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HEALTHCARE
COLLABORATIVE INTEGRATED HEALTHCARE DELIVERY SYSTEM
INTRODUCTION
This document presents a brief summary of the PATH SYSTEM project supported by American Medical Resources Foundation, Harvard Medical International (HMI) Volunteers, Beth Israel Deaconess Medical Center Volunteers, Family Van and Boston Globe News Agency, all based in the United States of America. Cameroonians in the Diaspora and Mbengwi District elites in Cameroon are also major participants of the project. The project targets a pilot provision of health facility in Mbengwi District through a collaborated integrated healthcare delivery system. Its pilot scheme will be the Acha-Tugi Presbyterian General Hospital and Healthcare Centers located in Mbengwi District, Momo Division in North West Province.
This presentation develops a brief historical background of the Acha-Tugi Presbyterian General Hospital, highlights the origin of the project, the difficulties of the healthcare delivery system of the hospital, the general and specific objectives of the project, exposes the different components and methodology for its implementation, the outcomes and challenges of the project, defines the roles of principal actors, develops a method for sustainability as well as presents the equipment available to startup the project.
BACKGROUND INFORMATION
HISTORICAL BACKGROUND OF ACHA – TUGI GENERAL HOSPITAL
This very famous health facility started in 1963 and was officially opened on the 15th February 1964 by Madame Germain Ahidjo, wife of the first President of Cameroon, El Alhadji Amadou Ahidjo. The first medical officer in charge was Dr Haaf and the first matron Sir Margrit Schmidt. It started with the name Basel Mission hospital and in 1968 took the present name. The first local staff of the hospital were Mr. Lucas Tasi and Mrs. Chamfor. The first Cameroonian to hold posts of responsibility were Mr. Tamon Christopher (1972 as Administrator), Mr. Lucas Tasi (1979 as Nursing Superintendent) and Dr Charles Pascal Tima (1984 as Medical Officer in charge). The hospital has 109 beds for inpatients, an outpatient department, ANC, MCH clinic and family planning clinic and a theater and technical department.
MAIN PROBLEMS OF THE HOSPITAL
- Poor roads
- Extreme poverty,
- High infant mortality rate
- High overall mortality rate
- High HIV / AIDS high rate,
- Insufficient trained medical staff,
- Insufficient # of qualified medical staff (Doctors, and nurses) to give care,
- Lack of medical equipment
- Lack of medication,
- Lack of hospital management and leadership,
- Lack of goals and plan for improving the situation,
- No standard protocols for patient care – patient tracking through the hospital at point of care,
- Lack of accountability
- Lack of patient management information systems
- Poor MR keeping
- Lack of assessment methodologies
- No mentoring, education and training programs
OBJECTIVES
GLOBAL OBJECTIVES
Improve the quality care and open access to healthcare services provided to patients at General Hospital Acha Tugi and Health Centers in Mbengwi District.
SPECIFIC OBJECTIVES
- Develop a paradigm shift to increase access to basic health care services at General Hospital Acha Tugi and Health Centers in Mbengwi District.
- Use Mobile outreach Clinics to service regions that have no formal medical care settings
- Provide accessible basic health care through treatment, prevention, screening and outreach education starting with HIV/AIDS, Tuberculosis, Pediatrics and child bearing mothers
- Replace obsolete 1964 medical equipment with refurbished or new equipment (mobile X-ray, wheel chairs, EKG, Microscope, Operating table, Operating lamp, emergency beds, stretchers etc)
- Provide basic consumables (syringes, gloves etc)
- Provide medications
- Provide in-service training and mentoring at Presbyterian General Hospital Acha Tugi (PGHAT)
- Provide an equipped medical van to overcome the challenges of poor roads, and poor communications' technology,
- Install a patient registration system, customized to meet the needs of patient management at PGHAT
- Create a canopy wireless intranet system to share patient information in a collaborative environment
11. Develop and implement a management and leadership strategy for Presbyterian General Hospital Acha Tugi in a collaborative and integrated healthcare delivery approach
12. Create an HIV/AIDS treatment Center at Presbyterian General Hospital Acha-Tugi
13. Create an NGO in Cameroon to manage the implementation of the project through a well defined accountable, leadership and management structure.
