 Good day and welcome to Issues and Answers, a production of the Government Information Service. Today I'm here with Quality Assurance Officer in the Corporate Planning Unit of the Ministry of Health, Wellness and Elderly Affairs. Mr. Lenlios, welcome. Hello, good to be here. Yes, good. And today we're going to be talking about an initiative from the Ministry of Health called the Continuous Quality Improvement Initiative. So, before we even get to that, tell me, what is a Quality Assurance Officer? Okay, before I begin, in the last few strategic plans of the Ministry of Health, we have identified quality, quality improvement as a key component of our strategic plan for health care in Indonesia. And we realized that it was ignored somewhat. So the Corporate Planning Unit of the Ministry of Health, they formulated in the last financial year, a Quality Assurance Unit. So a Quality Assurance Unit, I'm a part of this unit. And we're charged with ensuring and improving, putting things in place to improve the level of quality of care in Indonesia. Okay, so when you talk about an improvement in quality care, what exactly would that look like in the St. Lucian context? Okay, this will look at, we will try to implement new processes, tools, mechanisms to increase efficiency, reduce wastage of resources, and enhance the stakeholder engagement, both internal and external stakeholders. Okay, so we will get to a little bit of that a little later on. Now, the purpose of why we're here is to talk about the initiative called Continuous Quality Improvement. So why don't you explain to us a little bit about what that is? Okay, Continuous Quality Improvement, it's a management philosophy where you evaluate how a job is being done, and it's an ongoing process where you realize what processes and tools you can use to improve how better the job can be done, how you can improve on the job being done. Now, as you are part of the corporate planning unit, what is the CPU's role in the development of CQI? Well, the corporate planning unit along with the World Bank, Ministry of Health, we are undergoing a project, the Health System Strengthening Project. This project is being funded by the World Bank, and one of the consultancies under this project is the Continuous Quality Improvement project. And it's being done right now by Accreditation Canada, where it started in December of 2020. And right now, we're at the stage where they're designing a quality improvement roadmap for St. Lucia. Now, you mentioned an organization just now, Accreditation Canada. I know they themselves have a role as well as the Health Standards Organization. Could you talk a little bit about the aid they have given to the Ministry of Health in the development of the CQI? Okay, well, Quality Accreditation Canada, there was a tendering process and they warned the tender. They have done work throughout the Caribbean and the world. They are a standards organization. They specialize in health standards. And they're assisting us in developing our quality improvement process. Now, when you say they aiding, what sort of technical assistance do they give? Okay, so initially, at the first stage of the project, they did an assessment of our health care system. They realized they assessed both patient and inclined of all our health services. And then they provide training based on what they found. And then they will develop a roadmap to improve our health care system. Can you talk a little bit about the sort of training that would have been undertaken? Well, this training, it includes how they can improve the culture of quality in our sector. How they can, the role we as health care providers play in improving quality. How we can better monitor and evaluate the level of quality of care that is provided in St. Lucia. How we can analyze it better. So it's a whole approach to improving quality of care, making our health care providers champions of care in St. Lucia. So what in the entire process, especially in a monitoring and evaluation, have you come across areas that we in St. Lucia, in our medical field, or our medical care industry, what areas we need to improve? Well, we have identified some dimensions in quality. Our safety of health care, how equitable our health care access, how easy we can access health care, how effective it is, efficient. And we want to make health care client centered. We want to focus on the patient, engage the patient and the client, our health care workers in the quality improvement process. Okay. I just want to stop us here for just a little bit we do for our first break. And when we come back, we will continue this discussion. You're watching Issues and Answers. We'll be back in a moment. I'm so fed up with my 13-year-old child. She's driving me crazy. I just don't know what to do. All that I need is some good legs to wake up. Alice, ignore the counseling pension given. Government employees have free access to professional counseling services under the Employee Assistance Program known as EAP. EAP? What's that? Not me that telling people my business. Listen to me, Alice. I was struggling with my child. I made an appointment to see an EAP counselor. And I was very satisfied with the service that I received. And you know what? Up to a day like today, my information remains confidential. Cox, how