1. Governance of a Department of Surgery – an Overview Using a Framework Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg Annual Conference of Tripartite Training Institution in Manila March 27, 2015

2. Governance of a Department of Surgery – an Overview using a Framework Greetings! Thank you! invitation and opportunity to share with you my thoughts, perceptions, opinions and recommendations (TPOR) on Governance of a Department of Surgery

3. Governance of a Department of Surgery – an Overview using a Framework ROJ’s TPOR derived mainly from being Chief of Division of the Surgical Oncology, Head and Neck, Thyroid, Breast, Skin and Soft Tissues and Esophago- Gastric Surgery (from 1991 to 2000) Chairman of Department of Surgery of Ospital ng Maynila Medical Center (from 2000 to 2009) Lecturer on Administration of a Department of Surgery for Master in Hospital Administration students (since 1993 up to present)

4. Governance of a Department of Surgery – an Overview using a Framework Definition of Governance “Establishment of policies, and continuous monitoring of their proper implementation, by members of the governing body of an organization. It includes mechanisms required to balance the powers of the members (with the associated accountability), and their primary duty of enhancing the prosperity and viability of the organization.” Source: http://www.businessdictionary.com/definition/govern ance.html#ixzz3Q13RuEMphttp://www.businessdictionary.com/definition/govern ance.html#ixzz3Q13RuEMp

5. Governance of a Department of Surgery – an Overview using a Framework This topic on governance of a department of surgery is relevant to all of you - whether you are surgical residents or surgical consultants whether you are members of the governing body or not

6. Governance of a Department of Surgery – an Overview using a Framework Governance is related to one of the competencies expected of surgeons, that is, being a physician-manager or surgeon-manager aside from being a clinician, teacher, researcher, etc.

7. Governance of a Department of Surgery – an Overview using a Framework Governance of a department of surgery - extensive topic to discuss and to learn! Will just give an overview of governance of a department of surgery and

8. Governance of a Department of Surgery – an Overview using a Framework Governance of a department of surgery - extensive topic to discuss and to learn! will just present 3 projects (developed when I was Chairman of Department of Surgery of the Ospital ng Maynila Medical Center from 2001 - 2009)

9. Governance of a Department of Surgery – an Overview using a Framework Governance of a department of surgery - extensive topic to discuss and to learn! The 3 projects selected by the OMMC Organizing Committee: Problem-based Learning Issues Medical Anecdotal Reports Indigent Patient Help Program

10. ROJoson Framework - Overview of Governance of a Department of Surgery

11. Have been lecturing to students taking up Masters in Hospital Administration since 1993 Over the years, specifically, in 2010, came up with this framework which can use as a guide and checklist in the establishment and development of any department in a hospital by the governing bodies, both at the top level as well as at the department level

12. ROJoson Framework - Overview of Governance of a Department of Surgery A generic framework which can be used for a department of surgery Just change the word “Department” into “Department of Surgery”

13. ROJoson Framework - Overview of Governance of a Department of Surgery

15. Primary responsibility of governing body or leadership! For each box, must have documents - design and development blueprint evidence of implementation evaluation results of implementation

16. ROJoson Framework - Overview of Governance of a Department of Surgery Basic processes of management – inputs, outputs, throughputs and evaluation and continual improvement

17. ROJoson Framework - Overview of Governance of a Department of Surgery Systems Approach to Hospital Operations: Department of Surgery http://www.slideshare.net/rjoson/systems-approach-to-hospital- operations-department-of-surgery

18. ROJoson Framework - Overview of Governance of a Department of Surgery

19. Functions - officially authorized functions of the department of surgery Have to be clearly and completely spelled out and publicized Serve as the main steering wheel or compass for the department development Bases for interfacing with other departments in hospital Bases for evaluation purpose

20. ROJoson Framework - Overview of Governance of a Department of Surgery Example of authorized functions: General Function: To provide quality health services to all patients needing management in the field of surgery (general surgery, colorectal surgery, pediatric surgery, urologic surgery, neurosurgery, plastic and reconstructive surgery, thoracocardiovascular surgery, and orthopedic surgery).

21. ROJoson Framework - Overview of Governance of a Department of Surgery Example of authorized functions: Specific Functions: To provide quality health promotion and disease prevention program in the field of surgery to clients in need of such service. To provide quality and safe diagnostic and therapeutic procedures to all patients with surgical problems. To provide quality and safe pre-operative, intra-operative, and post-operative surgical care to all patients in need of such health care service. To provide quality rehabilitative health programs in the field of surgery to all clients in need of such service.

22. ROJoson Framework - Overview of Governance of a Department of Surgery

23. Service outputs - ultimate goals of the department of surgery in terms of service generally and basically cost-effective or value-based services In simpler terms: good health care delivery outcomes (good results) such as optimal surgical mortality and morbidity rates success treatment rates quality and safe services with reasonable costs and expenses

24. ROJoson Framework - Overview of Governance of a Department of Surgery

25. RISK MANAGEMENT PROGRAM - planned and systematic process or program to reduce and/or eliminate the probability of a “risk” that usually results in injuries, losses, and legal suits BUSINESS DEVELOPMENT PROGRAM - program that will develop the business of the department of surgery to make it viable and sustainable

26. ROJoson Framework - Overview of Governance of a Department of Surgery REGULAR PERFORMANCE EVALUATION AND CONTINUAL IMPROVEMENT PROGRAM -appraising extent of accomplishment of the department of surgery in its authorized functions and business plans -at planned intervals (quarterly, biannually, and annual) and -to determine areas of improvement and to act on them.

27. ROJoson Framework - Overview of Governance of a Department of Surgery Primary responsibility of governing body or leadership! For each box, must have documents - design and development blueprint evidence of implementation evaluation results of implementation Advices: Use as checklist Start develop them now To become an excellent department of surgery!

28. ROJoson Framework - Overview of Governance of a Department of Surgery Systems Approach to Hospital Operations: Department of Surgery http://www.slideshare.net/rjoson/systems-approach-to-hospital- operations-department-of-surgery

29. ROJoson Framework - Overview of Governance of a Department of Surgery Details on what and how I did in Department of Surgery of Ospital ng Maynila Medical Center from 2001 to 2009, when I was its Chairman, visit the following website: (https://rojosonommcsurgeryfilesandnotes.wordpress.com/governance- 2001-to-2009)

30. ROJoson Framework - Overview of Governance of a Department of Surgery Feel free to ask me questions either through email (rjoson2001@yahoo.com)rjoson2001@yahoo.com or through my cellphone number (09188040304)

31. Governance of a Department of Surgery – an Overview using a Framework Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg Annual Conference of Tripartite Training Institution in Manila March 27, 2015