The significant problems we face cannot be solved by the same level of thinking that created them'

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• The significant problems we face cannot be
  solved by the same level of thinking that created
  them.
• Albert Einstein

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HEALTHCARE QUALITY IMPROVEMENT INNOVATION FUND
FY 2010
Briefing on Administrative Guidelines Standards
and Quality Improvement Division
21 October 2009
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BRIEFING OUTLINE

• Background and Objectives of HQI2 Fund
• Fund Administrative Cycle and Guidelines
• Project Assessment Criteria
• Project Application Management
• Frequently Asked Questions
• Contact Person Weblink

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DEFINITION

• IMPROVEMENT
• Quality improvement is a continuous process that
  identifies problems in health care delivery,
  examines solutions to those problems, and
  regularly monitors the solutions for
  improvement

INNOVATION . . . is generally understood as the
successful introduction of novel and useful ideas
to the general organisational processes and
procedures and leading to significant
improvements in terms of improved or new business
products, services, or internal processes.
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Background of HQI2 Fund

• Healthcare Quality Improvement Fund
  (HQIF) Health Innovation Fund
• (started in FY05) (started in FY08)
• Healthcare Quality Improvement
  Innovation Fund
• (with effect from FY2010)

• Set up to support
• Public Healthcare Institutions
• Statutory Boards
• Intermediate Long Term Care Institutions
• with seed funding to pilot creativem innovative
  new value clinical quality improvement projects
  to advance the standards, safety quality of
  patient care

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Objectives

• Encourage creativity innovation from
  healthcare professionals to conceptualise,
  initiate, review, design and pilot clinical
  quality improvement projects or mini breakthrough
  collaboratives
• Support healthcare institutions to pursue
  innovative processes that needs to be
  experimented and trial tested
• Identify and promote best patient safety
  practices that can be propagated to other
  healthcare departments/institutions locally
• Strengthen patient safety culture among health
  care professionals

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Priorities for FY2010

• Alignment with Ministrys National Standards
  for Healthcare that addresses national patient
  safety and clinical quality improvement in the
  areas of
• i. Accessible Care
• (projects that attempt to redesign processes to
  reduce bottlenecks in patients flow, streamline
  operations, etc)
• ii. Appropriate Care
• (projects that expedite the adoption of evidence
  based practices)
• iii. Patient Centred Care
• (projects that facilitate the integration and
  coordination of care across the continuum of
  services)
• iv. Safe Care
• (projects that attempt to reduce HAIs,
  Medication Errors, and Pressure Ulcers etc)

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Who Can Apply ?

• MOH HQ Divisions
• Health Sciences Authority
• Health Promotion Board
• Restructured Hospitals / National Centres
• Form Partnership/Collaboration with
• Community Hospitals
• Intermediate Long Term Care Sector
• (government funded nursing homes)

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FY2010 Administration Cycle
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Fund Administration
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Assessment Criteria

• All applications will be assessed based on merits
  and against
• the extent to which they demonstrate the
  following
• Clearly identified aim and purpose
• Concise description of the proposed methodology
• Identification of possible obstacles and
  strategies to overcome the odds
• Baseline results should have been gathered and
  interim, final targets and outcome measures are
  clearly set to monitor the success factors
• Involvement and participation of
  multidisciplinary staff with the necessary
  skills, knowledge and experience in the project
• Serve national priorities rather than
  institution-specific priorities
• Opportunity to populate ideas to other healthcare
  institutions
• Management and financial commitment from the
  institutions to invest the resources to scale up
  the project upon successful completion.

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Projects Not Eligible

• Projects that have been or currently funded
• by
• Reinvestment Fund
• Health Services Research Competitive
• Research Grant
• Health Service Development Programme
• Health Research Endowment Fund
• Community Tote Board Fund
• Innovative Service Development Fund
• Mainstream funding from Block Budget and any
  other sources of Government-related or
  pharmaceutical company funding.

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Fund Administration

• The Ministry reserves the rights to terminate the
  project and stop all fund disbursement at any
  point in time if the Ministry deems the project
  to have failed to meet the pre-agreed targets and
  outcomes.

