2017 in review

Sustaining solutions to protect and improve people's health

Tuesday, 2018-01-02 17:07:29
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Doctors provide treatment for a patient under medical insurance policy at Tan Trao commune Health Station, Son Duong district, Tuyen Quang province. (Credit: Dang Anh/NDO)
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NDO – Independent survey results have shown that the people’s satisfaction index on the services provided by health workers has reached 87%, exceeding the 80% target set by the Government by 2020. The result reflects the efforts and solutions that the health sector has been implementing in recent times.

Bringing high quality services to local level

Identifying local level healthcare as the foundation for public health care, with support from the Government, the health sector has developed priority policies for grassroots health care. The policies have helped to ensure the effective operation of the health system in order to ensure that all people have access to basic and quality healthcare at their place of residence, thus ensuring fairness in healthcare. Many investment projects on constructing, renovating and upgrading medical facilities have been implemented to help local medical stations and hospitals to improve their capacity.

Staff training is also being implemented in many forms, such as on-the-job training, short-term training, appointing professional staff from the upper level to assist lower-level hospitals in improving the quality of medical examinations and treatment (Project 1816), and choosing lower-level hospitals as satellites for higher levels ones. As a result, tens of thousands of grassroots health workers have been trained and updated with knowledge, contributing to improving the capacity building for local medical facilities.

After three years of implementation, in 2017, the young doctors trained under the project to take young volunteers to work in mountainous, remote and disadvantaged areas (Project 585) have officially graduated. They have begun working in such disadvantaged districts across the nation. Prior to that, these doctors were trained in primary level (under their specific programmes, focusing on clinical knowledge training) and had been granted practice certificates. After completing their duties in disadvantaged areas, they will return to work in higher hospitals, where they were recruited before working in difficult areas.

Surveys in medical human resources, the need for doctors and medical training, the situation of medical facilities and disease structure show that 62 disadvantaged districts are in lack of about 600 doctors in 15 specialties. At present, many special courses under Project 585 are being held at major medical schools, such as Hanoi Medical University, Hai Phong Medical University and Hue College of Medicine and Pharmacy. It is expected that by 2020, 300 to 500 young doctors will be sent to work in difficult areas.

According to Minister of Health Nguyen Thi Kim Tien, Project 585 is a breakthrough of the health sector in ensuring sufficient human resources with professional and technical skills to meet the healthcare needs of local people is difficult areas.

Previously, high technologies, which were only being used in the central hospitals such as cardiovascular surgery, traumatic brain injury treatment or endoscopic intervention, have become familiar to many district hospitals. Local patients are examined and treated in grassroots areas, thus reducing the overload for upper level hospitals.

Satisfaction is the ultimate goal

Along with improving the quality of medical examinations and treatment, the health sector has implemented a range of solutions to improve the morale and attitude of health workers. To date, the quality of health services, morale, and the service attitudes of medical staff has changed in a positive way over each year. The results of independent surveys on patients' satisfaction in 29 hospitals across the nation showed that 89.9% of the respondents were satisfied with the medical examination and treatment at their hospitals.

In a meeting with the Ministry of Health (MOH), the delegation from the Government's Public Administration Reform Steering Committee highly appreciated the satisfaction of the people concerning the activities of the health sector, including public medical services. The measure of people's satisfaction towards medical examination and treatment services is at 87%, exceeding the 80% set by the Government by 2020.

The MOH is coordinating with the Vietnam Medical Association to measure and evaluate patients' satisfaction on the serving style and attitude of health workers; building green and clean health facilities; and hospital quality at all central and local hospitals across the nation. It is a national-scale activity to measure the satisfaction of patients according to the Government's administrative reform regulations, as well as seeking solutions to problems and limitations after the implementation of the set plans. In parallel with the monitoring and evaluation process, the MOH also assigned the relevant units to organise an independent mission to review the hospitals’ operations and receive patient's feedback.

According to Head of the MOH’s Treatment and Examination Management Department Luong Ngoc Khue, to date, leaders and health workers have been thoroughly aware of the need to innovate towards better serving patients in their operations, especially in service quality management. Putting patients at the heart of care and treatment, while making the safety of patients a top priority, accompanied with improving quality, is a critical task of medical facilities.

Lessons learned from medical incidents

There are still a number of issues in the public healthcare system that need to be overcome. In 2017, two serious medical incidents occurred in Hoa Binh General Hospital (killing eight people, forcing ten others to be sent to Hanoi’s Bach Mai Hospital for treatment) and Bac Ninh Obstetric Hospital (four newborn deaths). The causes of the above serious incidents have been clarified by the concerned authorities, but the prestige of the health sector, as well as the physicians involved, has been reduced. This is a lesson for the whole health sector.

Statistics show that up to 70% of medical incidents are due to system failures. This condition can be reduced by half through the use of strict patient safety standards. In order to reduce system errors, it is necessary to tighten management over treatment procedures, medicine quality control, the procurement and use of equipment and chemicals, as well as the work environment and professional training. Among them, treatment effectiveness should be set as the most important factor and the principle covering the whole process rather than merely being a slogan.

In addition, it is also necessary to publicise and clarify the medical problems as prescribed. The disclosure of medical errors is the duty and morality of the physician and the medical staff. It is also the basis for drawing experience and correcting system errors in the examination and treatment of patients to ensure patient safety and help the physician to avoid any medical problems.

According to experts from the Vietnam Medical Association, errors from physicians are closely related to professional competence and work caution. Every career needs caution. In medicine, cautiousness is considered as paramount importance because the medical profession is closely related to human health and life. Compliance with regulations, rules, and guidelines is a prerequisite in any treatment procedure, covering prescription, injection or the use of machinery and equipment. The negligence or extinguishment of some processes may result in problems that there is no chance to repair.

Moreover, more than 181,000 people were infected with dengue fever in 2017, of which 30 died, and it is also a matter of concern, as not only did the number of infected increase by 20% over the previous year, but also because the localities with the highest number of infections are the unthought-of, such as Hanoi, Nam Dinh, Da Nang, Quang Nam, Ho Chi Minh City, Dong Nai and Binh Duong. Among them, Hanoi, with adequate conditions in terms of facilities, equipment and human resources, was the centre of the epidemic. It thus draws a lot of lessons on the role of the professional bodies, the participation of the relevant sectors and public awareness in dealing with the outbreak.