Cam Thuy Hospital’s ‘Vision 2020’: How Vietnamese-German cooperation has helped to transform a district hospital

Hospital Billboard

Ambitious objectives

When our team of the GIZ Health Programme “Strengthening Provincial Health Systems” visited Cam Thuy District Hospital at the end of March 2014, the first thing we saw at its entrance was a big billboard spelling out the hospital’s “Vision 2020”:  “By 2020, this hospital will have undergone comprehensive developments and be equipped with adequate high-tech equipment. It will have good managers, skilled and patient-centered professional staff; it will be a clean and green hospital providing a friendly and cooperative working environment. It will be trusted and held in high esteem by the entire population because it meets all their needs regarding examination and treatment.”

These are ambitious goals, we thought. Can this hospital meet them in only six years? We were skeptical - and then we had a closer look.

Developing a strategic plan

In 2010, our programme had supported Cam Thuy Hospital in developing a strategic plan for the period 2011 to 2015 and a first vision reaching up to 2020. After the plan had been approved by the provincial authorities, in March 2011, it was introduced to health staff of all departments at a launching workshop. The plan spelled out clear roles and responsibilities for every hospital staff member and it allowed them to use the document as an orientation for their work and as a basis for their annual hospital planning.

Three and a half years later, all of us could see that the hospital had changed quite dramatically. Both on the outside, with its green surroundings, and on the inside, the hospital today looks fresh and clean. The Outpatient Department is well organised and there is a lot of information for patients on signboards, including an organisational chart indicating who is responsible for what. The staff we spoke to appeared busy, professional and committed to their work. 

Comprehensive technical support and new equipment

This impression was confirmed by Dr. Nguyen Van Nguyen, the director of the hospital. According to him, ”the hospital staff is very pleased with the changes in the hospital and enjoys working here.” According to him, the progress has largely been due to the technical support of GIZ provided over the past few years. The GIZ-supported capacity building measures included:

  • training in endoscopic surgery
  • training in live saving skills for the staff of the emergency department
  • an introduction to Total Quality Management (TQM) for the hospital managers and
  • trainings for newborn emergency care for the nurses in the neonatal department.

In addition to the capacity development, Germany supported investments in new equipment and hospital infrastructure through KfW Entwicklungsbank: A digital electro-encephalography machine, endoscopic as well as resuscitation equipment and modern incubators were installed in the respective departments.

Impressive results

Following the introduction of the Total Quality Management approach, Cam Thuy Hospital worked hard to achieve high quality standards for its patient records. And the efforts paid off: While in June 2011 only half of all patient records met the required standards, in 2013, this was true for 87 % of them.

The quality management measures also improved the hospital’s rational drug use: Whilst in January 2011 100% (!) of patients received antibiotic injections, this proportion has today been reduced to a realistic rate of 72%, and the use of more than two antibiotics at a time has been eliminated completely, indicating that the hospital has sustainably established rational drug use by its medical staff.

The improved management and the broad range of services the hospital is now able to provide has made a big difference for the surrounding population: Today, if they need endoscopic surgeries for the treatment of appendicitis, ovary cysts or even complex bone surgery, they no longer need to travel the 70 km distance to the provincial hospital: They can access all these services nearby, in their own district hospital.   

As a consequence, between 2012 and 2013, the number of outpatients almost tripled from 1.715 to 4.597 and the number of inpatients increased from 12,526 to 14,479. Correspondingly, the number of cases that had to be referred almost halved from 3,7% to 1,9%.

This increase in patients also meant that Cam Thuy Hospital’s revenues increased markedly so that the management decided to increase their health staff’s monthly income by 30%.  In addition it invested a substantial proportion of its revenues in new hospital equipment.

Dynamic leadership is key

One thing we learned when visiting Cam Thuy Hospital is the importance of a dynamic and passionate leadership when it comes to improving hospital management and service delivery. In response to the health worker shortage in his province, hospital director Dr. Nguyen Van Nguyen came up with creative solutions. He set up a student recruitment programme for students from Hanoi and Hai Phong Medical University and organised a cultural festival to attract them to his district and district hospital. And this approach has worked: Today, the hospital has gained a good reputation for its quality management among students and many of them have come or are planning to come to work in Cam Thuy.

In 2013, six young doctor’s positions and two management positions were filled. The newly recruited managers, Dr. Tuan and Dr. Trong, made it clear to us that they are dedicated to even further improve the services in the surgery and obstetrics department.

At the end of our team’s visit to Cam Thuy Hospital, our initial scepticism had vanished. With this kind of leadership and the staff’s level of skill and commitment, Cam Thuy hospital is well underway to achieve its Vision 2020.  

MD. MPH. Ngo Le Thu
GIZ Programme Strengthening Provincial Health Systems, Vietnam

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