Federal Ministry of Health

Office of Director General for Medical Services

Preparation Guide to Conduct Lab Session for Hospital’s I-CARE Program Implementation
Introduction

After several discussions with local and international key stakeholders including senior
administrative and technical experts, it is officially known that the Federal Ministry of Health
through its office of Director General for Medical Services has identified and decided BFR-
Model to be used for the effective management and implementation of the National I-CARE
Program at all levels. Following this ministerial strategic decisions on the importance and need
to uniformly use BFR-Model, the 24 hospitals which are nationally selected as implementation
sites for the national I-CARE Program are strictly expected to go through all steps of the model.
With the aim to make clarity on the concept, objectives, implementation strategies and ultimate
outcomes of the I-CARE Program starting from its inception, the Office of Director General for
Medical Services at Ministry of Health has been actively engaging these 24 hospitals during the
development stages of the program.

In his opening speech at the 21st Health Sector Annual Review Meeting (ARM-2019) of Ministry
of Health, H.E Minister Dr Amir has officially announced the National I-CARE Program as his
top priority of 2012 E.C and beyond. Promising to provide all the necessary supports from
ministry’s side, he has also emphasized and urged leaders of the 24 hospitals and regional health
bureaus to immediately start preparation right after closing of the 21 st ARM-2019. To all
representatives of the 24 I-CARE implementing hospitals and regional health bureaus, the
Director General for Medical Services of the ministry has briefly presented and explained
priorities of I-CARE Program. After having thorough discussions and consideration of all
valuable comments raised by leaders of I-CARE implementing hospitals including other key
stakeholders, the following priority areas are fully agreed to be implemented in the 24 hospitals
for 2012 E.C. These priorities include:

 Improve Hospitals’ Innovative Financing

 Improve Hospitals’ Data Quality and Data Utilization
 Improve Hospitals’ Professional Dressing Culture
 Improve Hospitals’ Catering Services
 Improve Hospitals’ Amenities Management
 Improve Hospitals’ Medical Device Management

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  Improve Hospitals’ Pharmacy and Laboratory Services
 Improve Hospitals’ cleanliness, infection prevention and security
 Improve Hospitals’ legal services
 Improve Hospitals’ senior staffs engagement and ownership

Since BFR-Model and its implementation approach is new for both the health sector and
particularly for all hospitals, the office of Director General for Medical Services is prepared to
provide an orientation and also will send technical experts to each I-CARE implementing
hospital. Knowing each hospital will receive technical supports from ministry’s side, all I-CARE
implementing hospitals are expected to conduct, finish and submit reports of their respective Lab
Sessions before mid-December 2019. The Lab Session is expected to take 3 to 4 weeks
depending on the type of the hospital (patient volume, teaching and non-teaching). Except
transportation which should be covered by the hospital, all the incurring costs of this lab session
will be covered by the office of Director General for Medical Services of Federal Ministry of
Health.

Therefore, this document is designed to effectively guide I-CARE implementing hospitals for
them to conduct their respective Lab Sessions without possible confusions based on BFR-Model.

Pre-Lab Session Preparation

Before starting the Lab Session, each I-CARE implementing hospital is expected to finish the
following pre-lab session preparation:

 Identify 25 key senior experts of all fields including administrative and clinical
background who will be actively engaged during lab session weeks. The identified
experts should be the ones who are willing to commit him/herself for the intended I-
CARE goals, who knows and has clue of hospital’s working culture, system thinking,
health system and major initiatives and programs being implemented in the hospital.
 Discuss and reach on 100% consensus with Hospital’s Governing Board, SMT, general
staffs on the importance, benefits and expected outcomes of the lab session including the
time it takes and the people who will be part of the lab session

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  Develop and approve clear delegation and means of decision making protocol (two
pages) for the absence of the 25 senior experts who may have formal and informal
leadership role in the hospital. Make sure no interruption or discontinuation of any
service will happen for the period of the lab session
 For the agreed I-CARE priority areas, collect and compile all the relevant and available
working documents of major initiatives, projects or programs (national and regional) ,
assessment or performance reports of any type, policies of any type (financial,
proclamation, HR..) , any local and international referable documents, articles, policy
briefings,
 Identify appropriate place for the lab session and the identified place should be capable of
providing enough space, accommodation service, avail timely water, refreshment, meal
and internet connection. As much as possible, the place should be free from disturbing
noise. Since there may be a need to go to the hospital, the place should not be that much
far from the hospital.
 Prepare and approve excel planning format consisting of major interventions, detail
activities, measurements with targets, responsible body by person’s name, time of
completion and required resources (budget and material)
 Prepare and approve daily and weekly lab session performance reporting format
including signing sheets.
 Prepare and approve conflict management protocol (max two pages) for the lab session
and make sure all the 25 experts have agreed and signed for adherence. There should not
be any disagreement or idea conflict that will be left before the completion of the lab
session
 Give an official letter of assignment with clear role and responsibilities of the 25 senior
experts who will be part of the lab session. It is highly recommended that the hospital
should also plan means of official recognition for those who successfully engaged and
complete the lab session.
 Identify and assign two or three rapporteurs who have good experience of summarizing,
writing and documenting. The rapporteurs are expected to compile their taken notes in to
one single report and submit it to the chairperson (CEO/CCO/CED) each day and each
week after getting approval from each of the 25 senior experts of the lab session

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  All the 25 senior experts must be well aware of administrative and logistic issues of the
lab session
 Make sure that each of the 25 senior experts are well oriented and aware of the whole
concept, norms, principles and details of the lab session including what to do and what to
deliver. The hospital is fully entitled to get all the required guidance and fullest
information from Ministry of Health necessary to conduct effective and successful lab
session
 The hospital must have contact addresses (mobile phone and emails) of officially
assigned individuals from the Ministry of Health/MSGD, Universities, and RHBs

During Lab Session

Despite each hospital will have its own detail schedule for their respective lab sessions approved
by the team, during Lab Session, each I-CARE implementing hospital is expected to do the
following key procedural activities entirely addressing the identified priority areas for I-CARE
Program 2012 implementation period.

