strengthening specialized clinical services in the pacific
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Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Overview of presentation
• Background info abut SSCSiP• What SSCSiP is about• Activities in the Northern Pacific• Regionalism lens • Lessons learnt • Way forward
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Project Scope
• Level of clinical support beyond that of the primary health care worker
Examples: surgery, internal medicine, paediatrics, anaesthetics and trauma/critical care, obstetrics and
gynaecology.• The personnel providing specialised clinical
services - medical specialists, nursing officers, biomedical technicians, radiographers etc
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Service delivery modalities
• Offshore referrals
• In-country through visiting teams
• In-country though local specialists
Issues• cost-effective and equitable -
agreed medical and equity guidelines); patient outcomes
• Planning (Not Demand driven, no objective needs analysis, poor hosting, lack of coordination) evaluation of patient outcomes; adjunct services
• Lack of skill/knowledge transfer from visiting specialist to local clinicians.
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Example of Regionalism
PICs identifying a common issue of concern
PICs identifying a common issue of concern
PICs & Development partners coming together to discuss identify a solution – SCS Project
PICs & Development partners coming together to discuss identify a solution – SCS Project
Project design reviewed & endorsed by MoH, and Pacific Island Ministers Meeting
Project design reviewed & endorsed by MoH, and Pacific Island Ministers Meeting
Australian Government Funding
FNU as implementing agency
Australian Government Funding
FNU as implementing agency
SSCSiP ProjectSSCSiP Project
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Coverage
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
SSCSiP Team • Secretariat (Based at FNU – Fiji Islands)
– Dean, PM manager, Health planner, M&E coord, Project coord, Biomed engineer, clinical advisors
• Budget of 1.2 Million AUD p.a• Next phase June 2012 – Dec 2014
– Planning, managing and evaluating SCS (VT, OR)– Information system for SCS (OR, VT, patient
outcomes)– HRH planning and capacity development (SCS)– Responding to urgent needs (VT, locums)
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
SSCSiP Governance• Secretaries/CEO of MoH and Directors of clinical services from 14 PICs• Annual meeting
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Achievements to date
• Started in June 2011 (11 mo old) • Collection of Baseline data
– SA of SCS, Mapping of Clinician’s profiles, Mapping of biomedical services capacity, Costing studies
• Planning workshops (Palau, FSM & RMI)– ToR for visiting teams, preparedness checklists,
evaluation of visiting teams, offshore referral policies
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Achievements
• Supported capacity building initiatives for clinicians & nurses (gastroenterology – FSM)
• Responded to urgent needs:– Locums (Palau) – pediatrician & obstetrician – Biomed equip maintenance (Palau & FSM)– Ophthalmology scholarship (FSM)
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Mapping of biomedical services capacity
1.Equipment Management
Policy and Procedures
Procurement
Inventory
Minimum Equipment Standards
Disposal of Old EquipmentDonated Equipment guidelinesNew Technology Assessment
2. National Repair Capacity
Service Contracts
MOH/Private Sector balance
MOH Engineers
MOH Senior Biomeds
MOH Biomeds
MOH Trainees
Succession Planning?Repair Facilities
Urgent Spare Parts procurement?Adequate Tools/Test Equipment
Work Recording Systems?
Management Reports?
Equipment Identification?
Biomedical Budget allocation?
3. Hospital Repair Capacity
Regular Preventive maintenance?Safety &Function Checks?
Check Due Date marking?
Job Documentation
Total Equipment Inventory?
Total Inventory Value?
Equipment waiting diagnosis?
Equipment waiting spares?
Equipment waiting disposal?
Service manual availability?
Specialised test equipment?
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Northern pacific situational analysis
1.Equipment Management Current Status
Palau Pohnpei Kosrae Yap Chuuk Majuro RMI
Policy and Procedures Policy Being Developed Procedures No
Being Developed Yes Yes No No
Procurement Contracts Yes Specs Yes
Contracts OK Specs Not OK
No Yes Contracts OK Specs Not OK
Contracts No Specs Not sure
Inventory Being Developed Being Developed No Yes HC’s No Hospitals Yes
Yes
Minimum Equipment Standards
Being Developed HC’s NoHospitals Not Sure
No No HC’s Yes Hospitals No
HC’s Yes Hospitals: Being Developed
Disposal of Old Equipment Not sure Yes No No Yes No
Donated Equipment guidelines
No Not Sure No No No No
New Technology Assessment
No Not Sure Not Sure No No No
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Country scores
Recruited a BME – work with PIC; coordinate BEMI BME; BMT training
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Total Dr (locals + expats) per 10,000 population
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Areas of specialization for local Drs
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Total no. of specialists (locals + expats)
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Reflections & the way forward
• …
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
Strengthening Specialized Clinical Services in the Pacific www.sscsip.org
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