Loading page...

Provincial hospital, international standards

Published: 
9 May 2017

A shortage in medical personnel saw the new Dong Nai General Hospital create a long-term training programme to meet its human resource needs as well as achieve international accreditation.

Like many other public hospitals around the world, Vietnam’s Dong Nai General Hospital was no stranger to the chronic problem of patient overload. Just a provincial hospital when it was established in 1952, the hospital struggled for many years to accommodate 2,000 to 2,500 patient visits per day while handling 1,000 inpatients with only 800 beds available. In 2006, based on the proposal of the Dong Nai Provincial People's Committee, the Prime Minister approved US$210,000 in funds for the construction of a new Dong Nai General Hospital.

Construction was completed in April 2015. The new hospital boasted 1,400 new beds, nine functional offices, 23 clinical departments, and 10 sub-clinical departments. At the time, Dong Nai General Hospital Director, Dr Phan Huy Anh Vu, noted that the new infrastructure, equipment and its management team and staff would contribute heavily to the hospital’s future success. Since then the  hospital has become one of the largest hospitals in the country, offering high quality healthcare services. By 2020, it expects to have in place accredited international standards that will see it provide medical services to foreign professionals working in the various local industrial parks.


Dong Nai General Hospital

Challenges to human resources

To achieve the ratio of 0.2-0.3 doctors per bed specified under the guidelines from the Ministry of Public Health in Decision 2997/QD-BYT, the hospital needed to recruit around 380 to 400 doctors, The additional doctors were expected to be sourced from the medical workforce in both Dong Nai province and across the nation, as well as from new graduates of medical schools such as Dong Nai Medical College and the University of Medicine and Pharmacy.

It also designed attractive compensation schemes to attract graduates and experienced doctors,[1] including the immediate payment of VND10 million to doctors completing their first day of employment. “The Board of Management understands the aspirations of young doctors to have education opportunities as well as career development and advancement opportunities, together with a stable job, a secure income and a personal life,” said Dr Le Ngan, dean of orthopaedics.   

However, as Le Tram, the hospital’s human resources manager notes, there is a human resource gap in terms of quality. “We need more leading experts and professional managers to run the hospital,” she says. The hospital lacks skilled doctors who are able to proficiently operate advanced equipment and treat serious diseases. Up to 59 percent of the doctors are undergraduates and details of employee education levels are given below in Table 1. According to Dr Le Ngan, young graduates obtain their general medical knowledge at college. When they come to work at the hospital they will be oriented and trained in a specialisation.[2]

Weak management skills are also of concern. The hospital’s management team mostly have medical backgrounds: the leading medical experts appointed to management positions have little experience in directing hospital operations even though they excel at medical treatments. “Members of the leading and managing team are doctors, who are prominent at their majors, but not well-trained in managing,” said Dr Vu, a director of the hospital. The management team also has limited experience in operating and managing the hospital in the context of a combination of the public and private model.

Le Tram corroborated Dr Vu’s observation, adding that the management team  needs to be trained in cutting-edge management skills to facilitate the productive capacity and sustainable development of the hospital.

Table 1. Employee education levels.

Source: Employee Track, Dong Nai General Hospital, December, 2014
 

Diversified and flexible training as a solution for the gap

When the labour market failed to supply employees with sufficient skills, training became the most desired approach to filling the HR quality gap. This saw Dong Nai General Hospital collaborate with the Dong Nai Department of Health to design the five-year Human Resources Training Project for 2014-2018, which covers every aspect of medical staff capability training, including technical, management, and communication skills. Training costs are covered by the government.


Table 2. Breakdown of employee training.

Source: HR Training Plan 2014-2018, Dong Nai General Hospital.


The hospital employs several means to customise training for its employees.

Medical staff are sent to training sessions at reputable hospitals in Vietnam, such as Cho Ray, Tu Du and Hung Vuong hospitals, where they are able to become familiar with modern medical equipment and perform under pressure in real time. Doctors are also supported to take extra external classes in order to pursue postgraduate degrees. The higher education allows them not only to deal with more complex treatments in serious diseases, but also to prepare for future career progression including to take on management roles such as the vice dean or dean of a medical department. At present the Vietnam Ministry of Health requires doctors to have Specialist I (a Master’s degree equivalent) or Specialist II (a PhD degree equivalent) qualifications.

It also invites experts to support technical training such as interventional cardiology and thoracic surgery. Doctors take turns to be trained so that their daily duties are not compromised and the hospital minimises the possibility of doctor shortage. New doctors are mentored by experienced colleagues within three to six months to be ready for specific tasks. On-the-job training is the most flexible form of training and allows junior doctors to learn every day under the guidance of senior doctors during real-case diagnosis and treatment.

For overseas training, the hospital has various cooperative arrangements with Taipei Chang Gung Memorial Hospital (Taiwan) and King Chulalongkorn Memorial Hospital (Thailand). Managers and medical staff from 20 faculties and functional departments are sent to Taiwan and Thailand to experience technology transfer as well as to improve their technical and management skills.          

Most importantly, the hospital is now implementing a project to achieve accreditation from the Joint Commission International (JCI), considered to be the gold standard in global health care. By meeting JCI standards, the hospital will operate more efficiently, its employees will have greater competence, and it will be able to attract international patients who will be able to declare the cost of treatment at the hospital with their insurance companies.   

Accreditation means the hospital will have to operate under the 321 JCI standards, including 3,000 detailed terms, with the quality of human resources being an important JCI standard. All staff must be trained under a professional JCI standards programme. This has seen Dong Nai General Hospital hire external experts to help it design and implement the programme successfully, and ultimately help it meet the shortfall in the number of qualified medical professionals needed by the hospital. Experts and specialists drawn from the United States and Southeast Asia as well as Vietnam also help.      

In Vietnam, only one health institution has thus far received JCI certification. All employees at Dong Nai General Hospital are now working hard to achieve this accreditation by 2019.

Conclusion

The Vietnamese government is investing to improve its healthcare system in three key areas, the development of facilities, a technology upgrade and an improvement in the quality of human resources. In addition to the attractive compensation for the medical workforce, human resource planning now needs to focus on increasing training opportunities and exposure to technology education. By leveraging the support of the government, neighbouring hospitals, and international health institutes to facilitate learning exchange and application of advanced healthcare practices and technology, Dong Nai General Hospital is on the right track to achieve its vision. Its win-win solutions will facilitate the operations of all partners as well as boost the quantity and quality of human resources at the hospital, while the application of various types of human resource training and development demonstrates the flexibility and determination of the hospital’s management team.

Viewed together, Dong Nai General’s achievements provide an example to other public hospitals in Vietnam, and is to be emulated in their transformation to self-responsibility in all aspects of management.

 

Minh Tan Nguyen is a full-time lecturer in the MBA programme, Huong Thi Thu Pham a former student, and Ngoc Hai Nguyen a student at the School of Business, International University, Vietnam National University, Ho Chi Minh City, Vietnam

 

[1] See“Attraction Compensation Scheme” below.

[2] Medical undergraduates in Vietnam receive general training aimed at treating a broad category of patients. After graduation, doctors are then able to pursue postgraduate training by attending a two-year programme in their chosen specialisation known as CK1 (Specialty 1). CK1 is the clinical track equivalent of a Masters degree in the medical academic track.

 

References

     Recordings (Vietnamese)

Keep up to date with what's happening at the Asian Management Briefs.