Health service quality has always been high on Sarawak Health Department’s management agenda resulting in the introduction of various quality improvement initiatives, especially over the last two decades. One of the first initiatives adopted in 1984 was the use of Quality Control Circles (QCC) to solve work-related problems through staff participation. QC Circles are now an integral part of Sarawak Health Department’s quality improvement programme and annual QCC Conventions have been held since 1985 to provide a venue for QCC members to share their achievements.
In addition, Sarawak Health Department also implements other quality-related policies and strategies initiated by the Malaysian Ministry of Health and the Prime Minister’s Department. These include Quality Assurance, Hospital Accreditation and MS ISO9000 certification. So far, Sibu Hospital, Miri Hospital, Bintulu Hospital and Serian Hospital have been accredited, while the Sarawak State Health Office, Sri Aman Divisional Health Office, Dental Specialist Clinic in Sarawak General Hospital and Divisional Health Offices in Kuching, Sri Aman, Sibu, Miri, Sarikei, Samarahan and Bintulu have received MS ISO 9001:2000 certification. The other hospitals and institutions are still in the process of preparing for certification or accreditation.
The Quality Assurance Program was launched by the Ministry of Health, Malaysia in 1985. It was envisioned as one of the many approaches to measure quality of the service provided by the Ministry of Health, to be monitored nationally but investigated locally with subsequent corrective actions. In 1986, it was implemented at a few selected hospitals and by 1987 QAP was extended to all government hospitals. The Public Health Programme namely the Maternal & Child Health Section, Food Quality Control Section, Control of Communicable Diseases Unit together with Pharmacy programme started QAP in 1989. The training schools started in 1993 followed by the Dental programme in 1994.
The Medical Care Programme monitored a total of 19 quality assurance indicators from 1985 to 2000. Since 2001, this was revised to 53 indicators, which were developed by the health care professionals themselves. It included some new indicators addressing the areas of concern covering the 6 dimensions of service quality i.e. equitable access, effective, efficient, safe, appropriate and consumer-centered service.
The Dental Programme monitored 7 indicators in 1994. This was modified to 4 indicators in 2007, addressing areas of concern such as the percentage of repeat posterior fillings, percentage of primary and secondary school children rendered "orally fit", percentage of 16 year old school children free from periodontal disease, gingivitis.
Apart from the National Indicator Approach and Hospital/Health Specific Approach to Quality Assurance, the Ministry of health has implemented many more Quality Initiatives such as
Peri-operative Mortality Review
Mortality Reviews (Maternal and Peri-natal)
Clinica Practice Guidelines
National Nursing Audit
National Audit on Adult ICU(NAICU)
Quality Control Circles
Total Quality Management
Development Administration Circulars
Key Performance Indicators (KPI)
The State Health Department convenes a Q convention annually where there is an oral competition for the best QCC Project and Poster exhibition or competition for Quality Assurance, Innovations and other Q initiatives such as Research and Quality Service projects. In 2004 the convention was held in Miri with the theme “Enhancing Competency through Continuous Improvement”. In 2005 the host was Sibu, in 2006 the host was Mukah and in 2007, the Q Convention was hosted by the State Health Office. The Convention is an avenue for staff who have been actively involved in Quality Initiatives to come together to showcase their projects, share knowledge and as a learning experience to promote a Quality culture amongst the department.
The Sarawak Health Department has won several State and National Awards for its quality initiatives.
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