During 2018, Project KSV/017 supported the General Hospitals of Gjilan and Prizren in introducing quality improvement tools in selected departments. A series of workshops with the clinical and administrative staff of the hospitals introduced them to the basic principles of quality management and enabled them to apply what they learned. There were two main directions of work. The first was the development of standards of operations and related documents for the most common clinical procedures in selected departments of both hospitals. Gjilan Hospital developed the material for stroke, heart insufficiency and chronic obstructive pulmonary disease. Prizren Hospital addressed appendectomy, cholecystectomy and abdominal hernia repair. The second direction involved working groups engaged in the development of regulations that defined the structural aspects of quality standards for each hospital.
With the assistance of KSV/017, the Gjilan Hospital team produced following documents:
Scope of services for internal medicine department; Medical equipment policy; Assessment of patient condition; Nursing plan; Discharge planning process; Medical history; Physical examination.
Prizren Hospital team developed following documents:
Scope of services for the surgery department; Medical equipment policy; Operating room register and equipment checklist; Anesthesia procedures; Regulation of sterilization and disinfection.
It was an intensive process of learning, information sharing and brainstorming. Normally, the technical team of KSV/017 would work with individual hospital teams until the products were in their advanced form. This time, however, the use of shared workshops enabled both hospitals to learn from and exchange with each other. This provided an opportunity for reviewing and fine tuning all products being developed, including the standards of operation and the regulations that defined quality standards.
At the beginning, Project support was primarily focused on the development of the staff’s capacities in both hospitals. The first improvements and changes of practices are now visible. Tens of staff in both hospitals have benefited from the development of quality standards related to practice or to structural aspects of quality assurance. The level of their participation and individual contribution to the development of each quality instrument is a testimony to the impact of the project on their professional capacity. Staff from both hospitals have lead the efforts, reviewed the materials, came up with better ideas and worked collaboratively. At practice level, the signs of change are visible, with the alignment of care provision to new quality standards. Gjilian has implemented the systematic use of spirometry for diagnosis of chronic obstructive pulmonary disease. The nurses are more prepared and better informed, providing better care and sharing more information with patients especially in the Coronary Department. In the Neurology Department there is now a clear drive to reshape the outlook of the facility.
In Prizren, medical staff has harmonised their procedures in surgical care. The amount of variation of practice among specialists in the performance of appendectomy, cholecystectomy and hernia repair has started to diminish as they follow the standards of operation. Both hospitals, after an initial quality standards assessment by the KSV/017 team, have generated ideas and discussed a course of actions that will address existing bottlenecks in the provision of healthcare in their respective hospitals. With a strong support of the Ministry of Health and Kosovo Hospital University Clinical Services (KHUCS), the Project will pursue the goal of supporting secondary healthcare institutions in the improvement of quality of healthcare provision. It’s hoped that the processes used and results obtained will serve as model for other secondary hospitals.
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