Week Major task Remark

Detailed SWOT analysis By the end of the first week, the hospital will have
Week-One Route causes for all weakness and well defined, agreed and prioritized problems
threats
Problem matrix
Priority identification
Identify implementable interventions By the end of the second week, the hospital will
Week-Two Develop measures with targets have well defined, agreed and coasted
Major activity Costing interventions for the identified/prioritized
problems. The hospital is also expected to have
well defined measures with targets by the end of
second week.
Develop detail implementation plan By the end of the second week, the hospital will
Week-Three with defined timeframe have clear and detailed implementation plan
Develop M&E framework including M&E and accountability framework
Develop accountability framework

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 Detailed service to academics This is only for teaching hospitals
Week-Four integration plan
Identify research areas that will be
linked to clinical service QI projects

Post Lab Session

After the successful completion of the lab session, all I-CARE implementing hospitals are
expected to perform the following things:

 The 25 senior experts who participated in the lab sessions should approve and sign the
final agreed improvement plan of the hospital
 The CEOs/CEDs/CCOs or rapporteurs are expected to submit summary of lab session
performance report with final plan to Office of Director General at Ministry of Health
and regional health bureaus
 Prepare to proceed the next steps of BFR-Model which is open day program to get further
feedback and enrichment of the developed improvement plan during lab session

Lab Session Monitoring and Performance Reporting

Throughout the I-CARE lab session, each hospital is expected to have strong performance
monitoring and reporting mechanism which mainly addresses the following key activities:

 The hospital must have clear and agreed detailed plan for the lab session with expected
deliverables for each day and weeks of the lab session total period
 Before the commencement of the lab session, the detailed plan for the lab session
including the expected deliverables of the hospital must be shared with officially assigned
persons of the Ministry of Health/MSGD, Universities, and RHBs
 Between 6 and 8 PM, the hospital must have clear and agreed daily and weekly reporting
formats (see annex for draft template which can be adopted by hospitals)
 Agreed and signed hospital’s lab session daily and weekly performance reports must be
submitted via email to the relevant or contact persons assigned by the Ministry of
Health/MSGD, Universities, and RHBs

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Annexes

Table-1: Daily I-CARE Lab Session Performance Reporting Format

Daily I-CARE Lab Session Performance Report of [Hospital Name]

I. General Information

Date: DD MM YY (Ethiopian Calendar)

Place: Site of Lab Session

Reported By: Name and Role of Person who reported

Number of Attended Participants: Total # of people who attended the lab session

Number of Not Attended Participants: Total # of people who didn’t attend the lab
session while they are invited

II. Performances

Major Activities Performed During the Day

 Total duration (number of total hours used) including start and end time
 List down key performed activities such presentations made, types of discussions held,
approaches used
 New or innovative ideas raised with brief narration
 Rate of overall performance against expectation of daily deliverables
Major challenges faced During the Day
 Technical
o Please briefly highlight, If there are any technical issues that are not well
understood or created confusion or need further clarification
 Administrative

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 o Please briefly highlight, If there are any administrative issues
encountered, not solved and need quick actions
 Logistic
o Please briefly highlight, If there are any logistic issues encountered, not
solved and need quick actions
Major issues that need attentions from higher officials
 University
o Please briefly highlight, If there are any issues that need attentions and
quick interventions from University’s higher officials
 Regional Health Bureau
o Please briefly highlight, If there are any issues that need attentions and
quick interventions from RHB’s higher officials
 Ministry of Health
o Please briefly highlight, If there are any issues that need attentions and
quick interventions from FMoH’s higher officials

III. Next Priority

Priority of the Next Day Lab Session

o Please briefly highlight the top priorities planned for next day of the
hospital’s lab session

This daily hospital’s I-CARE Lab session performance report is approved by:
Name role of person signature

IV. lists of attendants

Attendants
S/No Name Tittle and Mobile Email Signature

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 profession number

Table-2: Weekly I-CARE Lab Session Performance Reporting Format

Weekly I-CARE Lab Session Performance Report of [Hospital

Name]
V. General Information

Date: DD MM YY (Ethiopian Calendar)

Place: Site of Lab Session

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Reported By: Name and Role of Person who reported

VI. Performances

Major Activities Performed During the week

 Total duration (number of total hours used)
 List down key performed activities such presentations made, types of discussions held,
approaches used
 New or innovative ideas raised with brief narration
 Rate of overall performance against expectation of weekly deliverables
Major challenges faced During the week
 Technical
o Please briefly highlight, If there are any technical issues that are not well
understood or created confusion or need further clarification
 Administrative
o Please briefly highlight, If there are any administrative issues
encountered, not solved and need quick actions
 Logistic
o Please briefly highlight, If there are any logistic issues encountered, not
solved and need quick actions
Major issues that need attentions from higher officials
 University
o Please briefly highlight, If there are any issues that need attentions and
quick interventions from University’s higher officials
 Regional Health Bureau
o Please briefly highlight, If there are any issues that need attentions and
quick interventions from RHB’s higher officials
 Ministry of Health
o Please briefly highlight, If there are any issues that need attentions and

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 quick interventions from FMoH’s higher officials

VII. Next Priority

Priority of the Next week Lab Session

o Please briefly highlight the top priorities planned for next week of the
hospital’s lab session

This weekly hospital’s I-CARE Lab session performance report is approved by:
Name role of person signature

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