708 posters, 8 topics, 16 sessions, 1,190 authors, 600 institutions

ISQua's 39th International Conference 2023

August 27 - 30, 2023 | Seoul, Republic of Korea

ISQUA2023-ABS-2261

ENSURE SAFER SYSTEMS: SINGAPORE’S PUBLIC HEALTHCARE INSTITUTIONS’ ZERO HARM JOURNEY BEYOND ACCREDITATION

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Poster Presenter

Yuchan CHEN

Authors

Yuchan CHEN, Melissa Mei-Hsia CHAN, Oviliani WIJAYANTI, Mun Foong KOK, Albert TY

Affiliations

Ministry of Health, Singapore, Joint Commission International

Part of Topic

Patient Safety & Quality Improvement

Ensure Safer Systems: Singapore’s Public Healthcare Institutions’ Zero Harm Journey Beyond Accreditation

Yuchan CHEN1, Melissa Mei-Hsia CHAN1, Oviliani WIJAYANTI2, KOK Mun Foong1, Albert TY1

1Clinical Quality, Performance and Value Division, Ministry of Health, Singapore

2Joint Commission International

Introduction & Objectives

Singapore’s healthcare system prides itself with delivering world-class services resulting in health outcomes that are comparable to OECD countries. Extensive accreditation experience under the Joint Commission International (JCI) and greater local expertise and capabilities served as an impetus to develop a Singapore-specific national high reliability strategy leveraging on the expertise of the JCI.

In 2021, MOH embarked on a five-year collaboration with the JCI through the Joint Commission Center for Transforming Healthcare to develop a systematic approach to raise capabilities to allow for sustainable and credible self-assessment anchored on the principles of high reliability and quality improvement.

Referred to as the Ensure Safer Systems (ESS) programme, the collaboration aimed at (a) institutionalising core principles of leadership and safety culture across the system, (b) developing and implementing a Singapore contextualised performance standard manual and evaluation system, (c) training a cadre of quality leaders, (d) providing ongoing support from JCI experts to support organisations in evaluating gaps, prioritising most critical issues, and continually improving quality care and patient safety.

Method & Results

ESS was conceptualised and implemented as a multi-phased effort with the participation of public healthcare institutions covering the following six workstreams:

1.Developing a core infrastructure for oversight and governance

2. Developing Singapore-contextualised standards for hospitals, ambulatory care centres, and primary care centres

3.Developing a customised performance evaluation system including baseline assessments, ongoing coaching for self-assessments, and prioritised action planning for each institution to focus continuous improvement efforts

4.Capability building, including change management, through training, coaching, and provision of ongoing improvement expertise

5.Developing measures for success

6.Creating Whole-of-System Enablers for participating institutions

Preliminary feedback from 5 hospitals on their baseline assessment experience**: Leadership and staff perception have been positive. ESS was viewed as a less stressful and more effective approach to building trust, open communications and teamwork to create an engaging learning experience to improve quality of care and patient safety.

Insights obtained from the first 2 years:

•Co-development with partners allowed for shared ownership and improved buy-in.

•Hospital leadership commitment to high quality self-assessments and meaningful change via continuous education, training and collaborations is essential.

Conclusion

Ensure Safer Systems is the Singapore Ministry of Health’s developmental journey with public healthcare institutions towards empowering and advocating for patients and staff in a culturally safe environment (non-punitive) to improve quality of care provided by public healthcare institutions.

The adoption of internationally recognised standards that is contextualised to the local setting and greater involvement of stakeholders in its development has the potential to foster greater ownership and sustained active participation by Singapore healthcare institutions.