Abu Dhabi hospitals docked for poor services

Hospitals in Abu Dhabi that provide inadequate treatment or fail to meet quality targets will have their funding cut. The rules will affect all 41 public and private hospitals in the emirate.

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ABU DHABI // Hospitals in Abu Dhabi that provide inadequate treatment or fail to meet quality targets will have their funding cut.

The rules will affect all 41 public and private hospitals in the emirate.

Funding cuts will be applied directly to public hospitals, and may be applied to private hospitals by reducing their grants or holding their payments from health insurers.

“We want to create a system to encourage good performers and not give incentives to poor performers,” said Dr Asma Al Mannaei, director of strategy at the Health Authority Abu Dhabi.

“If there is a continuous poor performer of healthcare delivery in Abu Dhabi, we cannot let it continue.

“We need a fair measure of quality. One of the drivers of improvement is finance.

“We are working with the payers on developing a linked system where we are going to link quality to the payment the hospital receives.”

The scheme is still being developed and no date has been set for its introduction.

“We have an internal target. Once we finish our pilot, we will have a clearer idea,” Dr Al Mannaei said.

Dr Fraser Lamond, regional medical director for medical security risk services company International SOS, said: “This is an excellent initiative from the Health Authority Abu Dhabi and something that should be replicated in other emirates once a process is established and defined.

“It will lead to a healthcare system that is essentially led by health quality in both the private and public sectors, and which will be in the best interest of patients entering our health services.”

Financial penalties for hospitals that deliver poor quality care are the most recent move in a drive by the authority to establish and enforce standards of health care, which began with the Jawda – Arabic for “quality” – initiative in September 2014. Jawda indicators cover safety, effectiveness of care, speed of its delivery and ensuring that patients come first, with targets in each area.

“The culture of safety has improved,” said Dr Omar Najim, quality adviser at the health authority.

“One of the first initiatives was the requirement for every hospital to have a quality team.

“We are holding all the quality teams and chief executives to account at a meeting that examines the result each quarter. We are putting it on top of the agenda.

“The quality index is the first in the region in its validity and comprehensiveness. We started with 11 waiting time indicators and added patient safety indicators.

“Establishing a quality-control mechanism increases transparency, clarifies accountability and tracks quality performance.”

On Monday, the authority introduced 13 quality metrics that fall under patient safety and effectiveness of care.

The new indicators include the rate of unplanned readmissions for emergency heart failure and emergency appendectomy, the rate of emergency primary c-sections, the number of surgical site infections and rates of perinatal and neonatal mortality.

The authority said further improvement was needed in standards for emergency care, infection control and perinatal and maternal care.

But more hospitals are meeting their overall waiting-time targets – 87 per cent last year compared with 82 per cent the year before.

The target for 90 per cent of patients to be given a primary care appointment within 48 hours was met 98.8 per cent of the time in the second half of last year, compared with 97.7 per cent in the first half.

The target for patients to wait no longer than an hour to be seen was met on 91.3 per cent of visits, compared with 89.3 per cent earlier in the year.

And the percentage of hospitals that met the two-hour target for the time between a patient registering and leaving accident and emergency departments rose from 65.8 to 69.4.