1. Vietnam : A Quality Improvement Application Thuy Trang Nguyen Thi Hloliphani Juta Jasmine Paul Lara Kesteloo

2. An Introduction Population: 91,519,289 Most common diseases: 1. Diarrhoea Average life 2. Avian influenza expectancy: 72.41 years Vietnam 2.Dengue and dengue hemorrhagic fever 3. Hand foot and mouth Hospital bed density: 2.87 beds/1,000 population

3. Challenges in Vietnams healthcaresector include Most Vietnamese seek Outdated medical initial and rudimentary equipment medical treatment at Low salaries for public hospitals clogging healthcare an already overcrowded professionals system Insufficient government High child mortality and subsidy other national health issues Vietnams healthcare HIV/Aids, Hepatitis B & C system remains largely infections, liver underdeveloped and cirrhosis, lung disease both the number and and asthma are all on the quality of rise hospitals, clinics, and High incidence of deaths doctors have not kept related to road accidents pace with Vietnamese societys needs or Overcrowded facilities expectations

4. Overview of Quality Issues in HealthCare Country Macrosystem governance Level Hospital system Intra-hospital unit Individual patient Microsystem or health care worker

5. Quality Improvement: A Focus on Natural Disasters

6. Impact of Natural Disasters Drought Financial hardship Famine Loss of family or Water contamination friends Disease Increase in hospital Loss of property access in an already crowded system Loss of income Injury Mental health disorders

7. Vietnam Disaster Preparedness According to the World Health Organization (2011), Viet Nam is one of the most disaster prone countries in the world natural disasters such as typhoons, tropical storms, floods, drought, landslides, forest fires, and earthquakes occur frequently between May to DecemberQuestion: How does Viet Nam prepare for these frequentdisasters?

8. Viet Nams disaster preparedness planning The Viet Nam National Strategy for Natural Disaster Prevention Response and Mitigation from 2007 to 2020Goal: Mobilize all resources to effectively implement disasterprevention and response from now up to 2020 in order tominimize the losses of human life and properties, the damage ofnatural resources and cultural heritages, and the degradation ofenvironment, to ensure the country sustainable

9. Goals and Achievements Goals Achievements Increase the early warning of storms Legal documents: Law on up to 72 hours in advance Dykes, Water Resources Law, Law on Forest Protection and Development, and Law on Ensure 100% of local staffs who Environment Protection to guide directly work in the field of disaster appropriate action prevention and response to be trained Annual allocation from donors for Promote community awareness to ensure preparedness at an individual emergency relief and prompt damage level recovery e.g. Vietnam Fatherland Front, Trade Union, Youth and Women Associations Protect water system by improvement of flood discharge for rivers and Application of new materials and canals, construction of sea dykes for salinity prevention, and fresh water technologies to construct several preservation. disaster prevention structures.

10. Areas for ImprovementInfrastructure built is usually poor and vulnerable to disasterForecast and warning systems are not advanced enoughEmergency relief, damage recovery, and rehabilitation services are limitedSearch and rescue activities are limited due to lack of equipment and little collaboration between healthcare professionalsTraining and raising community awareness of disaster prevention and response are infrequent and unsystematic; disaster preparedness training programs have not been included in school curriculumInvestment in natural disaster prevention, response and mitigation has been minimal and has not metrequirementsLack of strong leader(s) to seriously implement plans and invest money

11. References Australian Nursing Journal. (2001). Volunteering in Viet Nam. Australian Nursing federation Central Intelligence Agency. (2012). The world factbook: East and Southeast Asia: Viet Nam. Retrieved April 17, 2012, from https://www.cia.gov/library/publications/the-world-factbook/geos/vm.html Hien, T. T et al. (2005). Viet Nams war of flu. Nature Publishing Group. Partnerships for Disaster Reduction South East Asia. (2008). Monitoring and reporting progress on community- based disaster risk management in Viet Nam. Retrieved April 17, 2012, from http://www.adpc.net/v2007/programs/CBDRM/INFORMATION%20RESOURCE%20CENTER/CBDRM% 20Publications/2008/final_crvietnam_23nov.pdf Respondek , A., Hao T. T., & Nguyet, N. H N.(2010). Viet Nams legal aspect of health care system. Ho chi Minh City: Respondek and Fan Ltd. Richards J. R. (1996). Emergency in Viet Nam. American College of Emergency Physicians. California Socialist Republic of Viet Nam. (2007). National strategy for natural disaster prevention, response, and mitigation to 2020. Retrieved April 17, 2012, from http://www.isgmard.org.vn/VHDocs/NationalPrograms/National%20Strategyfordisasterprevention2020.pdf Schmidt, W. et al. (2011). Population density, water supply and the risk of dengue fever in Viet Nam: Cohort study and spatial analysis. Pub Med, 8(8) World Health Organization. (2008). Country health profiles: Viet Nam. Retrieved April 17, 2012, from http://www.wpro.who.int/countries/vnm/36VTNpro2011_finaldraft.pdf

12. Search Strategy General Google search for orientation and introduction to Vietnam as a country, and their health care issues. Searched UVic and other peer reviewed source databases according to our individual focal point. Used search terms such as: Vietnam + health care, Vietnam + nurse+ working conditions or Vietnam + disasters

13. Collaboration We met up three times as a group. 1) To decide on a topic and split research responsibility for finding quality improvement issues with relation to health care. 2) To bring together our findings, decide on an issue to focus on and split the research responsibilities accordingly. 3) To pull the individual parts together in a way all four of us were satisfied and the presenter felt supported