LocationsHealth center of Sarajevo Canton
Better health services for 420,000 people with lower costs made possible by improving management
December 16, 2022
JU Dom zdravlja Kantona Sarajevo
"The pandemic of the COVID-19 virus has significantly burdened the functioning of the Public Institution Health Centre of Canton Sarajevo (DZKS), which takes care of the primary care of about 420,000 people living in the Canton, and brought to light many problems in its functioning, primarily related to the organization of work, lack of staff and the disorderly process of public procurement", said the director, Assoc. Ph.D. Abel Baltic.
DZ KS employs over 2,100 people in 84 locations and 206 family medicine clinics, and during the biggest shocks during the COVID-19 virus pandemic, the number of persons examined per day reached close to 60,000, or the total population of KS in seven days, but due to the emergence of respiratory infections among children, the pressure it does not abate, so pediatric services sometimes examine up to 6,000 children a week, said Baltić.
"Public Intitution Health Centre of Sarajevo Canton is one huge apparatus, in which many problems, many weak points have been recognized. We didn't know how many vehicles we had, legal acts were unorganized, relations with employees were unresolved," said Baltić.
Through the project "Strengthening the integrity of public enterprises" (PEIP), which was launched in July 2019 at the initiative of the then cantonal government and which is financed by the Government of the Kingdom of Norway and implemented by the United Nations Development Program (UNDP) in Bosnia and Herzegovina, DZ KS has identified and analyzed in detail many shortcomings in the management system and laid the foundations for solving them, said Baltić, who took over the management of this institution in August 2021.
The director of DZ KS believes that these and other measures and activities will help this institution to recover from the shock caused by the pandemic and to be ready to respond to its tasks in the best way in the near future..
"It's finally time to deal with medicine, to deal with improving the quality of health services we provide to citizens".Director of Health Centre public institution, Canton Sarajevo dr. Abel Baltić
From the middle of December, a new systematization of workplaces, prepared in accordance with the laws and the collective agreement for healthcare employees in KS, entered into force, Baltić said, and added that the employment of about 100 new doctors, about thirty nurses and technicians, about forty female workers personnel shortages caused by inadequate planning should be solved for hygiene maintenance and eight drivers.
In addition, in the past period, DZ KS renewed its medical equipment with, among other things, four new modern x-ray machines, five ultrasound machines and two medical vehicles equipped with defibrillators for resuscitation of patients with pacemakers, added Baltić.
During the participation in the PEIP project, the DZ KS paid special attention to developing mechanisms for strengthening integrity and preventing corruption, strengthening the internal audit function, adopting ethics and codes of conduct, and overall improvement of the institution's transparency.
"We created a new Integrity Plan, i.e. the first Integrity Plan, in which we identified in detail all risky processes and formulated measures. We also adopted the first Code of Ethics and changed the Ethics Committee. We created a new website where every decision signed by anyone from the administration is public and transparent", said the director of the DZ KS at the final conference of the PEIP project, where it was evaluated as a positive example for all levels of government and other parts of BiH.
Završna konferencija PEIP projekta
"The adopted Integrity Plan now gives us some hope that the management of public institutions, primarily ours but also others that will be lucky enough to be involved in this type of project, will be correct in the long term and contribute to the improvement of efficiency and better provision of services to our end users. This would mean that they are not guided by some kind of intuitive abilities of certain managers who come to the head of the institution, but that transparent, public and high-quality parameters on the way of management are set," adds Baltić.
As DZ KS is an institution with one of the largest budgets in KS, special focus within the project was placed on the need for proper and efficient management of its resources, such as the public procurement process. From the total amount for the functioning of the DZ KS, 3-5% will be spent on public procurement and other expenses, while the rest is intended for the gross personal income of the employees, says Baltić.
"Nevertheless, the figures that are annually spent on public procurement in our institution are not small, but now everything is public, everything is transparent. We are connected to the Office for Combating Corruption and Quality Management, and every document we release into legal circulation is automatically forwarded to them. We want to work even better and more transparently so that we can get everything we need for a smaller amount of money," he said and added:
„We are doctors by profession, and we thought that we should only practice medicine, that we should improve in that part, but that is wrong. Now we're learning and trying to do things in the best possible way in an area where we didn't do very well."
"In these 14 months, and especially the last seven months, we have significantly increased the number of services and reduced business costs, which I consider a significant progress".Director of Health Centre public institution, Canton Sarajevo dr. Abel Baltić
In order to strengthen the capacities of personnel participating in public procurement processes, the PEIP project, through targeted and need-based training and mentoring support, worked to strengthen the critical skills and knowledge of personnel in the field of planning and implementation of public procurement, including areas such as market research , the responsibility of individuals in this process as well as the management and monitoring of contract execution.
For the sake of greater transparency of the public procurement process, the DZ KS has started using a computer program that monitors the implementation of all contracts and eliminates the possibility of any error, said Baltić.
The new Code of Ethics was adopted with the recommendation of the PEIP Project that the best practices and experiences should be included in order to prescribe an acceptable way of behavior of the staff in terms of professional and conscientious business, relations with patients and respect for their rights, preservation of personal, professional and institutional integrity and monitoring implementation of the Code itself.
DZ KS also adopted the proposed Code of Conduct, with the aim of establishing a protective mechanism against unethical and unprofessional behavior of staff. The Code offers practical guidance for dealing with ethical dilemmas on issues such as integrity in the provision of health care (including gifts), responsible treatment of patients, protection of confidential information, and professional relationships and collaboration with colleagues.
In addition to the Integrity Plan, in accordance with the recently adopted Law on the Prevention and Suppression of Corruption in the KS, the DZ of the KS adopted the Policy on Mandatory Disclosure of Assets and Income of Holders of Executive Functions as well as the Rulebook on Prevention of Corruption.
Abel Baltić, direktor JU Dom zdravlja Kantona Sarajevo