The Bulamu Health Center Excellence (HCE) Program

HCE Program Launched at 26 Public Facilities

Dick Chandler shown here with: Dr. Diana Atwine, Permanent Secretary of the MOH (in red); David Kabigumira, Chairman LC IV, Sheema District (far left); David’s wife, Jolly (in blue); and Mackay Masereka (far right), Bulamu‘s Uganda Program Director.

Beginning in April 2019, the Bulamu Health Center Excellence Program has been installed at 26 Ministry of Health (MoH) facilities in Sheema District that treated 224,000 patients in 2018. The HCE program is a comprehensive hospital and clinic management system designed to improve clinician productivity and raise the level of patient care.

Besides introducing 24 new patient treatment forms and management reports, we also donate badly needed medical devices, hospital equipment, computers, and supplies as part of this program We have executed a Memorandum of Understanding (MOU) with the Ugandan government that provides a template for extending this pilot program, once its efficacy has been demonstrated, to other local government districts where we have held Supercamps.

How does the HCE Program work?

Here are some of the key innovations that have been built into the Bulamu HCE Program, which is embodied in a 125-page Standard Operating Procedure Manual.

  • New outpatient, inpatient, and maternity treatment forms that go into a file folder for each patient, with a copy for them to take home.
  • A package of medical devices and office equipment for each facility, including stethoscopes, thermometers, scales, blood pressure monitors, glucometers, pulse oximeters, hand-washing stations, timeclocks, computers, printers, and file cabinets.
  • New clinical procedures, such as taking vital signs and instituting standardized antenatal exams for each month of pregnancy.
  • A tracking system for measuring outpatient treatment times, unfilled prescriptions, and other customer service indicators.
  • Weekly dashboards to measure Key Performance Indicators (KPIs), such as clinician productivity, staff absenteeism, patient cycle time, procedures performed, disease occurrences, unfilled prescriptions, medication stockouts, and training hours.
  • A cloud-based data warehouse system to store all the new data being collected on staff productivity and clinic performance.
  • New business processes for addressing out-of-stock items and redistributing these needed drugs and supplies between facilities.
  • Issuance of regular management reports and facility rankings for the first time, so district officials can provide proper oversight and actively manage the facilities.

System strengthening

Because Bulamu has earned the trust and admiration of the 15-20 local district governments where we have held medical camps, we are uniquely well positioned to reform the MoH network of facilities from the inside. Senior officials in the MoH in Kampala are very supportive of the HCE Program and have asked us how quickly we can extend it to all 3200 public health facilities. The Ugandan government has shifted its priorities from building more bricks-and-mortar health units to emphasizing “system strengthening” across their existing network. Thanks to the HCE Program, Bulamu is perfectly positioned to help lead that transformation.