1. Rabab Diab, RN, MSN, CPHQ HCAC, Deputy CEO, Director of Education & Consultation MEDHEALTH Cairo 2014 Thursday, 13 March 2014 Human Resources: The Essential Ingredient for a Culture of Quality

2. Outline Introduction Healthcare Human Resources in Jordan Quality and Patient Safety Challenges Standards for Human Resources Management Competency based practice Conclusion

3. Outlines Introduction Healthcare Human Resources in Jordan Quality and Patient Safety Challenges Standards for Human Resources Management Competency based practice Conclusion

4. Research has been showing that human resources are very essential in developing and sustaining any quality practices in the health sector Most of literatures have showed the importance of human resources management on developing the quality of healthcare service (Yu, 2007; Michael, 2009; Patrick, 2011) Incentives and providing motivation and use system of bonuses by competencies improve the performance of individuals working in hospitals (McKinnies, 2011) Training courses for workers in the hospitals in the area of the dimensions of medical service quality, and to deepen the quality concept between the staff and to achieve the quality dimensions at the best degree (Diab, 2012). Perceived safety climate in the relationship of high performance human resources and organizational performance is confirmed. The finding suggests that organizational emphasis on safety issues contributes to establishing effective high performance human resources and driving organizational performance (Chan and Mak (2012))

5. Especially in developing countries or young health care systems, there are many challenges to having and retaining human resources that embrace quality Supply of trained Health Professionals in local market Insufficient and ineffective professional institutions No structured career guidance. Brain drain of skilled individuals. Inappropriate placement and distribution of work Lack of continuous capacity building No embracing of latest technologies Weak laws and regulations (and / or their enforcement) to ensure continuous medical education No real HUMAN RESOURCES systems – everything still is a personnel management world

6. Outlines Introduction Healthcare Human Resources in Jordan Quality and Patient Safety Challenges Standards for Human Resources Management Competency based practice Conclusion

7. Human Resources in Jordan have different strengths but face several challenges Strengths  Established graduate and post graduate education programs  Qualified Healthcare professionals  Good health out come indictors in terms of communicable diseases, infant and maternal health Challenges  Lack of leadership competency  Lack of established human resources management programs  Lack of regulations  No policies, procedures, clinical guidelines  Lack of credentialing and privileging system for medical staff  No relicensing system  No mandatory continuous education  No medical liability laws

8. Although the numbers in Jordan are relatively sustainable…. Nursing and Midwifery/10,000 Population 2005 – 2012 Pharmacists /10,000 Population 2005 – 2012

9. …Jordan still faces similar challenges for the retention of skilled and patient centered resources Lack of proactive measures No On The Job Training Programs Still no Compensation alignment: No Career Growth for Professionals No Competency based Pay Limited professional training institutes, Lack of uniform and Structured Programs No Licensing body, No accreditation and no affiliation of these programs

10. Outlines Introduction Healthcare Human Resources in Jordan Quality and Patient Safety Challenges Standards for Human Resources Management Competency based practice Conclusion

11.  chemical exposure  Lack of radiation safety  Absence of basic hygiene  Lack of privacy  No fire safety procedures and systems  Untrained staff on basic resuscitation  Lack of leadership competencies  Lack of medical staff management systems  Competency of healthcare providers  No documented policies, procedures, plans,  No clinical guidelines  Not in compliance with laws and regulations regarding fire safety, radiation safety, staff qualifications, and medication management processes.  Lack of qualified staff in quality management, risk management, and infection prevention and control  Reporting culture Additionally, Quality and Patient safety still faces many challenges in Jordan

12. 12 Developing standards Building Capacity But to address both challenges “quality issues and human resources challenges” Jordan adopted a two prong approach

13. Outlines Introduction Healthcare Human Resources in Jordan Quality and Patient Safety Challenges Standards for Human Resources Management Competency based practice Conclusion

14. 14  Each hospital leader’s job description identifies qualifications that include formal training and experience in health management.  Quality improvement, patient safety and risk management are part of that training.  The leaders have documented formal leadership training within the past two years. Accreditation standards support the provision of qualified personnel: Leadership! Leadership competencies Managing projects and programs Leading organiza tions Managin g self and people

15. 15  The quality improvement coordinator has knowledge in risk management methodologies.  The quality improvement coordinator completes continuing education activities at least annually to increase knowledge regarding current quality improvement practices and risk management The standards also require quality improvement coordinator who coordinates QI activities Quality Planning Quality Measurement Quality Improvement Manage Change

