From the emerging of Ottawa Charter, There are a lot of movements about health promotion in Thailand. Almost of Public hospitals in Thailand try to develop themselves to be Health promoting hospital. Ministry of Public Health of Thailand, by Department of Health established the standard criteria for Health promoting hospital (HPH) accreditation and co-operate with Institute of Quality Improvement and Hospital Accreditation of Thailand to accredit his standard. And now this standard is integrated to Haspital Accreditation standard for convenience implementation in hospital.
Bantak hospital, the 60 beds hospital in Bantak District, Tak Province, in the Northern part of Thailand has received HPH Accreditation since 2004. I (Director of Bantak Hospital 1997-2007) and my staffs created the new model for developing to be HPH. This model is called Total Healthy Management or The 9th Disciplines for Health promoting hospital.
This model has 9 elements as the following:
1.Focus on health : It has to take care of population as Holistic approach, Bio-psycho-social dimensions, not only cure the disease in patient but care the illness in whole person, to make population having good health in physical well-being, psychological well-being, social well-being and spiritual or intellectual well-being.
2.strategic driven : It has to apply strategic management concept in working. Setting appropriate vision, goals, objectives, strategies. Implementation these strategies by using Balanced scorecard technique. This element needs the leader whom has system approach, visionary leadership, system perspective with agility of teamwork.
3.Empowerment : Health empowerment need to be created in population for having health literacy and self efficacy. This slogan is “Good health is not for sale, but do it by your-selves.” So everybody is stakeholder to give and take good health to themselves and each others.
4.population & community focus: Health care provider need to do more than in hospital, but to do for all population in their catchment area. It has to shift from patient centered care to population centered care. They have to classify their customers to at least 3 groups, Healthy population, Population at risk, Sick and disability population. Then they should establish the appropriate health program for each group. They have to work with community and social responsibility and use correctly data and information.
5.process management : It has to fulfill with 4 main functions of management; planning, organizing, leading and controlling (monitoring, supervision, evaluation) in core process management of service; registration, evaluation, care delivery, discharge, follow up. Quality of care is the first priority in process management in all kinds of services such as individual service, mass service, social/community service and in all elements of service such as personalized service (professional or technical skill, communication skill, good behavior in service), facility content in service (i.e. Building, Environment, Equipments) , product content in service (i.e. food, drugs, water, medical materials).
6.Innovation & creativity: It has to have individual and organization learning for being intellectual capital of organization. Intellectual capital will be emerged when the staffs have competency and commitment. So the leader have to behave to human resources as asset, not cost. The staffs will create innovation in health services. And it require the 4 creative thinking; Integrated thinking, system thinking, positive thinking, lateral thinking and application of appropriate knowledge management tools to track the tacit knowledge for approving best practice.
7.teamwork with commitment: All of staffs need to work together to make good results of organization with shared vision, making consensus and opened mind. They have to shift paradigm from focusing on “Me” to “We”.
8.participation: They have to work together by joining thinking, planning, implementing, monitoring, evaluating with Democratic culture, two ways communication, qualitative information, management by fact, Evidence-based approach and knowledge sharing (especially tacit knowledge).
9.sustainability: It take long time to do for good health, so we have to focus on ultimate outcomes and create value of our work. The sustainability in health promotion have to produce “KSAB” in population. KSAB is Knowledge, Skill, Attitude and Behavior. You have to think globally, but act locally.
If you want to implement this model to improve your hospital to be HPH. You have to clarify, understand each elements and make it easy or simple. The hospital will be survived because of quality, efficiency and economy that making good health at low cost by avoiding illness, high risk, high technology, high cost but low touch and producing healthy, use low technology, low risk, low cost but high touch.
Phichet Banyati,
Verbondstraat 52, Antwerp, Belgium
October, 17th , 2007
I just put THM Model here.