THE DIFFERENT COMPONENTS OF THE PROJECT
- HIV/AIDS education, prevention and treatment
- HIV/AIDS Treatment Center
- Prenatal, Pediatrics and care for child bearing mothers
- Tuberculosis
- Malaria
METHODOLOGY FOR ITS IMPLEMENTATION
- Implement a collaborative Integrated healthcare Delivery System by linking network of health centers to Acha-Tugi hospital
- Establish an information technology system using canopy repeaters to create an intranet for patient information sharing in a collaborative environment
- Use an outreach mobile van for patient education, screening for HIV/AIDS and general consultations
- Create an implementation team (Technology and an Administrative Teams) of volunteers
- Develop a solid and effective patient management strategy
- Appoint an Operation execution team of
- 1 Physician
- 4 Nurses
- 1 Administrative Assistant
- Create and Support the HIV/AIDS treatment Center
- Support outreach programs using mobile clinic (Protocols and Policies created)
- Provide on-going support, coaching, training and feedback for sustainability
THE OUTCOMES AND CHALLENGES OF THE PROJECT
Presbyterian General Hospital Acha-Tugi, Cameroon needs the following:
- Medical Equipment to replace the broken and obsolete equipment left by the Swiss and Germans since 1964.
- Medications
- Management expertise
- Training needs:
o Orientation
o Self Development Training
o On-Going Training and Development
o Delivery Training
o Internal Training
o External Training
o Outsourcing Training
o E-Learning
o Evaluation of Training
o Cost – Benefit Analysis
o Return on Investment (ROI)
o Benchmarking Training
o Evaluation Designs Training
DETAILED DESCRIPTION OF THE PROJECT
Project for Acha-Tugi Healthcare System represents a paradigm shift in the way we craft access to basic health care services for the Mbengwi District region of Cameroon. It is a collaborative integrated healthcare delivery system. The system is made of Acha-Tugi hospital, Health Centers in the Mbengwi District, and Mobile Outreach Clinics for servicing regions with no formal medical care settings. The system will provide accessible basic health care through treatment, prevention, screening and outreach education. It is a structure to collect, share, transfer, and store patient medical history for ongoing medical care in a team or cooperative environment. The challenges of poor roads, poor communications' technology, dilapidated buildings, inadequate management strategies, inadequate accountability, and limited assessment strategies, lack of equipment and medications, and limited trained medical staff create a complex structure for implementing effective patient care services. To develop a solution we will think ‘out of the box’, stretching knowledge boundaries from traditional medical care settings so that each solution for each challenge or around each challenge results in saved lives.
An implementation strategy, vision or roadmap for Mbengwi District will revolutionize a new way of assisting regions that have similar challenges. The methodology represents a cultural change to save lives. Let’s all be change agents by supporting the project.
MAIN OPERATIONAL ACTIVITIES
Provide critical diagnostic medical equipment, supplies and human resources and concentrate (preliminary) on:
- For example:
- HIV/AIDS: Education/Awareness/Prevention/Treatment
- TB
- Setup an HIV/AIDS treatment Center at Presbyterian General Hospital Acha-Tugi
- Pediatrics and child bearing mothers
- Malaria
- Human Resources Development
o Training/Orientation of Medical staff
o Mentoring
- Define strategy with foot soldiers
- Setup of IT Management system
- Build and sustain management team
STRATEGIC APPROACH ACTIVITIES FOR SUCCESS
- Understand the culture of the indigenes
- Create environment for motivation to change
- Recognize internal resistance of cultural change
- Facilitate the change with a reward system
- Design solutions with indigenes, but allow them to take ownership
- Create conditions to sustain the change
- Support, coach and provide feedback
- Establish a working relationship with the Government
- Empower the locals
- Create an NGO (PATH SYSTEM) with s solid management stricture to coordinate PATH
LONG TERM ACTIVITIES
- Patient consultations referral
- Real time medical services through conference or video conferencing
- Collaborative external medical care
- Patient monitoring
- E-medical education
- E-training
- Shared information technology
- Shared patient info management systems
- Health medical information transfer – x-rays, ekgs, lab interpretations
PROJECT LENGTH
- Create Change
- Sustain the Change
- Embed the Change as Culture
(- Based of Leadership Healthcare Management strategies
- Estimated time to create sustainability (1 – 6) years)
MONITORY INDICATORS
- Patient satisfaction surveys
- Employee Surveys
- Access and Quality Determinants
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