partnerships, payer/provider relations and health insurance. A New Zealand national, Dr. Khaleghian holds a medical degree from the University of Auckland, New Zealand and a PhD in Health Policy and Management from The Johns Hopkins University, USA.
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Innovation: Promoting New Partnerships French Hospital Federation Sylvia BENZAKEN
Vice-President of the Medical Board, Research and Teaching Hospital of Nice
Deputy Head of the medical committee, Immunology Laboratory
Nice University Hospital, Archet 1
Jean DEBEAUPUIS
Chief Executive, Research and Teaching Hospital of Grenoble French University
Hospitals promoting technologies at home for chronic, ageing or disabled patients With their corporate partners, professional associations, national and local governments, 4 university hospitals have joined their efforts in a national center promoting technologies cost-effective for improving health status of persons living in their homes with chronic illnesses, ageing or disabled patients. With a 3-5 years grant from French industry ministry, they will issue national guidelines for families, professionals, and insurers, drawing from the experience and resources in Toulouse (e-health), Nice (high security communicating devices), Grenoble (assessment), Limoges (intelligent homes)
Vincent DIEBOLT
Director, National Center for the Management of Trials on Health Products.
“Notre-Recherche-Clinique.Fr ”, An Initiative on the Web of French Hospitals to Reconcile French Citizens with Clinical Research
Medical research is one of the official mission of French hospitals. Clinical research, meaning human testing new health products, is the last step of development for medical innovation, and is determining for Hospitals, especially the university ones, are directly involved in clinical research. First, for law in France, medical research is one of their missions with care and medical training.
Secondly, hospitals are deeply involved because they are the meeting place for patients, medical investigators, clinical research sponsors, with the availability of an advanced technical support for conducting clinical trials. The development of this activity is essential for the first access of patients to medical innovation. Several recent surveys and opinion polls made clear that French citizens are aware of the role played by clinical research in assessment of medical innovation, and the continuation of medical progress, but are reluctant to take part in it themselves. It appears their mistrust comes from an ignorance of what clinical research really is, of its aims, its restrictions and the risks. The consequence of this reluctance is a difficult for sponsors to lead their clinical trials and to find volunteers. And the delay to conduct them is one determining criteria to choose the place where clinical trials will be carried out. Time is money for sponsors. This fact explains a part of the decline of the number of new clinical trials in France launched each year for the last 12 years. From 1998 to 2009, this number has decreased from 1467 new clinical trials to 920. In response to this observation, French hospital federation in partnership with the National center for management of clinical trials in health products decided to launch a web portal on clinical research. This web site has been conceived not for specialists or professionals but for people at large. After a benchmark which confirmed the expectations of the French population, the development of the web site was launched. It has two complementary parts: - some information as complete and accessible as possible on clinical research - a directory of ongoing clinical research. This directory is available to academic/hospital sponsors as well as industrial sponsors By the beginning of August 2010, three months after its launch combine with a national public communication campaign and a support of social networking websites, “notre-recherche-clinique.fr” had welcomed almost 40 000 web visitors and helped several clinical trials to be concluded.
The session will present the landscape of university hospitals in Belgium. It will highlight the specific missions of these hospitals, with a suitable financing.
Emphasis will be placed on quality management as well as on an experience of joint venture between a Belgian university hospital and a hospital in Kuwait.
Guy Durant General Manager, Cliniques Universitaires Saint-Luc
Brussels (Belgium)
Christian Bouffioux
Honorary Medical Director,
University Hospital Liège
, Belgium
"Adequacy or inadequacy of financing specific missions of University hospitals." University hospitals have 3 different missions:
* Medical care like other hospitals but with heavier pathologies
* Education and training of future doctors and specialists
* Medical research, basic and applied.
The way the latter two missions are financed is very unequal from a country
to another.
It is most often insufficient to fulfil the goals.
The presentation analyses the situation in this respect, in different
countries.
Johan Kips
Chief Executive Officer, University Hospital KULeuven
Hospital accreditation from the perspective of a Belgian Academic Medical Center.
The Belgian health care system does not impose mandatory hospital accreditation. In this presentation, we explain why from our perspective as academic medical center, accreditation on a voluntary basis was felt to be an essential aspect in legitimising our mission. We also describe how we think that the attention to patient safety in a continuous quality improvement process, ought to be complemented by pathology specific quality of care improvement measures.
