What’s up, Doc?: Delivering Service Excellence in Health Industry

What’s up, Doc?: Delivering Service Excellence in Health Industry June 22, 2012; 6 – 9 pm Ateneo Professional Schools AuditoriumRockwell, Makati MBA students from all the programs of Ateneo Medical students from Ateneo School of Medicine and Public Health

What’s up, Doc?: Delivering Service Excellence in Health Industry What’s up, Dr. Rey Joson? What are your thoughts, perceptions, opinions and recommendations (TPORs) on delivering service excellence in the health industry in the Philippines with focus on hospitals? MBA students from all the programs of Ateneo Medical students from Ateneo School of Medicine and Public Health

ROJ’s TPORs on Delivering Service Excellence in Health Industry with Focus on Hospitals Outline of Presentation • When does one say there is service excellence in the health industry? • When does one say there is service excellence in the hospital industry / in hospitals? • .……….. • ………...

ROJ’s TPORs on Delivering Service Excellence in Health Industry with Focus on Hospitals Outline of Presentation • .……….. • ………... • What are some recommended strategies for delivering service excellence in hospitals? • What are the most difficult (outstanding) challenges in delivering service excellence in hospitals?

ROJ’s TPORs on Delivering Service Excellence in Health Industry with Focus on Hospitals

Q1. When does one say that the health industry in the Philippines is delivering service excellence? The health or medical industry - a sector within the economic system that provides services and goods to people with health concerns.

Q1. When does one say that the health industry in the Philippines is delivering service excellence? Health or medical industry – a conglomeration of • regulatory bodies and offices on health programs, goods, and services; • health care facilities; • health care products and their manufacturers and sellers; • health care practitioners and providers; • health care insurances; • health and medical educational and research institutions; • other activities associated with human health.

Q1. When does one say that the health industry in the Philippines is delivering service excellence? Just like any other industry, health or medical industry is expected to deliver, in a collective effort, excellent services and products to the community. Question: what criteria and indicators do we use?

Q1. When does one say that the health industry in the Philippines is delivering service excellence? Look at Health care outcomes of catchment community – Philippines, a province, a city, etc.

Q1. When does one say that the health industry in the Philippines is delivering service excellence? Look at Health care outcomes of catchment community – Philippines, a province, a city, etc. Are the set and agreed indicators being achieved or not? If yes, EXCELLENT! If no, NOT or “NOT SO” excellent!

Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent? Excellent hospitals contribute to the achievement of targeted health outcomes in catchment community. National / Local Government Health Departments Catchment Community Hospital Targeted Health Care Outcomes Life span Infant mortality rate Maternal mortality rate Control of specific diseases Quality of life Access to health care Others Programs for targeted health care outcomes

Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent? Excellent hospitals provide value-based health services (inclusive of cost-effective-efficient, quality and safe services). Value-based medicine (Porter & Teisberg) Evidence-based medicine Quality and safe medicine Cost-effective-efficient medicine

Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent? • Value-based Medicine or Health Services • Value created for and appreciated by patients served and for services rendered. • Value = health outcomes achieved per peso spent, not just access, convenience, volume, and cost containments.

Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent? • Value-based Medicine or Health Services • Good health care outcomes (good results) on community and individual patient indices • Quality and safe services • Reasonable costs and expenses

Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent? ROJoson’s Survey on Excellent Hospital (2010) [141 Hospital Administrators; Physicians; Non-physician Health Care Providers; Patient-clients]

Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent? Excellent hospitals are those that are managed to be sustainable while providing excellent services. A hospital is sustainable if it has the ability to continue to achieve its operating objectives and fulfill its mission over the long term and is resilient over time!

ROJ TPORs on Sustainability of a Hospital Financial Sustainability • Indicators: • Constantly positive net income • Constantly adequate liquid asset • Constantly manageable debt burden Management Practice Sustainability • Indicators (COMPLIANT): • Baldrige Health Care Criteria for Performance Excellence • Quality and safe patient care standards • Investors in People

ROJ TPORs on Sustainability of a Hospital

Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent? Excellent hospitals contribute to the achievement of targeted health outcomes in catchment community. Excellent hospitals provide value-based health services (inclusive of cost-effective-efficient, quality and safe services). Excellent hospitals are those that are managed to be sustainable while providing excellent services.