16. 16  The hospital has a risk management coordinator who meets the qualifications outlined in a job description, which includes: 1.Attendance in formal risk management training course or 2.Risk management certification The qualifications are met within one year of assuming the position of the risk management coordinator  The risk management coordinator completes continuing education activities at least annually to increase knowledge regarding current quality improvement practices and risk management.  The risk management coordinator participates in training staff on risk management measures. The standards require a qualified risk management coordinator who coordinates risk management Risk management process and program Safety culture Patient safety

17. 17  There is at least one qualified nurse, or professional in related field, who coordinates the infection prevention and control activities.  The IPC Preventionist is responsible for the surveillance, data gathering, aggregation and analysis of IPC data.  Infection prevention certification  The IPC Preventionist in the related field has knowledge in quality improvement and risk management methodologies.  The IPC Preventionist completes continuing education activities at least annually to increase knowledge regarding current ICP practices, quality, and risk management. And the standards also stipulate a qualified nurse, or professional to coordinate the infection prevention and control activities Microbiology Adult Learning Surveillance Quality Management Program manageme nt Risk management

18. 18 For example, the tailored certification courses introduce concepts of continuous education while ensuring applicability to the field practicum Portfolio assignmentsMentorship program Class room Training Each course consists of different modulesThe class room training ranges between 6 – 12 days Pre course Selection criteriaPre course readings and assessment Certification Complete Assignments Pass certification Exam Recertification every 2 years Recertification

19. 19 There are several opportunities in place for human resources development crucial to the quality journey Enabling Services Certification courses Workshops and Trainings Knowledge Transfer Not just academic, includes practical and hands on Rich yearly schedules Walkthroughs and 1 to 1 consulting, coaching and mentoring

20. Outlines Introduction Healthcare Human Resources in Jordan Quality and Patient Safety Challenges Standards for Human Resources Management Competency based practice Conclusion

21. 21  Individuals qualified to perform health care are defined in a policy, according to specific patient populations, e.g. emergency, pediatric, ICU.  Only those individuals permitted by license, certification and/or competency-based testing perform healthcare procedures.  Staff members demonstrate competency in managing patients within their area of work. Additionally, standards specify that at all times qualified individuals provide health care services in timely and efficient manner.

22. Additionally, in Jordan, we are trying to promote and push for competence based practice as it clearly supports quality improvement 22 Definition Competency- based practice (CBP) is that it focuses on the ability of healthcare provider to provide safe, consistent care to patients when their performance is measured against valid, reliable and objective evaluation criteria. Advantages  Establish recognition for the practice  Establish minimum standards in practice  Establish quality training programs  Establish criteria for evaluation of practice  Establish commitment to good practice

23. 23 Competency-based performance improvement frame work is a very straight forward and goal oriented approach feeding into quality improvement requirements Need analysis, assessment, and planning Competency model development Education modules planning Learning intervention design and development Evaluation Strategic goals, objectives, and business plans External environment Internal environment

24. 24 The concepts and methods for developing competency based framework are supportive of quality improvement practices Competency Assessment Competencies should be…  Ongoing  Systematic  Demonstrable ( capable of being demonstrated)  Improved  Addressing age-specific issues(if applicable) Competency Continuum Competencies should be assessed when An individual is hired During their orientation period to the position Throughout employment as the requirements of the job and needs of the organization change. Dynamic competencies should exist that address each period separately.

25. 25 CBP is continuum with ongoing work, and new education programs need to be developed to address development and changes in healthcare field. Ongoing Work  Ongoing competency assessment is NOT annual re-assessment of the initial competencies for the job.  Ongoing competency assessment is a dynamic process that is based on the ever-changing needs required to carry out the organization’s mission and goals.  Ongoing competencies will be different than the initial competencies identified for the job. Educational Program  New procedures  New equipment  Maintenance of current competencies  Improve Performance

26. Outlines Introduction Healthcare Human Resources in Jordan Quality and Patient Safety Challenges Standards for Human Resources Management Competency based practice Conclusion

27. 27 To address Human resources challenges, interventions need to be introduced on the organizations level, as well as changes in the policy level.  Human resources management is an integral part of quality culture  Established continuous education programs and certification courses one of the key elements in addressing human resources challenges  Advocate for changes in laws, regulations that mandate continuous education to maintain licenses Policy Change Post Graduate Citification Courses Established Education Programs based on CBP Human Resources Management Programs

28. 28 Questions and Comments 28

29. 29 Thank You