1. CAPACITY DEVELOPMENT CONSULTATION TO IMPROVE PATIENT SAFETY IN THE PACIFIC REGION

2.  MOH Fiji consist of :  3 Major Hospital  17 Sub divisional hospitals  81 Health centers  98 Nursing stations  2 Specialist hospitals Which provides health services to a population of ¾ million

3.  MOH Fiji has identified risk managers and infection control officers in each divisional and sub divisional levels.  Development of Risk Management/QI Policies to guide the Health System.  Development of Clinical Practices guidelines which acts as a guide to all clinicians  Development of Clinical Service Networks for each specialty  Identification of a project officer –Clinical Service Framework was also developed.  Development of nurse’s procedure manual to guide the nursing fraternity in Fiji.  Patient Satisfaction Surveys conducted quarterly to gauge the level of patient perception of our health service delivery  Waste Management policy developed and implemented with regular audits done

4.  Regular meeting of QI committees at respective health institutions to review implementations & recommendations and also to discuss strategies for improvements within the health care systems.  Clinical Audits on adherence to guidelines & policies in place is conducted quarterly in each divisional & sub-divisional hospitals by respective risk managers and infection control officers( emergency trolleys audits, Partogram, Patients satisfaction surveys (PSS)Waste Management audits  Clinical Services Network (National & speciality levels) - meets regularly to review and develop protocols/Standard Operating procedures (SOPs)/guidelines. Implementations of strategies are discussed further at the National Clinical Services Planning meeting quarterly  Clinical Practice Guidelines for Fiji

5.  A 28yr old Gravida 2 Para 0 was booked and had Antenatal Clinics in Navala. She was deemed low risk so was only referred to Lautoka when she became postdates. At this time it was decided to give her a few more days to go into spontaneous labor and she did. However, labor progressed slowly and eventually she was taken in for an Emergency Caesarian Section after a failed Ventoused. A few minutes after having spinal anesthesia she went into a systole but was successfully resuscitated. She however never fully recovered and despite intensive care she died several days later.

6.  A 24 yrs old lady was admitted for a routine hysterectomy. All pre op tests were normal and she seemed stable, however once under anesthesia she initially was tachycardic before being intubated. Soon after intubation she went into asystole and was resuscitated. Despite active management she repeatedly went into asystole requiring CPR several times. She was transferred to intensive care after surgery but never improved and eventually died.

7.  RESOURCE CHALLENGES- MOH budget constraints  CAPACITY BUILDING–human resource training and retentions.  Implementation,Monitoring & Evaluation  Skill mix – young workforce.  Increase patient load  Retrieval of patients from the maritime zones

8. THANK YOU