Democratization in South Africa has seen the opening up of State health care facilities to all in need. Nelson Mandela has expressed his desire to “put children first.” The State has correctly prioritized primary and secondary care which has inevitably been at the expense of Tertiary facilities. The Nelson Mandela Children’s Hospital will be one of two specialist children’s hospitals in South Africa. The hospital will house appropriate “centers of excellence” for children from the SADEC region.
HosPilot - Intelligent Energy Efficiency Control in Hospitals Hannu Puolijoki
Associate Professor & Medical Director
The Hospital District of South Ostrobothnia, Seinajoki, Finland
HosPilot is a project which is focused on energy efficiency in hospitals. It is initiated by EU (contract no. 238933) and involves 11 partners (of which 3 hospitals) from 5 European countries. The project belongs to ICT Policy Support Programme. The main goal of the project is to develop a methodology for creating an energy efficient hospitals. The HosPilot methodology will be able to provide a hardware description for an energy efficient system for any hospital, based on specific requirements of that hospital.
This will be a unique methodology, which considers energy efficient installations in all the domains (lighting, HVAC, ICT…) and it will be made combining the expert knowledge of all the partners in the project. It will also define a standardised method for auditing a hospital, in order to obtain the most relevant data, for the methodology to be applied to this particular hospital. The HosPilot project takes into account the full set of requirements and will put its emphasis on the building, its surroundings and its usage. We do this by combining the expert knowledge of construction builders, system suppliers and the requirements of end users, i.e. patients, staff and visitors. Of-the-shelf technologies are integrated into one system to implement the energy saving service, meaning that its holistic approach to lighting, HVAC, monitoring and ICT systems makes a real novelty. The methodology will be proven by creating 3 pilot sites in the partner hospitals and monitoring those pilots in the period of one year. In this process, the methodology will be improved further. Also, it will be safeguarded that the HosPilot methodology is applicable everywhere in Europe. Applied to any hospital it will give results based on the particular needs of this hospital. In this paper the HosPilot project and results achieved so far will be presented.
Modern advances and challenges in neuropathology: King’s College Hospital (London) experience
Summary of presentation:
“Health Records in Digital Age: Managing Knowledge Meaningfully with ICD-11 in Hospitals”
Health information management is essential in monitoring and evaluation of efficacy, safety, quality in all interventions made in hospitals. If health information is managed in a systematic and standard way, it provides immense opportunities to evaluate to measure outcomes, and assist us in making decisions, share knowledge and manage resources. How do we organize health information, how do we create architectures to capture information in useful and user-friendly ways? How can we exchange knowledge meaningfully?
Today health information has become extremely complex spanning an immense universe from genes to clinical manifestations to population level indicators. How can we ensure comparable and consistent data across health information systems? Such humongous information can only be handled through computerized systems that can integrate multiple aspects of health information. Human beings can certainly design these systems collectively to represent knowledge in a meaningful way so that everyone (including patients and all hospital workers) could use, contribute, develop and sustain such health information systems.
If we can use smart systems to represent "concepts" (knowledge entities) we can then build systems to understand data, search data and make statistical indices on communities. Similar systems successfully exist in electronic banking, electronic trade or weather monitoring and others. Health information systems are next to follow this path at this global digital age. WHO is committed to create ICD-11 as a global health information standard to enable meaningful knowledge exchange in hospitals. Conclusions:
• Development of Health Information Systems is the most critical issue in Health Care today
• Development of ICD-11 is essential for creating a common standard with to serve the information needs in hospitals to record mortality, morbidity, safety, quality and efficacy.
• Hospital Information Managers can work together with WHO in building ICD-11 and testing it for reliability, utility to make it fit for their purpose.
Canada has been recognized as a leader in providing universal health care to its citizens, but has been criticized internationally, particularly on issues of access, despite having invested heavily in a wait-times program over the past 5 years. This session will address what a country should/can/must do to re-energize and sustain its universal health program, in the face un seemingly uncontrollable rising costs, yet a strong Canadian value that insists on health care for all.
Pamela C. Fralick
President & CEO, Canadian Healthcare Association (CHA)
Health care in Canada is a $192 billion enterprise with an increasing appetite – one that some say Canada cannot afford. What are the cost drivers in Canada’s health system? What are the options to improve health care delivery? How do we achieve better care and health outcomes without breaking the bank? How do we get better value, more appropriate care, increased patient satisfaction and better management of our public system? Stay tuned for the answers!