come nobody in the office knew anything about your counseling? Ah, that's because EAP counselors work under strict clauses of confidentiality. I know you know what confidential means. EAP providing professional counseling services? How much is it? Girl, the counseling is free. Free for you, free for your child. And you know what? Your information remains confidential. Call the EAP unit at the Ministry of the Public Service. Telephone number 468 2269 for more information. EAP Works, let it work for you. Welcome back to Issues and Answers. I am your host, Jacques Kingston Compton. If you'll recall, we are speaking with Quality Assurance Officer, Mr. Lenlios. And we're talking about Continuous Quality Improvement, which is a relatively new initiative of the Ministry of Health Wellness and Elderly Affairs. Now, before we went to break, you mentioned with regards to the CQI, a project called the Health Systems Strengthening Project. And the CQI would fall under that. Could you tell us a little bit about that World Bank funded project? Okay, so this project starts with, it's a four-year project. It starts with strengthening our health care services. So we're looking at infrastructure, our facilities, our technology. There is another consultancy going on where they're evaluating the various facilities around the island. And looking at ways they can improve it in terms of adding new technology, doing construction, renovation. We look at training. We identify new training that is required in the health care sector. It's going to be funded by the project. We're looking at policy, also policy direction. We're looking at quality improvement. There is also the licensing and standards consultancy where we're trying to regulate our health care both private and public to make it standardized across the board. So there are various consultancies that are going on. It's even at strengthening our primary health care service to ease the pressure on our tertiary and secondary health care services. Now, there are a couple of things based on what you just said I want to speak on. I also understand that SMART health facilities is an initiative under the health system strengthening project as well as, I guess, continuous improvement. Yes, the SMART health care services project. It's a consultancy going on where we identified various health facilities around the island. Also, Comfort Bay, the facility for the elderly care, they're including this. So we're trying to make our facilities sustainable and resistant to natural disasters while reducing on, we're trying to use solar energy at our facilities. So it's, again, we're trying to make the facilities run more efficiently and become more durable to earthquakes, tsunamis, hurricanes, natural disasters. And you also mentioned primary health care. For those of us who don't know what exactly is that. Okay, so primary health care is our community health centers, our wellness centers. So the project is we're trying to evaluate how we can strengthen the capacity of these facilities so that you do not reach a stage of going to, having to go to the hospital. So you ease the burden on our hospital. So we try to strategically diversify our services, give our staff the capacity to diagnose and deal with issues. And make you comfortable coming to our primary health care, our community wellness centers, rather than reserving going straight to the hospital, putting pressure on the ER and the tertiary services provided. And I suppose that's very important, especially now under the entire COVID era. Yes, COVID, especially now with COVID, we're trying to ease the strain on our health care providers. And we're trying to build that community networking. So you know your illnesses, you know your health aids, you know your community health aids. So you feel comfortable going to the community wellness centers to seek health care services. This CQI will benefit both internal and external stakeholders. Could you talk a little bit about how this will especially benefit medical staff, other than easing the burden on them? Okay, medical staff, they stand to benefit just as much as the clients. They will be receiving care, training, the capacity building, and they will be part of the process. They are engaged. So they will be, we will be going to them asking them, how can we make your job easier? What can be done to help you perform your duties in a more efficient, because they're the ones providing the service. They know first hand, rather than the officers sitting in the offices, although we guide policy, but we have to come to them rather than just going straight to giving out policies. So they have to be directly engaged in any process, health care process that we're trying to achieve. So how exactly have you engaged with those medical staff? Well we, during the assessment by Creation Canada, they did go out to the community, community centers, the hospitals, the different health facilities. They did assist them on the quality of culture, what processes can be done to ensure their jobs are done easier. And we, I'm trying to form a relationship where there is constant dialogue between the quality assurance officers like me and the health care professionals. So they're involved in the entire process of continuous quality improvement. It's an ongoing