Accreditation Journey in Sri Lanka
Establishing standards in healthcare quality and safety toward accreditation is a key strategy of National Policy on Healthcare Quality and Safety in Sri Lanka. The basic objective of accreditation is to ensure that areas of critical importance to the delivery of quality health services are evaluated by appropriate methods and methods are developed to confirm their efficacy, validity and reliability.
The process have been initiated in year 2015, resource person from Australian Council on Healthcare Standards (ACHS) visited Sri Lanka and has had several interactions among relevant stakeholders.
Activities Conducted with the Collaboration of ACHS
- Consultative Meeting to Establish Healthcare Accreditation System conducted on 05th of May 2015 with the participation of Dr. P.G.Mahipala the Director General of Health Services (Former) and Dr. Desmond Yen (Executive Director, International Business, Australian Council on Healthcare Standards-ACHS). The discussion was mainly based on setting up of National council for accreditation and how to make it an independent body based on importance of setting up a National council for accreditation.
- A workshop for the professionals on Accreditation Standards Development for healthcare services in Sri Lanka was held on 13th, 14th and 15th of September 2016 at BMICH. The program was organized by the Directorate of Healthcare Quality and Safety. Areas for standards were identified and subcommittees were nominated to prepare local standards based on the ACHS standards.
- Surveyor Induction Workshop was conducted by ACHS on 4th to 8th of June 2018. There were 28participants and they were evaluated throughout the 5-day workshop to assess their knowledge on ACHS standards for hospital accreditation. At the end of the workshop 12 participants were selected as local trainee surveyors.
- Surveyor team from ACHS conducted gap analysis in six selected hospitals with participation of local trainee surveyors who selected from the Surveyor Induction workshop. The main aim of gap analysis was to provide initial education regarding the evaluation & quality improvement program to local trainee surveyors in preparation for a future accreditation survey.
- In addition to above activities, one day refresher training was conducted by Mr. Michael Giuliano for the selected six participants.
In 2019 the accreditation process was reviewed.
Future of Accreditation
Global Fund Proposal for Resilient and Sustainable Systems for Health (RSSH)/Debt 2 Health proposal
The Government of Sri Lanka received an offer of €20 million debt swap from the Government of Germany. The Ministry of Health in collaboration with the Global Fund has agreed to use the Debt2Health swap proceeds to further develop a resilient and sustainable systems for health. Accreditation activities were included into Debt2Health proposal
This project aims to upgrade the approach of the national quality assurance program to allow it to adopt a more systematic approach to improving quality, emphasizing the three diseases, TB, STI & AIDS and Malaria with interventions to support quality improvement in selected hospitals.
Project includes development of an HMIS-based quality monitoring system, upgrading quality management system, development of quality standards and training of healthcare staff in quality improvement.
Development of an HMIS-based, data driven quality monitoring system
- Revision and Standardization of the Quality Performance Evaluation Tool (QPET) for collection of quality metrics
- Development of additional HMIS module to collect and report quality improvement data from hospitals, including data for a hospital Quality Performance
- Evaluation Tool (QPET) to assess quality performance at different levels of hospitals (Divisional hospitals, Base Hospitals, District General Hospitals, Teaching Hospitals)
- Identification and development of new quality performance indicators that can be generated by the core HMIS to be used to generate and track quality at facility levels on a routine basis
- Design and distribution of an annual Healthcare Quality and Safety Bulletin to routinely report the new hospital-level quality data.
Restructure and upgrade the national healthcare quality management system
- Undertake and review a gap analysis of the National Quality and Safety Management System emphasizing issues pertaining to three diseases such as poor referral of indicated patients for diagnosis and inadequate implementation of infection control activities.
- Strengthening Quality Management Programmes at healthcare institutions through Quality Management Units to address gaps identified by the gap analysis.
- Conduct National Convention of Healthcare Quality & Safety annually to provide a forum to review quality issues, share best practices and to communicate new quality initiatives
- Leadership development programme for health managers as a training of trainers’ programme based on the priority areas for improvement (Short term fellowships/attachment to centres of quality excellence). 30 health managers will be trained
- Strengthening System Research and Innovations through clinical audits, operational research, and quality improvement projects.
Development of quality standards and assessment of need for accreditation for Hospitals
- Consultative meetings to develop standards for seven elements of quality improvement through technical assistance
- Piloting of standards in two selected hospitals in each level. (Altogether 10 hospitals)
- Refining of standards with seven workshops
- Capacity building (surveyor induction and mock training) to conduct baseline assessment in few selected hospitals
- Seek expertise to review the applicability of accreditation in Sri Lankan healthcare system and develop a road map and strategy for future efforts.
Strengthening training of critical healthcare staff categories
- Advocate to incorporate healthcare quality and safety module in basic training of healthcare professionals
- Conduct training needs assessment with respect to quality improvement in undergraduate curricula and Continuous Professional Development (CPD) for critical staff categories
- Development of a common training module for CPD for critical staff categories (in service training) (doctors, nurses and paramedical/ supplementary professions)
- Training of Trainers to teach the CPD module
- In-house training in Sri Lanka for 60 mid-level managers involved in healthcare quality to learn from global best practices with international experts acting as resource persons.
- Collaboration with SLMA (Sri Lanka Medical Association) and professional colleges to design and pilot CPD programmes on ‘Clinical Governance’ in all provinces over two years.
- Establish multi-disciplinary clinical societies at facility level to foster team working to improve quality
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