Having completed its fourth operational year at the end of 2011, SEHA can look back on remarkable progress towards the goal of world-class healthcare that was set as a fundamental principle at the time of inception. In this end-year report we open with an overview of the three primary areas that determine SEHA’s success: clinical, operational, and financial. Readers can thus quickly absorb a broad-brush perspective of achievements to date and the strategies that are driving the company to its ultimate objective. Detailed information on every aspect of SEHA’s activities is contained in the latter sections of the report.

CLINICALRead more    

Matching up with the best

SEHA’s emphasis is now even more strongly focused on quality, patient safety, and process improvement leading to better patient outcomes. More and more facilities are achieving the ‘gold standard’ of JCI Accreditation, and strong data collection mechanisms enable better measurement of performance at all levels.

Continuous quality improvement to recognized international standards has always been a cornerstone of SEHA’s professional culture, and this will reach new levels in 2012 when evidence-based medicine (EBM) standards will be introduced to provide more detailed reporting on clinical quality issues and outcomes.

EBM has been defined as “the integration of best research evidence with clinical expertise and patient values” and is a major driving force for many of the world’s best national healthcare organizations.

EBM advocates the use of up-to-date ‘best’ scientific evidence from healthcare research as the basis for making medical decisions, offering the surest and most objective way to determine and maintain consistently high quality and safety standards in medical practice; speeding up the process of transferring clinical research findings into practice; and helping to achieve significant reduction in healthcare costs.

SEHA Business Entities already adhere to the Quality/Patient Safety Core Measures that underpin international standards and best practices. These include: Joint Commission core measures, Institute of Healthcare Improvement (IHI), Centers for Disease Control (CDC), and Healthcare Effectiveness Data and Information Set (HEDIS) for primary healthcare indicators. In 2011 Dialysis Clinical KPIs were introduced, based on guidelines from the World Health Organization and the National Kidney Foundation.

The success of the quality management practices being adopted has been endorsed at a high level of independent external authority. The European Society for Quality Research (ESQR) gave SEHA its 2011 Gold Award for achievements in customer satisfaction and outstanding results.

External recognition is confirmed by internal research. Patient satisfaction remains high despite growing sophistication and discernment flowing from greater availability of choice between the public and private sectors. As perceptions become more acute, patients tend to grade harder but SEHA’s high scores are being maintained.

Achievements at SEHA hospitals give some pointers to the patient satisfaction scores. Every facility has recorded significant advances – from basic improvements such as reduced waiting patient times to conducting complex surgical procedures that had not previously been undertaken in the UAE (or even the wider Middle East region).

SEHA hospitals are now evolving as state-of-the-art facilities that are the cornerstones of an integrated healthcare network. Each has its unique characteristics as a center of dedicated patient care, united in a common commitment to excellence.

Terminology explained

The healthcare business has its own specialist language – terminology, abbreviations, and acronyms that may often be confusing for lay readers. To help achieve comprehensive understanding and to save repetition, we explain the terminology commonly used in this report.

Joint Commission International (JCI): JCI is the Joint Commission International and JCIA is Joint Commission International (Accreditation). This independent and globally recognized third party provides external standards of excellence for hospital services. Evidence-based medicine (EBM): Evidence-based medicine (EBM) or evidence-based practice (EBP) aims to apply the best available evidence gained from the scientific method to clinical decision making. It seeks to assess the strength of the evidence of risks and benefits. The Centers for Disease Control and Prevention (CDC): Centers for Disease Control and Prevention is a United States federal agency operating under the Department of Health and Human Services and headquartered in Georgia. It protects health and safety by providing information to enhance health decisions, working in partnership with state health departments and other organizations. The Institute for Healthcare Improvement (IHI): The Institute for Healthcare Improvement (IHI) is an independent not- for-profit organization helping to lead the improvement of healthcare throughout the world. It was founded in 1991 and is based in Cambridge, Massachusetts. HEDIS: The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90% of America's health plans to measure performance on important dimensions of care and service.

FINANCIALRead more    

Revenue growth trend continues

SEHA’s most important financial performance indicators maintained an upward trend, meeting or exceeding targets.

This was particularly true of net patient revenue, which was well ahead of budget in the second half of 2011 and showed a significant increase on the same period of 2010, reflecting growing efficiency in SEHA’s ability to provide treatment within the available reimbursement mechanisms.