Danielle Frechette
Director, Office of Health Policy, Royal College of Physicians and Surgeons
Old and new ideas to sustain universal healthcare: pitfalls and missed opportunities
Universal healthcare defines Canada as a nation. With soaring expenditures, many fear the system’s sustainability is in peril. Much ink and many tears have been spilled about privatization as a solution. Have we missed an important piece in our privatization discussions? While we must challenge the status quo and do better with what we have, why not also look at reducing preventable use? Can this easily be done? Is it worth the effort? Stay tuned.
Hugh MacLeod
President and CEO, Canadian Patient Safety Institute (CPSI)
Healthcare delivery in Canada gives rise to a dynamic set of patient safety priorities, policies, and opportunities. The Canadian patient Safety Institute does not own the delivery system. We do however have a mandate of safe care….accepting no less. We can achieve this because the system’s priorities are our priorities. We know that if we take the time to ASK. LISTEN. TALK– we are able to work with our partners and continually reassess our initiatives in order to streamline our efforts to maximizing impact.
The percent of GDP that Canada spends on health care is predicted to rise from 12% to 19% by 2031. Bridgepoint Health, a publically funded hospital, primary care and research organization in Toronto, is focusing on chronic disease and complexity to improve value and outcomes and bend the cost curve that is threatening Canada’s highly prized public system. The relevance of this work for health systems everywhere will be discussed
Summary of Presentation
How can we combine human caring with new technologies, in order to provide better health care and reduce the growing burden on the health care system - maybe even work smarter? The University Hospital of North Norway (UNN) have a fully digitalized patient record and also uses telemedicine to provide health care services in its sparsely populated area. This session will present how such practices can be implemented as well demonstrate the factors that need to be considered in organizing such services.
Erik K. Normann
Director,
The Norwegian Directorate of Health, Department of Hospital Services
President, Norwegian Hospital and Health Service Association (NSH)
Susann Baeckstroem
Manager of clinical systems, Norwegian Centre for Telemedicine (NST)
Electronic patients records - the virtual hospital
Digitalized patient records and patient administrative tools represent new possibilities in clinical work. They also have great impact on how work is performed and organized. But they are also important when it comes to managing clinical services, as they make a virtual hospital that is a parallel to the “physical hospital". Thus, managing clinical services is also managing a virtual hospital. What are the implications to this?
Astrid Buvik
MD , Orthopedic surgery department, University Hospital of North Norway (UNN)
Decentralized orthopedic consultations
Reduction of patient travel cost will have great impact on hospital economy, and UNN has much focus on finding new ways of health care delivery in such a sparsely populated area. Does orthopedic consultations done by telemedicine give the same results as ordinary consultations in the out- patient clinic? This is one of the questions asked in Buviks Ph.d study, and an important question to ask before new services are put into routine.
Markus Rumpsfeld
Ph.D, MD, Director for Division of Internal Medicine, University Hospital of North Norway
Gains and losses with telemedicine consultations Consultations by telemedicine represents a new way of performing in health care. This makes it important to focus on how this tool is working; what are the strengths and weaknesses to it. What considerations must be done to compensate the fact that the patient is not physically present? This way of working challenges the traditional doctor’s role, and might be seen as a threat of the professionals. This represents another challenge in establishing such services.
8
Retaining High Quality of Care through the New breed of Medical Graduates
Saudi Arabia Chapter Salem Malik
Advisor and General Supervisor of International Affairs
Ministry of Higher Education Abdullah Al Shammery
Chairman Saudi Board in Advanced Restorative Dentistry,
Rector , Riyadh Colleges of Dentistry & Pharmacy
The Canadian accreditation program was implemented in four hospitals in the Middle East over a period of 22 – 34 months. The compliance with the ethical criteria was evaluated at the time of the readiness or baseline assessment and compared to the results of the survey, and differences were measured. Significant improvements were achieved including formation of an ethics committee, development of policies and procedures, increased education and training to staff around ethics, and development of a code of ethics.
Globalization is creating an extraordinary transformation to the delivery, financing and access of healthcare. Improving standards of treatment, based on higher international standards and the offering of far more affordable services, is positioning Egypt as a viable participant in a global healthcare system. It is important to understand Egypt’s evolving transformation into a medical service destination so policymakers may understand the emerging ethical concerns this evolution may impose on this third-world and traditionally underserved population.
Recognition of Medical Ethics Education in Hospital Staffs Ran-Chou Chen
M.D., Associate Professor, Dept of Biomedical Imaging & Radiological Sciences
National Yang-Ming University (Taiwan)
Director , Taipei City Hospital , Heping Fuyou Branch
Ethical Framework for Delivery of Excellence in Nursing Services Craig Luzinski
Director, Magnet Recognition Program, American Nurses Credentialing Center
