Quality standards for health promotion and disease prevention services in Thailand

1. Background

Since 2011 the Ministry of Public Health (MOPH) and the National Health Security Office (NHSO) has collaborated in health promotion and disease prevention program, which aims to provide a high quality of health promotion and disease prevention services for all Thai people. Although the NHSO has indicators for health promotion and disease prevention services, health care providers still have unclear standard guidance. Consequently, this can lead to misunderstanding among health care providers and relevant stakeholders regarding how health promotion and disease prevention services should be delivered in an appropriate manner to ensure the best quality of services.

One initiative developed for improving quality of care across primary and hospital care settings is the implementation of Quality Standards (QSs). QSs are a concise set of evidence-informed statements, designed to drive and measure priority quality improvements, within a particular area of care [1]. QSs provide guidance and advices for health professionals, as well as a range of information services for patients and public.

The Global Health and Development Group, Institute for Global Health Innovation, Imperial College London (IC) has succeeded in developing QSs not only in the United Kingdom (UK) but also in India and Vietnam. For Thailand, QS development could underpin the work of health care institutions, for example, the NHSO can use indicators based on QSs for evaluating quality of services and allocating budget accordingly. The MOPH can use QSs for monitoring and evaluating the performance of sub-coordinated organizations, as well as for planning and improving of its services, and QSs could interface closely with other quality improvement initiatives, including clinical audit.

QS is a new concept for Thai health care system and Thailand has never implemented this initiative before. However, Thai policy makers especially NHSO anticipated that this initiative could be helpful for Thailand to improve quality of care. Therefore, the NHSO approached the Health Intervention and Technology Assessment Program Foundation (HITAP Foundation) to develop evidence-informed quality standards on health promotion and disease prevention from existing Thai clinical practice guidelines.

2. General objectives

1. To develop process and method guide (“guidelines to develop QS”), with related tools and templates, towards systematic, transparent and evidence-based approaches, and collaborated with relevant stakeholders

2. To develop QS for health promotion and disease prevention services

3. To provide recommendations for QS implementation in the Thai health system

3. Specific objectives

1. To develop QSs towards systematic, transparent and evidence-based approaches, and with collaboration of key stakeholders

2. To develop guideline for QS development including tools and templates, with technical support from IC team

3. To strengthen capacity of the NHSO staff, officials of the MOPH, staff from related organizations, and other Thai scholars regarding how QSs should be developed using systematic, transparent and evidence-based approaches

4. To prioritize and select three health promotion and disease prevention services for QS development

5. To develop QSs for the three prioritized services

6. To provide recommendations for QS implementation within the Thai health system and empowerment of relevant institutions

4. Methodology

The QS development in this project will follow different processes as describes below:

1. Convene the Quality Standard and Indicators (QSI) Committee and academic team (IC and HITAP Foundation)

2. Develop a method guide for QS development by academic team

3. Prioritize and select three health promotion and disease prevention services for QS development

4. Recruit working group for QS development including staff from the NHSO, Officials in departments in the MOPH, and academia and health professionals in medical schools and universities

5. Develop QSs for selected health promotion and disease prevention services

6. Present the QSs to related stakeholders

7. Present the QSs to the QSI Committee

8. Present the QSs to the NHSO for approving and implementing

To study QS implementation and empowerment, literature from the UK, Vietnam and India will be reviewed, as well as interviewing health care providers and consulting with IC team. Further, academic team will present recommendations to stakeholders and the QSI Committee, and draft the final report.

5. Action plan

This project is divided into two phases including phase I in 2017 and phase II in 2018. For phase I, there are QS guideline development, capacity building for working group and interested participants. This will be taken place in parallel with the QSI Committee appointment, service selection for QS development, and recruitment of QS working group (see table 1). For phase II, it is the process of QS development in the three prioritized health services, and to present these QSs to the QSI Committee, stakeholders, and the NHSO, as well as provide recommendations for QS implementation within the Thai health system, and empowerment of relevant stakeholders.