Benchbook

On Performance Improvement of Health Services

 

Philippine Health Insurance Corporation

Quality Assurance Research and Policy Development Group

2004

 

The Benchbook lays out basic concepts on the value of quality assurance in health care and how the accreditation process supports continuous quality improvement.

 

Francisco T. Duque, MD, MSc

President and CEO

PhilHealth

 

3 main parts:

 

Part I explains the context of PhilHealth’s paradigm shift from an accountability framework to that of continuous quality improvement.  It provides an overview and brief history of quality improvement from a global perspective.  It also highlights some of the milestone ideas in quality improvement in industries and how these were gradually appropriated for improving quality in health care.  Based on these trends, the PhilHealth developed Part II.

 

Part II contains the benchmark of performance improvement.  It lists seven major groups of standards, to wit:

 

  1. Patient Rights and Organizational Ethics
  2. Patient Care
  3. Leadership and Management
  4. Human Resource Management
  5. Information Management
  6. Safe Practice and Environment
  7. Performance Improvement

 

Goals are set to serve as targets for improvement.  These goals are concretized by standards which delineate the best possible condition that should exist in the organization for it to attain quality performance. Finally, one or more criteria flesh out the standards.  These criteria lay down specific actions that need to be done to meet standards.

 

Part III deals with performance improvement.  Using as framework the Plan-Do-Check-Act cycle, it discusses a Total Quality Management approach to performance improvement.  Highlighting the need for documentation, evaluation and action in improvement efforts, Part III also tackles activities and tools needed to attain quality health care.

 

PhilHealth Benchbook  is essentially a Quality Assurance Framework

 

Assessment Focus Points

 

Dimensions of Quality Health Care

                        Safety

                        Effectiveness

                        Appropriateness

                        Consumer Participation

                        Accessibility

                        Efficiency

 

Cross-Dimensional Issues

                        Competence

                        Information Management

                        Continuity of Care

                        Evidence-based Medicine

                        Education and Training

                        Accreditation

 

Implementation of QA Framework

 

            Accreditation

            Clinical Practice Guidelines and Clinical Pathways

            Performance Measurement

 

Quality of Care Assessment

Structure Component

Process Component

Outcomes Component

 

 

Starting 2006, the PhilHealth BenchBook will be used as a basis for accreditation of hospitals!!!!!

 

See Part II – PhilHealth Quality Standards