Haramaya General Hospital

PROJECT TITLE፡ IMPROVING HEALTH SYSTEM EFFICIENCY IN

PROCUREMENT, HUMAN RESOURCE AND SUPPLY CHAIN

REGION: OROMIA
HEALTH FACILITY: HARAMAYA GENERAL HOSPITAL
PRP BY HARIF A(M.SC.)

DATE: JAN, 2023

haramaya general Hospital cluster 1st Q report prp by HA

Background of Haramaya General Hospital

❑Haramaya Hospital is found in East Hararghe;

Oromia National Regional state; 507Km from
Finfinne and 18 km from Harar town
• It is established in 2005 Ethiopia calendar.
• It was upgraded from health centre
❑Then in 2009 it was expanded to a zonal
hospital by the Regional Health Bureau.
haramaya general Hospital cluster 1st Q report prp by HA

Cont…

• Now the Hospital have more than 172 beds and

giving health service for two towns and four
districts for more than 1.4 million people and
also there is 27 Health centers in the catchment
and two lead health centre
• It has 340 employees; 186 health Professionals
and the rest supportive staff
haramaya general Hospital cluster 1st Q report prp by HA

Cont…
• On averages Daily 320-460 patients visit OPD
• It has specialty in psychiatry, eye, ART clinic, Youth
friendly service ,ophthalmic clinic, and TBL among
other services and also four referral clinic
• To promote quality service effectively the hospital has
fully utilized all health reform core processes, namely
BPR,BSC, HCF, HMIS/DHIS2/HPMI, EHSTG, SaLTS,
CaTCH-IT, HSTQ, IPD initiatives and EHAQ/EBC
Organization’s Mission, Vision, Scope of Service
• Mission
Haramaya General Hospital plays a basic role to reduce morbidity, mortality and disability and
improve the health status of Haramaya hospital catchment population through providing and
regulating a comprehensive package of preventive, promotive, rehabilitative and basic curative
health services via a decentralized and democratized health system.
• Vision
To see healthy, productive, and prosperous Haramaya Hospital catchment population
Problem statement (prioritized for improvement)

• Us we assessed in our hospital there is sources of inefficiency in procurement, human

resource for health and supply chain
Aim Statement
• The Aim of these project is to improving efficiency in health system in our Haramaya
General Hospital start from January 11, 2023 to Feb 28, 2024 for evidence based
decision making.
Methodologies of the project
Model for Improvement
What are we trying to accomplish?

What change can we make that will

result in improvement?
How will we know that a change
is an improvement?

Act Plan

Study Do
Fishbone Diagram
workforce
Inadequate
Shortage of clinicians Products and services
knowledge
& training of
workforce Shortage of pharmaceutical expenditure
Lack of resource
Absence of Low FTE of GP that spent with patient
Inappropriate payment systems

employee
of Shortage of hospital budget
$$
engagemen Source inefficiency in
t health system our hospital
Inappropriate hospital
size with services Poor communication Poor mgt, Rx and Dx
and poorly managed of disease
patient flow
Unnecessary admission and
unnecessary referrals to specialists
Poor infrastructure
Low bed density

Lack of equipment and Inapproppriate ALS and low BORs

inappropriate use of technology

Environment/technology/ Services delivery

Aim Primary Drivers Secondary Drivers Change Ideas
By what, by when What must be present to achieve our aim 1 What must be present to deliver each
driver

Turnover and Recruitment Increase staff motivation, Introducing

performance-based payments
Premium Pay Work Days Lost Due to
Injury or Illness Staffing Efficiency Use appropriate incentive, reward and
appraisal systems
Improve staff efficiency
Needs-based assessment and Raising workforce awareness and training
workforce
training; revise remuneration
policies; flexible contracts; Using work measurement and time
management techniques
performance-related pay
Improve quality of Develop and implement guidelines
Enhance monitoring and clinical
care and decrease medical error, clinical
improve hospital size, improve audit; improve continuity of care
undertake more clinical audits; monitor
admission/length of stay hospital performance
Use input-output data to plan, match managerial Modifying hospital size: selecting an efficient
capacity to size; raise occupancy size and
provide alternative care (e.g. day care); alter preventing hospital overdevelopmen
incentives to hospital providers; raise Improving workforce, equipment, and beds
Improve use of procedures, based on
knowledge about efficient admission practice evidence
investigations and
equipment
Modifying hospital budget structures and Improve
Reform incentive, revenue and regulation/governanc
payment structures (e.g. capitation)
management techniques and methods of
economic analysis

Improve use generic drug, rational Improve drug regulation and

quality control; carry out product Developing appropriate tariff and payment systems
use of drugs
testing Value of purchased drugs, Value of stocked drugs
Value of drugs supplied, Volume of consumption of
improve prescribing guidance, specific drug and Share of generics in market
information, training and develop
active purchasing; reduce -Use of cost analysis and DEA model and other efficiency
mark-ups, raise public awareness measurement
A flowchart for the selection of policy tools for improving allocative efficiency
Measures/Indicators
Aim Outcome measure Change Balancing
Process measures measures
state ideas
ment
Indicator Numerator Denominator

Indicator Improve .
worker
Improving efficiency of health care system in

productivity

Numerato Improve
quality of
r care

Denomin Improve
hospital
ator products and
services
our hospital

Data HMIS report,

register,
Source satisfaction
pation
P of PDSA
Aim Improving efficiency of health care system in our hospital

S What Process Measure Wher Who How(descripti When (time table ) Rema
No
(Change e(ser (responsible on how to rk
.
ideas) vice body) deliver Start date End date
area) activities
1 Improve Increase staff motivation, Harama ➢HR, QI team and ➢Attendance, survey Feb 1, 2023 Dec 30, 2023
prepare appropriate incentive, ya SMT and guideline
worker reward and appraisal system,
productivity prepare awareness and hospital
training, using work
measurement and time system

2 Improve Develop and implement Harama ❖QI team, SMT ❖CA, HMIS report, Feb 1, 2023 Dec 30, 2023
quality of care evidence based clinical care ya ❖# Beds, #modified
guideline, undertake more
clinical audits, monitoring , hospital room/unit
improve admission/length of
stay, modifying hospital size,
✓Pharm Dep’t, ✓Value of purchased Feb 1, 2023 Dec 30, 2023
3 Improve Improve pharmaceutical
expenditure, prepare drugs, stocked drugs,
hospital Finance, QI team,
appropriate payment system, drugs supplied,
products and improve, improve use of Rx and SMT consumption of specific
services Dx in imaging and Lab, improve drug and Share of
use in generic drug and rational generics in market,
drug use

4
P of PDSA…
Measurement Plan /data collection plan
AIM/Out Come Data source Data collection Time Responsible
Indicator (Where) method (how) (When) for
Improve efficiency HMIS report, Feb 1, 2023, to QI team, SMT
Haramaya G
of health care dec 30, 2023
Hospital Clinical Audit,
system in hospital survey, FGD,
observation,
Do
• Test your change ideas one at a time
• Use Run chart to monitor your QI project over time.
Study
• Describe the measured results and how they compared to the predictions and
baseline
Act
• Here describe what modifications to the plan will be made for the next cycle
from what you learned (Adapt, Adopt, Abandon)