Novel Measurement For Performance Improvement Challenge.

The specific problem within the challenge l am working to solve is MEASURING THE IMPROVEMENT OF PRIMARY HEALTH CARE PERFORMANCE IN LOW AND MIDDLE INCOME COUNTRIES.

Primary Health Care System is very important as they play a vital role in first interaction with the patient at community level.

Statistic suggest globally that about 527,624 and 1,671,149 new cases of cervical and breast cancer respectfully are added every year. To this, India contributes about 122,844 cervical cancer and 144,937 breast cancer cases every year with women facing a 1.6% cumulative risk of developing cervical cancer and 1.0% cumulative death risk from cervical cancer. Similarly, the cumulative risk of developing breast cancer is 2.7% and cumulative death risk is 1.5%. A vital observation here is that, from the knowledge of preventive medicine, cervical and breast cancer are preventable and curable if diagnosed at an early stage.

The problem of malfunctioning and poor funding of Primary Health Care at community level has cause a lot of havoc due to poor access to high quality healthcare, periodic screening tests and regular follow up,  resulting in prolong hospital stay, increase costs of treatment, high morbidity and mortality.

With the conventional method of measuring the improvement of Primary Healthcare performance in low and middle income countries globally, yet statistic is still showing a high data of ill health cases. Therefore, invention of unconventional method of measuring the improvement of Primary Healthcare performance in low and middle income countries and implementation will help to increase access to high quality of life, periodic screening tests and regular follow up. From this context, MY SOLUTION INCLUDE THE FOLLOWING:-

1. COMPREHENSIVE COMMUNITY REGISTER REMINDER SERVICE.

2. EVALUATION SYSTEM ON PATIENTS SATISFACTORY SERVICES             AND PROVIDERS.

3.ONE-ON-ONE PATIENTS ENQUIRY SERVICE ON HEALTH            EDUCATION.

1. COMPREHENSIVE COMMUNITY REGISTER REMINDER SERVICE:-

OUTLINE:-

-Introduction

-Aim

-Process measure

-Balancing measure

-Outcome measure

-Conclusion.

                                  INTRODUCTION

About five percent (5%) of people in some communities are dying as a result of poor healthcare seeking habit which could be due to ignorance of seeking medical health services voluntarily or lack of funds. In view of this, a system of reminder for hospital appointment will be of great benefit to people of the community to make early diagnosis and to the primary healthcare system to improve their functionality.

                                                 AIM

The aim of Comprehensive Community Register Reminder Service is to :-

1. Measure the activity of primary healthcare worker at community          level.

2. Measure the cooperation/responsiveness of the community to              healthcare services.

3. Make Periodic screening test and early diagnosis.

4.Counseling and regular follow up.

                         PROCESS MEASURE

This indicate what healthcare providers does to improve health, maintain standard and remain important. Thus, this measure is as follows:-

1. The primary health care in all low and middle income countries             should have a comprehensive register of names and addresses of       every family in their various communities into the hospital                     computer data base or manual register.

2. The primary health care should afterward send a written and                 verbal announcement to the community members through their           community leaders, youth leaders and religious leaders informing       them on a certain fix date for hospital visits.

3. On hospital visits, complete evaluation and baseline measurement      should be taken and documented and next appointment visit is            inform.

4. For those missing their hospital visit date, a reminder should be            sent to them through mobile phone for those with phone, their              community leaders etc, informing them to come for their hospital       visits.

                                    OUTCOME MEASURE

This reflect the impact of healthcare services or intervention on the health status of people or patients. About 50% of people globally are living with high risk factors and life threatening diseases without knowing, with the implementation of this SERVICE, it will be easy and possible to make early diagnosis, commence  early treatment, regular follow up and achievement of cure. The outcome of this service will result in early intervention, high quality of life and reduce prolong hospital stay.

                                    BALANCING MEASURE

It determines whether the measure designed to improve healthcare is effective in one part of the system and cause problem in other part of the system, example does this new changes increase primary healthcare services to the community members and client(patient) satisfaction but decrease staff satisfaction?

                                     CONCLUSION

Community members who by ignorance or lack of funds can not access healthcare services voluntarily will be reach out to through comprehensive community register service. 

2. EVALUATION SYSTEM ON PATIENTS SATISFACTORY SERVICES             AND PROVIDERS.

                                     INTRODUCTION

This is a system that should evaluate the satisfaction of patient both on services rendered and services providers. Many people in communities and globally have various terrible and traumatic experiences from health providers that discourage peolpe from seeking clinical treatment from hospitals and this has made people to rather prefer chacks while some to traditional treatment where they are welcome but without indepth knowledge of the pathology and ofcourse result to death.