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Responsibilities of Project Director in the use
of Public Funds

• oversee management of project and to ensure that
  desired targets and outcomes are met
• ensure proper utilization and management of
  public funds by seeking Finance Department advice
  as and when necessary
• submit timely 6-monthly progress reports to
  update project achievement, cashflow (revision if
  any) and attainment of targets
• submit final report within one month of project
  completion
• inform MOH at any appropriate times if project is
  being delayed or has to be suspended/aborted
• submit ad-hoc reports as and when required by the
  Ministry
• present project at Healthcare Quality Improvement
  Innovation Forum and
• ad-hoc presentations as and when required by the
  Ministry
• inform MOH when the project is to be featured in
  media or publication
• accord due credits to MOH for provision of fund
  to support the project

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Common Issues Observed

• Manpower
• Unable to recruit suitable staff to kick off
  project
• Alternatives should be diligently explored such
  as
• arrange for existing staff from other department
  to kick start project on part-time basis until
  suitable staff is successfully recruited.
• Co-share staff with other Project Director(s) in
  your hospital/ institution/ cluster.
• Recruited staff fails to live up to expectation
  and under-performs
• Staff not compensated in accordance with
  institutions HR policy

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Common Issues Observed

• Finance
• Lack of oversight with fund usage/management
• Finance department deducts purchases/expenses
  from wrong account
• Source additional funds without seeking
  Ministrys approval
• Purchase additional IT hardware/ software without
  checking with IT Department on availability
• Grant additional perks/bonuses to project team
  beyond existing norms
• Failure to revise budget on a timely basis
• Funds is not permitted for overseas study trip

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Common Issues Observed

• Project Management
• Failure to seek institutions IRB approval when
  patient level medical related information is to
  be collected, analysed and published
• Failure to execute decision to suspend project
  when project was falling well behind schedule
• Failure to inform patients and seek patients
  consent or input when piloting solutions

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FAQ

• I might have over-projected the budget for my
  project. Will I be penalized? Can I retain the
  excess fund to pilot another project during the
  course of the year?
• MOH
• You will not be penalized for over-projecting
  the budget. However, you should revise your
  overall budget and declare the revision in your
  six monthly report.
• The Ministry will adjust the disbursement
  accordingly. Excess Funds can neither be
  retained by the Projector Director nor
  Institution to pilot other projects.

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FAQ

• I might have over-projected the budget for
  manpower and under budgeted for publicity
  expense. Can I move the funds around to make up
  the shortfall or should I seek extra fund from
  the Ministry?
• MOH
• If your project is still projected to cost
  within the overall approved budget, you have the
  discretion to move the funds from one account to
  another. However, you should revise the figures
  and reflect the actual expenditures in each major
  category in the final report.

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FAQ

• I received the letter from the Ministry
  informing that funds have been disbursed to me
  but I could not locate the fund to kick start the
  project. What should I do?
• MOH
• The funds are disbursed to your institutions
  existing account in the New Financial System,
  with a short description For HQI2F 2010/ xx
  Project. Your institutions CFO has received a
  list of all approved funded projects in your
  institution. You should get in touch with your
  CFO and/or Finance Officer in-charge to manage
  the fund prudently.

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FAQ

• I have another HQI Fund project from
  previous year and have yet to complete the
  project. Can I request for the new fund to be
  channeled to the existing account?
• MOH
• No.
• Each HQI Fund project is to be managed
  independently with its clear set of accounts i.e.
  expenditures. No transfer of funds is allowed
  between different HQI Fund projects.

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FAQ

• I decide to change the interventions mid way
  through the project and the additional lab tests
  may cost more. Do I need to inform MOH?
• MOH
• Yes.
• Once you decide to have any change in
  methodology/ interventions which would lead to an
  increase of expenditure and/or extension of
  project deadline, do write in to us providing the
  details and seek approval.

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FAQ

• The media would like to do a feature story
  on my project. Am I allowed to accept their
  request for interview?
• MOH
• The Project Director should inform the
  Ministry at least 2 weeks in advance of the
  interview. The Ministry must be acknowledged as
  the source of funding. You should also seek your
  managements approval and exercise sound judgment
  that no patient level details should be disclosed
  at all times. Any comments made will be deemed as
  your personal views. The Fund could only be used
  to register your participation and presentation
  at one local conference only.

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FAQ

• My team has worked very hard to help me with
  this project. Can I offer them a reward?
• MOH
• You have the discretion to use the balance in
  the fund to reward your team members at the end
  of the project to celebrate the successes. For
  instance, you may take the team out and treat
  them to a decent meal ie. capped at approximate
  30 per pax. However, the fund must not be used
  for staffs performance bonus or other
  salary-related payments. Giving of cash and cash
  vouchers to the team is strongly discouraged.

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FAQ

• Can I use the fund to present my project at
  local/international conferences?
• MOH
• You may only use the fund to co-pay conference
  participation after the project has been
  completed and report duly submitted to the
  Ministry and presented at the HQI Fund Project
  Forum, held every January and July. The Ministry
  would expect the institution to help with the
  co-fund of your conference registration. The
  Fund should not be used for procurement of air
  tickets, hotel reservations etc.

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Contact Person Weblink

• Jennifer Lee
• DID 63252944
• Email MOH_SQI_at_moh.gov.sg
• Admin Guidelines and Application
• form can be downloaded from MOH
• Internet weblink
• http//www.moh.gov.sg/mohcorp/hc
• system.aspx?id290

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Thank You