Self- Management of Government Hospitals
The implementation of the National Health Insurance System, and the competition it creates between public and private hospitals in terms of the quality of services provided to attract subscribers, requires a fundamental change in the management of public hospitals. The previous administrative system for public hospitals and health centers does not provide efficiency or flexibility in dealing with the new competitive situation. Therefore, enabling the management of public hospitals by granting it greater powers through the implementation of self-management system is necessary in order to compete and be able to attract a larger number of beneficiaries, through a special board of directors for public hospitals with extensive supervisory powers that will contribute to providing the best services to citizens and residents.
The board of Trustees will direct the hospital's Board of Directors to guide it financially and administratively, and deal with the requirements of competition with other health institutions to maintain the quality of service. The self-management system also gives the health institution the power of direct management, meaning changes in budget and human resource systems, including interaction with the civil service department in employment procedures.
This system places the management of government health organizations (Board of Trustees and Board of Directors) in a position of responsibility and accountability for the operation of the organization, achieving its tasks and goals in terms of the volume and quality of work. This will reflect on the organization's revenues to enable it to earn its overall budget. The management is also entitled to retain the profits generated in accordance with current laws and regulations in the case of satisfactory volume of work and an increase in income. However, if the management fails to do so, it will be held accountable by the higher health council and other regulatory bodies.
This system places the management of government health organizations (Board of Trustees and Board of Directors) in a position of responsibility and accountability for the operation of the organization, achieving its tasks and goals in terms of the volume and quality of work. This will reflect on the organization's revenues to enable it to earn its overall budget. The management is also entitled to retain the profits generated in accordance with current laws and regulations in the case of satisfactory volume of work and an increase in income. However, if the management fails to do so, it will be held accountable by the higher health council and other regulatory bodies.
Major achievements
- Completed analysis of the current status of government hospitals and the health sector in Bahrain.
- Completed research and study of what other countries have done in this field and learned relevant lessons.
- Determined all services required to be separated from the Ministry of Health.
- Identified key stakeholders in the strategic transformation of government hospitals.
- Identified government hospitals covered under the Health Insurance Program that will have self-management.
- Named Salmaniya Medical Complex and its affiliated hospitals as government hospitals.
- Established a strategy for government hospitals, including vision, objectives, values, clinical excellence, and accessibility to healthcare services, clinical outcomes, patient satisfaction, financial sustainability, and optimal resource utilization.
- Established strategic goals and initiatives and outcomes.
- Established a targeted operating model, which includes updates to the organizational structure and workforce calculations.
- Appointed a board of trustees, CEO, and board of directors.
- Approved updated financial and administrative regulations.
- Developed a plan to implement the targeted operating model, including establishing departments to support hospitals, such as the human resources department, financial resources department, and others.
- Completed the first phase of the integration project between primary health care providers under the Supreme Council for Health.
- Completed of the termination of all financial resources services from the Ministry of Health, including the transfer of employees from the Ministry of Health to government hospitals and the separation of the financial budget from the Ministry of Health.
- Completed of the termination of all human resources services from the Ministry of Health, including the transfer of employees from the Ministry of Health to government hospitals, the creation of an organizational structure, calculation of workforce, updating job descriptions, and the creation of an electronic system for employee data.
- Established a training department to follow up on the affairs of trainee doctors and residents, and procedures for residents on specialized rotations.
- Accomplished a package of development programs, including improvement of the drug dispensing service at the Salmaniya Medical Complex pharmacy, reducing the waiting time of patients in the radiology department, developing outpatient clinics by adding clinics during evening hours and reducing the waiting lists for new appointment reservations and reducing waiting lists for surgical procedures.
- Set up the clinical classification unit.
- Formed a Clinical Documentation Improvement Team (CDI Team)
- Worked on the ability to generate shadow bills
- Established policies and guidelines for transferring patients from and to primary care
- Set a policy to activate the integration of emergency care between government hospitals and primary care represented in 24-hour operating health centers.
- Set integration policies in supporting services such as the laboratory between government hospitals and primary care.
- Adopted a special logo for government hospitals and creating accounts on social media platforms.
Current Procedures
- Implementing the self-management plan by applying the targeted work model.
- Comprehensive institutional change plan, including holding workshops, awareness campaigns, monthly publications, surveys and others.
- Performance and incentive indicators. Separating contracts from the Ministry of Health.
- Updating the information technology system.
- Introducing the electronic classification program (DRG Grouper).
- Working on the ability to issue individual shadow bills for each patient, and linking them to the national electronic system under the Supreme Council of Health.
- Setting up centers of excellence in government hospitals
- Enhancing the provision of patient-centered health services
- Training programs for employees on new assignments.
- Expansion of the accident and emergency department, modernization of blood catheters and raising the capacity of operating rooms.
- Calculating the cost of health services and enabling the issuance of shadow bills, assessing the degree of readiness to collect fees for health services and working to raise the readiness and establishing a revenue cycle management.
- Work is ongoing with the activities of institutional change management.
- Building centers of excellence in seven medical specialties: diabetes, ophthalmology and surgery, pediatrics, sickle cell anemia, neurosciences, geriatric medicine, otolaryngology and surgery.
Next steps
- Dry run with Shefa Fund
- Creating and concluding contracts for cooperation in the areas of providing health services, training, financial reimbursement and cooperation with the Shefa Fund in specific health packages such as chronic diseases.
- Approval of the new organizational structure and placement of employees on jobs
- Separating the electronic domain of government hospitals from the domain of the Ministry of Health
- Establishing a training center for staff development in clinical research and education
- Investing in the infrastructure of the Salmaniya Medical Complex to enhance capacity and improve operational efficiency.