                                       AIM

1. To remind health providers that a patient is not a case but precious       in nature.

2. To re-enforce patients-healthcare-providers relationship.

                                       PROCESS MEASURE

The primary healthcare system should have a team that is assigned for evaluation of patients satisfaction on services and providers that will either go into the field(community) to ask questions on services rendered and their experiences at hospital or have a season with them on their follow up visits days to ask questions on their experiences.

This system will let the management share in the experience of patients and then address his members on the right approach to patients which will lead to improvement of the primary healthcare performance.

                                      OUTCOME MEASURE

When the approach is change or amended, patients will be encourage to visits hospitals and early diagnosis and cure will be achieve.

                                       CONCLUSION

Sharing in the experiences of your clients in health sector is a key to caring for soul and body.

3.ONE-ON-ONE PATIENTS ENQUIRY SERVICE ON HEALTH            EDUCATION.

                            INTRODUCTION

A lot of people out there are dying as a result of ignorance about health, for example cervical cancer. Creating public health awareness should go beyond public announcement on the street but in a way that clients have one-on-one communication with the health provider for clarification on the cause, risk, vaccination and negative effect of certain diseases to health etc.

                             AIM

1. To create in depth knowledge of health awareness on causes, risk factors and its effect of certain diseases to health.

2. To pick symptoms and make early diagnosis.

                             PROCESS MEASURE

The primary healthcare system should make it mandatory for every healthcare provider to carryout ONE-ON-ONE ENQUIRY SERVICE ON HEALTH EDUCATION after their routine regular hospital visits. For example, do you know about pap smear?, do you know how to examine your breast for changes?, do you feel urgency or incomplete bladder emptying after micturating etc.

                               OUTCOME MEASURE

ONE-ON-ONE ENQUIRY SERVICE ON HEALTH EDUCATION will help healthcare providers to detect early symptoms the clients think to be normal and aid in investigation and diagnosis.

                                CONCLUSION

Measures to prevent and/or control health challenges is better than managing complications.

The target population to my solution is low and middle income countries who by lack of finances, health education or due to ignorance can not voluntarily access healthcare services.

We as a team are working towards the betterment of the people in low and middle income countries, our communities and globally.

well, am just a medical student who need money to move forward. But to be candid, i am not writing this solution to use it and settle my challenges, but to contribute my little to impact health.

What matters is innovations that will help our primary healthcare system to improve for example, if there should be a system of healthcare service that intentionally call on client and get their baseline measurement and subsequently invite them for a check up and follow up, you will agree with me that there will be a positive impacts created across the primary healthcare system as well as increasing life expectancy across the globe.

The impact goals for the next five years through my solution are:-

1. Early diagnosis of diseases that will bring a drastic decrease of end stage conditions, example cervical cancer, breast cancer, diabetes mellitus, renal disease etc.

2. Improve patients-healthcare personnel relationship.

3. Increase life expectancy across the globe.

How i will measure the progress of my solution is:-

1. By carefully checking the community register to know the number of individuals that turn up on their own, those that turn up base on reminder.

2. By verbal interaction with the people either during their hospital visit or outside hospital.

3. Through data collection. 

My theory of change are:-

Compilation of community register and reminder of patients for check up and follow up ---> Early diagnosis ---> Early treatment and follow up ---> Decrease prolonged hospital stay---> Increase life expectancy.

The core technology that power my solution are:-

1. Sms technology.

2. Traditional technology.

3. Knowledge systems.

I paid three of my class mate for data collection and i myself also go in for data collection.

Today's model of Healthcare System has persistent challenges and culture competency, racial, gender and ethnic disparities. In view of this, the following approach will be use to incorporate diversity, equity, and inclusivity into my work:

1. By creating a Welcome Environment, Foster an environment of inclusiveness in every area possible.  2. Address Issues of Bias Quickly and Openly. 
3. Gear programms to recruit and retain diverse staff members.            4. Promote cultural competence in Healthcare system, as well as cultural competence training for healthcare provider. 

5. Use of interpreter services to ensure that individuals from differentl backgrounds can effectively communicates.                      

My business model is market intermediary where i provide services to my clients to help them access market and allow them stay and work in their community.

To become finantially sustained in my business, i will engage in selling of products, services charges, collection of mentorship fee, grants and donations.

So far, finantial sustainability in my business is through selling of products, service charges and mentorship fee.