EHSIG & HSPMIs
Briefing on
EHSIG & HSPMI
November, 2024
Dire Dawa, Ethiopia
OUTLINES
Introduction EHSTG & HPMI revision
Basic assumptions of EHSIG Why needy to revise EHSTG &
implementation HPMI
Gains of EHSIG implementation Future directions
01
2006
INTRODUCTION EHMI
HISTORICAL 2008
Blue Print of Hospital 02
BACKGROUND standards
2010
03 EHRIG
2011 04
HPMI/KPIs with site visit
and review meetings
05 201
EHAQ
2
2014
CASH/MCHQI 06
HSTP
2015/
2016 07 SaLTS/EHAQ
6
ENQS/HSTQ
EHSTG
08
OTHER REFORMS:
BPR, HCF, BSC, HMIS
HDA, ACCREDITATION, APTS,
HCSCG
Basic assumptions of EHSIG
implementation
Expectation - over time all hospitals (private
and public) will implement EHSIG and full
attainment of the Operational Standards (100%)
GAINS OF imple mentation
EHSIG
Significant to improve the performance of a healthcare
system
STRENGTHENING SATISFACTION UNIFORMITY
To strengthen the To improve the quality Creating uniformity in
capacity of the of service - patient service-based
hospital management satisfaction framework/ organogram
system among hospitals (create
Functional & Structural
twining)
EHSTG & HPMI Revision
PREVIOUSLY NOW
(Before the Revision) (After the Revision)
• EHSTG • EHSIG
• HPMI • HSPMI
⚬ EHSTG had 20 ⚬ EHSIG has 23 chapters
Chapters ⚬ 262 OSs
⚬ 197 OSs
The operational
standards (Oss) Minimum standards for
meeting the requirements of
quality patient care service
Volume -1 Volume -2
• Chapter 1HLGM • Chapter 13 Pain & Palliative Care
• Chapter 2LRS Services • Chapter 14 Pharmacy Service
• Chapter 3Emergency Service • Chapter 15 Laboratory Services
• Chapter 4Medical Record Mngt • Chapter 16 IPC
• Chapter 5Outpatient Services • Chapter 17 Teaching & Affiliated H S
• Chapter 6Inpatient Services • Chapter 18 Health Care Technology Mngt
• Chapter 7Nursing Care Service • Chapter 19 Hospital Infra. and Asset Mngt
• Chapter 8 Pediatric and child health S. • Chapter 20 Human Resource Mngt
• Chapter 9 Mat., New born. , RH & Midw S. • Chapter 21 Health Financing
• Chapter 10 Surgical and anesthesia Service • Chapter 22 Health Service Quality
• Chapter 11 Spec. & Sub-Speci. Service • Chapter 23 Hospital Performance M & R
• Chapter 12 Rehab Service Management
Why need to revise?
Leadership related issues
• Hospital leadership, Management and Leadership – clarity issue
on the roles of CEO, CED, SMT & GB
• Accountability issue (within the department)
Standard/indicator-related issues
• Presence of old-fashioned indicators as well as the method of
assessment (Neither effective nor practical) i.e. KPIs in the
HPMI
Because for instance
• Service automation on Medical record management- integration
of services with/ focus on EMR and all service digitalization
Why need to revise?
Chapter related
• Specialty and sub-specialty services like psychiatry, dermatology,
ophthalmology, neurology, Dental, ENT, and ICU are not given due
attention.
• Broad chapters into one, i.e. MNCH, Rehab- Pain- Palliative, Clinical
governance and quality chapter, Nursing and midwifery
• Endorsement of new guidelines, policies, strategies, and roadmaps
• The currently in use EHSTG volumes were endorsed in 2016; i.e. almost 8
years ago
Why need to revise?
Scoring/ implementation related
• Some standards are already met by most hospitals and a need to
upgrade b/c of service expansion & advancements
⚬Laboratory service management
⚬Pharmacy service management
⚬Diagnostic & imaging services
• Some standards were incomplete
⚬A need to harmonies academic activities with patient-
centered care activities (Teaching and affiliated institutions)
• Some services were not implemented as expected especially
specifically service
⚬Radiology and Imaging service
⚬Rehabilitative , pain and palliative care services, MNCH
Why need to revise?
Specialty services...
• RI Service Management
• Specialty and sub-specialty service
• Surgical and anesthesia service management
• Areas considered during the revision work
• Mental and psychiatric service
• Dermatology service
• Orthopedics
• Ophthalmology
• ICU service
• Oncology service
• Dental service
• ENT
• Neurology
• ++++
Why need to revise?
Assessment handbook (M&E related)
• There are some unpractical standards and verification criteria
• Some verification criteria are unrelated to the level/ capacity
of Hospitals, not considering the real scenario
• Some verification criteria are difficult to implement.
• The presence of too many unpractical & cumbersome
verification criteria for a single standard
Why need to revise?
Assessment handbook (M&E related)
• Each verification criteria have no cumulative value for
scoring (minimum??? In order to get met score, all criteria
must be fulfilled)
• Most of the standards are too shallow and most of them can
be achieved based on paperwork
Why need to revise?
Assessment handbook
General suggestions/ recommendations
• Avoid redundancy of the assessment standards among chapters
• Avoid cumbersome performance assessment approaches
• Make revisions on proofreading, linking the current practical
situation, focusing on a meaningful Rating system (met/Unmet) –
indicators shall advocate objectivity
• To link the guideline with the existing regulatory standards (4Ps)
Why need to revise?
HPMI to HSPI
• To qualify the previous KPIs i.e. definitions, formulas, interpret.
• To measure the clinical efficiency, productivity, and effectiveness
i.e. to assess the patient service in different aspect
• To detect patient care service challenges early to provide a proper
solution (by using the dashboard indicators)
• To monitor the EHSIG chapter implementation with that of HSPIs
to create synergy
THANKS !!!