Q3. What are some recommended strategies in delivering service excellence in hospitals? • Strategic Framework: • Set 3 key indicators of an excellent hospital as goals. • Design and develop hospital performance excellence program. • Get committed support of top management and staff. • ……… • ……… • ………

Q3. What are some recommended strategies in delivering service excellence in hospitals? • Strategic Framework: • ………. • ………. • ………. • Implement program perseverently. • Evaluate results of implementation. • Continually improve program until 3 key indicators of performance excellence are achieved to the highest degree.

Q3. What are some recommended strategies in delivering service excellence in hospitals?

Baldrige Health Care Criteria for Performance Excellence US-based standard designed to help hospitals use an integrated approach to organizational performance management that can result to: • Delivery of ever-improving value to patients and other customers, contributing to improved health care quality • Improvement of overall organizational effectiveness and capabilities as a health care provider Questions and guides on how to achieve performance excellence for hospitals

Comparison of Patient-care Standards

Investors in People Standards Business improvement tool designed to advance an organization's performance through its people!

Balanced Scorecard Blueprint formulated by organization to be used as a guide and reference for • implementation of strategies and tactical objectives • monitoring • evaluation of actions taken Management strategic tool as well as performance measurement system

Balanced Scorecard Popularized by Kaplan and Norton in 1990 Scorecard with four perspectives: • Financial • Customer • Process • Learning growth

MDH BSC What is the template being used in MDH BSC?

Balanced Scorecard (Sample) Vision: Leading center of excellence and wellness in the Philippines providing holistic quality patient care

History of MDH BSC (2004-2011) Outcome All departments have BSCs cascaded from hospital BSC! Has been useful in serving as - communication - alignment - collaboration - monitoring - evaluation tool in the implementation of strategic direction in Manila Doctors Hospital.

Q4. What are the most difficult (outstanding) challenges in delivering service excellence in hospitals?

Alignment, Integration, Coordination and Collaboration (Teamwork) Alignment of Players, Processes and Systems Goals and Objectives of Health Industry Hospital Integration of Processes and Systems Coordination and Collaboration of Players

Q4. What are the most difficult (outstanding) challenges in delivering service excellence in hospitals? Most difficult challenge – how to manage the people with different mindset and behavior, particularly in the face of a paradigm shift (community health outcomes targets, value- based delivery system, and corporate social responsibility)

Q4. What are the most difficult (outstanding) challenges in delivering service excellence in hospitals? • ROJ’s Recommendations to meet the challenges: • Facilitating strategies – Standards, IiP, and BSC • Leadership – direction, motivation, commitment, innovation, etc. • Managership – technical competence in planning, implementing and evaluating • Communication – clear and closed-loop communication • Education – mentoring and coaching of all concerned

ROJ’s TPOR on Hospital’s Medical Tourism Program • A hospital can have a medical tourism program as long as it does not forget its primary responsibility to its nearby society or its catchment community.

ROJ’s TPOR on Hospital’s Medical Tourism Program • A hospital • excellent based on the 3 key criteria • compliant with • Baldrige Health Care Criteria for Performance Excellence • international patient-care standards (JCI or ACI) • PhilHealth Benchbook • Attract international patient-clients to its premises • part of the medical tourism program • foreigners who got sick while visiting the Philippines as tourists

Integrated Value-based Health Services (2012-2014) Baldrige Heath Care Criteria for Performance Excellence Social Vision Accreditation Canada International ISO 9001:2000 /8 Balanced Scorecard V-M CSR Mission Investors in People PhilHealth Benchbook Center of Excellence 1999 2004 2005 2007 2009 2010 2011 2012 MDH Journey towards Excellence

Summary and Closing

Q2. When does one say that a hospital is delivering service excellence? What makes a hospital excellent? Excellent hospitals contribute to the achievement of targeted health outcomes in catchment community. Excellent hospitals provide value-based health services (inclusive of cost-effective-efficient, quality and safe services). Excellent hospitals are those that are managed to be sustainable while providing excellent services.

Why deliver excellent service in health industry? Obligation Health industry and its components owe it to the clients they have decided to serve! Clients = communities with families and individual citizens therein. They should do what is right for their clients.

What’s up, Doc?: Delivering Service Excellence in Health Industry