Inpatient admissions and outpatient visits were also up in the same period. Along with the favorable growth in admissions and visits, increased inpatient and outpatient revenue per admission reflected reduced claims denials and better collection patterns.

However, operating cost per adjusted patient day increased due to higher salaries, wages and benefits, and supply costs. This is partly due to compensation adjustments necessary to retain medical staff, having completed the Hewitt Project that realigned SEHA HR practices and salary scales across the board. Every SEHA employee now has a defined job and defined grade – a major achievement that will pay future dividends.

In implementing the four-party (SEHA, HA-AD, DoF, and Daman) Note of Understanding, discussions are taking place with HA-AD/Daman to finalize activity and non activity-based funded mandates, and an application package has been developed for submission to HA-AD for the required approval of additional non activity-based mandates.

Transformation of revenue cycle management (RCM) systems has enabled a substantial improvement in performance for the year, with the value of claims submitted increasing and the proportion of denied claims falling.

Full-scale simulation at Al Rahba Hospital of the Physician Pay-for-Performance system – based on quality, outcomes, patient satisfaction, and productivity – will be followed by system - wide application.

A costing function is now effective within Corporate Operations and has analyzed five areas of speciality services for three major hospitals as defined by HA-AD, while a cost of ownership study by the Supply Chain Department examined all aspects such as manpower cost, fixed cost, leased warehouses, and equipment. This is proving an excellent tool to determine which supply chain components should be outsourced or handled internally.

While these positive signs are encouraging, financial challenges continue in terms of productivity, outcomes management, and customer service delivery.

We have embarked on a three-year program to replace a number of ageing facilities. More contemporary features, allied to hotel-style levels of comfort, will ensure we attract and retain our customers.

OPERATIONALRead more    

Awards underline quality achievement

The completion of SEHA’s fourth operational year was marked by receiving a number of distinguished awards for operational performance.

Chief among these was the European Award for Best Practices 2011 (Gold Category) in recognition of achievement in customer satisfaction and outstanding results in quality management. The award attests to SEHA’s commitment to improve its quality management system by implementing the European Society for Quality Research quality performance model.

Similar endorsement came from the Arab Hospital Federation with the Excellence Award for Development of the Arab Healthcare Sector and the Sheikh Khalifa Award for Excellence (Silver Level), while Mafraq Hospital was granted the Sheikh Khalifa Award for Excellence (Diamond) in healthcare, the first such institution to be so recognized in that category.

These awards demonstrate the progress being made towards SEHA’s desired outcomes, focusing on optimizing operational efficiencies, improving productivity, and effectively utilizing resources.

The advance to excellence is also evident in some significant ‘firsts’ achieved during 2011. These included the formation of a Medical Response Team comprising 34 doctors (ER, anesthesia, orthopedics, surgery) in line with governmental directives for SEHA to support other agencies’ field operations when needed.

A first-of-its-kind training project in emergency management and disaster medicine involved all stakeholders in Abu Dhabi and the UAE (governmental, semi-governmental, and NGOs) and about 950 trainees from SEHA, half of whom were UAE nationals.

Implementation of the productivity management program across all SEHA facilities is leading the development of standards for nursing, ancillary, and health clinic services, while the new Clinical System Review Plan is designed to deliver consistent quality in a range of disciplines such as psychiatry, tuberculosis management, obstetrics and gynecology, operating rooms and anesthesia, intensive care, rural medicine, and radiotherapy.

Completion and implementation of an accounts receivable subsidiary ledger across the enterprise is a key element of billing and ERP enhancement. All remittance advices from Daman now automatically create cash receipts, providing SEHA with the true picture of accounts receivable.

Further IT enhancements have included implementation of several Core Clinical Systems applications across a number of SEHA facilities and operational functions, from hospital information systems to financial administration.

Such initiatives represent the essence of ‘continuous improvement to recognized international standards’ and are the cornerstone of SEHA’s ceaseless efforts to be world-class.

European Society for Quality Research’s mission
To enhance quality wherever organizations are willing to understand and commit to adhering to the European Values on which the ESQR Quality Performance Model is based.
ESQR’s core competencies
• Quality Research
• Best Practices Recognition
• Quality Assurance and Assessment
• Management Consulting
• Training
• Networking
The European Society for Quality Research hosts associates from academia, industry, and international organizations. In addition, ESQR partners with corporate executives, academic experts, manufacturing specialists, engineers, scientists, and technicians around the world to carry out its activities and projects.