process, so whatever advice they give us on the process, we implement it and then we look at ways we can make it better. We go back to them, we tell them, okay, so this was done so. But we have not realized any change. Can you advise us or if the changes are there, what other changes can be made to help the process? Now also I suppose just as important is how this initiative is going to benefit the patients or the users of primary health care. How have you, I know you've engaged as well, patients and their family and their relatives. How exactly have you engaged with these patients and their family? Well, also during the assessment, these patients were also engaged because they're the client, they're receiving the service. So you want to know how, what are they missing? Are they actively involved during the process of receiving health care? We don't want them to be, you come to a clinic and you quiet, the nurse gives you medication. We want feedback, direct feedback. We're also implementing different feedback boxes in the suggestion boxes at the various health centers. So it's an ongoing process. We're going to go into the communities, engage the clients and they know what service they want. They provide in the dollar, so they want money for their value. So I also understand in terms of the patients, a data collection is something that is, it needs to be improved upon. Can you talk a little bit about how you will improve data collection and how you will use it with regards to the patients and their own, I suppose, their own medical history? Okay, so first of all, for us to improve on our processes, we have to collect data. So we have to know what we're improving on. So if data collection process is improved, we have data we can work with. Also with our information systems, we're trying to have one information system where you can access, no matter which health facility you access in the island. There is information provided about you. So I can go to St. Jude's, even though I'm from Grozily, and then when I enter my whatever code or client information, my whole health background. And you can think of how this will improve on the quality of healthcare we'll receive. So it will be a sort of an intranet between all hospitals? Yes, a one system, community health labs, dental, the whole health system will be integrated on one database. And that's going to be, will that be across the board for public and private health facilities? Yes, it's when we try to regulate our health care services, so it will be across the board. That's our aim, that's what we work into it. Okay, we're actually due for another break, and then we'll move on to our final segment. You're watching Issues and Answers, a production of the Government Information Service. We'll be back right after this break. We are working parents. And we breastfed both babies exclusively. Mother's breast milk is naturally the best milk for baby. Love yourself and love your baby. Breastfeeding saves me money and it's free. Every moment I breastfeed strengthens the bond between me and my baby. I breastfed twin boys and lost all my baby fats. We are breastfed! And we have breast milk power. I am Pastor Alvin, and I support breastfeeding. For more information, call the Nutrition Unit of the Ministry of Health and Wellness at 468-5359. Welcome back to Issues and Answers. I am here with Quality Assurance Officer Mr. Len Lyons from the Corporate Planning Unit in the Ministry of Health and Wellness, and we're talking about continuous quality improvement. Now, before we went on break, we were talking about how the different health centers could share data, which I actually found was very interesting. But now I want to kind of move on to something that you touched on before. And this is the Licensing Certification and Accreditation Systems. Can you talk about how the proposed CQI system will integrate these elements into healthcare? Okay. So, under the Health Systems Strengthening Project, there is another consultancy which will be dealing with licensing and accreditation. This is important as we seek to regulate our healthcare services across the board, across Ireland, both private and public. We're trying to ensure that our services are consistent across the board. When you go into this facility, you know the level of healthcare you're going to provide is satisfied. You will be satisfied. By regulating it, there's going to be laws governing what the service is provided. This goes hand in hand with quality improvement, because if you're implementing standards, it has to be at a level of quality that is acceptable. So, the plan of the two consultancies, they're supposed to be working together, having dialogue with each other at various stages. So, although the continuous quality improvement consultancy is further along, it's planned that they will be working hand in hand with each other, as they are both important and they kind of lean on each other to be implemented. How will the average primary healthcare user be able to tell if a facility is accredited? Will there be some sort of indication in the building? Well, when a facility is accredited, when you enter the facility, you will see a seal of approval. When you go to the labs and it's accredited, accreditation Canada has done a lot of accreditation for our local