Policy Brief on National Policy Action Toward Improved Hospital Management and Administration

The interventions aimed to strengthen accountability of health workers and improve hospital capabilities to lower hospital-acquired infections. The EEHR Project implemented various interventions, including hospital visitor control policy and procedures, human resources management, incident reporting, medication administration, space utilization, outsourcing of non-clinical services, hospital environmental services, internal communication and public relations, customer care, and hospital autonomy. Lessons learned from the implementation of these interventions support the conclusion that national-level policy action is necessary to improve hospital management and administration. Human resource management practices were identified as a key area for improvement. Detailed job descriptions for each employee were found to be essential for holding employees accountable, measuring their performance, and planning for professional improvements. However, the practice observed in hospitals was for employees to have general job descriptions that were not individualized. The EEHR Project provided training and technical support to create job descriptions that are specific for individual hospital employees. These job descriptions were created collaboratively with employees and their supervisors and serve as a basis for holding employees accountable and evaluating their performance. New employee orientation was also identified as a critical area for improvement. New hospital hires need a good orientation on all key aspects of hospital organization and operations. The EEHR Project assisted the three pilot hospitals in introducing new employee orientations, which included developing employee orientation manuals and conducting orientation sessions for all current and new employees. The human resource departments working in conjunction with other departments are responsible for the planning and organization of orientation sessions. Effective hospital environmental services are also crucial for reducing hospital-acquired infections. The National Protocol for Prevention of Hospital Infections was published in 2012, and the NCQSA accreditation process emphasizes the importance of infection prevention. However, Infection Control Committees and Infection Units exist largely on paper, and sanitation services are not departmentalized as a separate functional area within the hospital. The EEHR Project trained groups of selected hospital staff on organizing and managing hospital environmental services and assisted pilot hospital teams in developing hospital-specific standards for cleanliness and inspection of sanitation and environmental issues. The HRISG meeting resulted in the approval of recommendations for national-level policy action to improve hospital management and administration. The recommendations include making individualized job descriptions a part of each employee record, requiring all hospitals to develop new employee orientation manuals, and implementing measures to make Infection Control Units and Infection Control Committees operational. Additionally, a working group is proposed to develop a National Program on Infection Control, inclusive of Terms of Reference for Infection Control Committees, Infection Control Units, and Environmental Services Departments.