labs. So, you see a seal, it says accredited by accreditation Canada. Same way, when you go to a doctor's office, you see this doctor is licensed. So, the plan is for all our facilities to be licensed and accredited. So, you will give the clients the surety that they're going to a facility that is licensed to provide care for them. The staff are providing it at the highest level of quality and you will feel safe and leave the facility knowing that you are in good hands. And that's accreditation and standards that's dental, medical facilities, labs, mental wellness, our tertiary primary, secondary facilities, the polyclinics. So, it's across the board. Now, can you talk a little bit in more detail what is involved in the whole licensing process? What exactly has to happen in, I guess, with regards to CPU and AC? Does it involve additional training, additional equipment? Licensing is an extensive process. It's a process that takes planning. It's a level of standard. It's an international standard that you have to meet. So, we will have to change our processes, how we do things and show that we are doing things safe. We meet certain international quality standards that we follow the laws of the island and it's a holistic approach to healthcare. It's a health reform process that is needed in St. Lucia because we hear a lot of complaints. We listen to the clients. So, with licensing, we cannot falter if our facilities are licensed. We have to maintain a certain standard. So, in the end, the healthcare providers, they will be providing services. They will be giving us skills to provide services in a more efficient manner. They will benefit and the clients will also benefit as they will be receiving the highest level of care. At the same level of care you receive in Barbados, we want to be able to reach a standard if our facilities are licensed. We have no choice. We have to meet the standards. That involves a lot more capacity building, I assume, for the medical staff. Yes, as I said, they will stand to benefit greatly. We know the pressure. We know sometimes training is expensive. You have to wait for a scholarship to get training. They will learn how to use new technology. Sometimes the last schooling might have been ten years ago. And new technology, well, technology is an evolving process. There is new technology. They will learn how to use it. Because, remember, we want to be on par with any hospital around the world. So, we have to have the latest technology, latest skills, latest processes. Best way of doing things. So, everyone stands to benefit. I stand to benefit as I feel good that the healthcare workers are better trained and that means I'm doing my job. Of course. And you're also a user of primary healthcare. You're a patient so you have a stake in it. Yes, I go to the hospital. I want to ensure when I personally go to the hospital that I receive the best care possible. Now, you mentioned technology. Actually, it was quite prominent in your answer a while ago. Will the initiative be involved in procuring new equipment? Well, under the HealthSystem Strengthening Project, there is a procuring component. Under this project, during the COVID, we used the project to procure PPEs, masks for the hospital. Any little equipment, the nurses would need the doctors. So, there's also a component where we can procure equipment for if we need a new MRI or not saying we're going to order a new MRI. I'm just giving an example. So, under this project, it's an extensive project in that strengthening whatever we need at this moment in our healthcare sector. Okay, so we're coming very close to the end of the program before we leave. Is there anything that you would like to add just before we go off? Okay, I'd like to say that we are the ministry. We're excited about these new initiatives that we put in place to improve on healthcare. It's long coming. We're happy to have the funding right now to do what we are doing. And we want to implore our clients, the customers, when we engage you, provide feedback, negative, positive. We're taking it into consideration and we're working to ensure that you're able to receive better care. Our healthcare professionals, we know you're working really hard during this pandemic. We're also trying to create new processes, provide you with the tools and mechanisms to perform your duties much better, easier, more efficient. We're hoping to provide training to you to be able to maneuver in a more efficient way around your duties. So we want everyone to be positive about what's happening and we look forward to engaging all of you. That's good. And just for the audience to know, if they see any of your colleagues, it's not that they're trying to find out your business. Yeah, we're trying to improve. We're trying to improve. We will identify ourselves, but we will try to make you relax and engage, provide feedback. At the end of the day, we're just trying to improve the process. Well, I want to thank you very much, Mr. Leonce, for coming onto our program. I've learned a lot and I'm looking forward to seeing the results of this new initiative. You're watching Issues and Answers, a production of the Government Information Service. I'm your host, Jacques Hingston Compton. Thank you very much for watching and stay tuned to more of our programming.