Statement on Risk Management and Internal Control Governance Major expenditures are subject to Tender procedures and evaluated by the Management Tender Committee or IHH Board Steering Committee as appropriate. There is also a Centralised Project Management office in each business unit to handle and manage major renovation and expansion projects undertaken by the respective business units. Legal and Regulatory The business units adhere strictly to the applicable Acts and Regulations, as required of an institution operating private hospitals, medical clinics, private higher education, and healthcare services. This includes the established Acts and Regulations applicable in the jurisdictions in which the Group operates. Clinical audits are also conducted by the Medical Affairs and Ǫuality Division on an ongoing basis. Fraud Prevention The Board strives to have zero incidences of fraud with strong internal controls, proper segregation of duties in the work processes, and regular audits carried out by the Group Internal Audit team. The inherent system of internal controls is designed to provide a reasonable, though not absolute, assurance against the risk of fraud, material errors or losses. Clinical Governance International Clinical Governance Advisory Council (ICGAC) In its eighth year as an independent high-level advisory committee, the Council continues to serve as an advisory in the areas of Clinical Governance which covers the management of Clinical Affairs, including Ǫuality and Patient Safety, Clinical Risk Management, Continuing Professional Development and Clinical Training. The Council comprises the following members: 1. Tan Sri Dato’ Abu Bakar Suleiman, Senior Advisor at International Medical University Malaysia (IMU) 2. Tan Sri Datuk Dr K. Ampikaipakan, Consultant respiratory physician at Pantai Hospital Kuala Lumpur, Malaysia 3. Dr E.H Akalin, Independent academic consultant, Istanbul, Türkiye 4. Professor Yeoh Eng Kiong, Director at Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong (CUHK) As of December 31, 2023, Management has achieved noteworthy advancements in the implementation of the recommended actions outlined by the ICGAC: 1. Significant progress has been made in the establishment of National Clinical Governance Committees in China and India, aligning with our commitment to global clinical governance standards; 2. Proactive review of quality indicators and serious reportable events underscores IHH’s dedication to healthcare quality and safety enhanced by (a) Communicating changes to respective hospitals by business unit Medical Affairs and Quality (MAQ)s (b) Incorporating revised indicators into reporting processes and close monitoring at relevant platforms (c) Close collaboration by Group MAQ with business unit MAQs for indicators that do not meet target or undesirable special cause identified through root cause analysis; 3. Exceptional efforts in implementing Value Driven Outcomes (VDO) and addressing Antimicrobial Resistance (AMR) noting the following (a) The VDO initiative marks a significant milestone, streamlining processes and fostering a culture of continuous improvement. (b) Progress in AMR highlights IHH’s dedication to global healthcare issues. Review of Clinical Quality Indicator (CQI) and Serious Reportable Event (SRE) Framework Group MAQ regularly and systematically assessed and refined all the Clinical Quality Indicators (CQIs) and Serious Reportable Events (SREs) through the development of a framework for the following reasons (i) continuous quality improvement (ii) enhanced patient safety (iii) outcome measurement (iv) foster transparency and accountability. Group MAQ does horizon scanning and literature review of internationally reported CQIs and SREs and performs crosswalk analysis using the indicators from countries such as the US, UK, Australia and Singapore. Key considerations are identified to determine if the indicators should be included, retained, revised or retired. Indicators are grouped into care domains or SRE categories in accordance to international healthcare quality framework and standard. The indicator technical manuals are revised to ensure benchmarks and references are up-to-date; standardise terminologies; ensure indicator definitions and measurements are logical and accurately reflect country differences. This process ensures relevancy of indicators that gauge safe and quality care as well as effective risk management and control in our healthcare. In 2024, Group MAQ will introduce 2 new indicators, retire 2 current indicators, revise definitions where appropriate and make adjustment to the group targets for all indicators to align with international definitions and benchmarks. This is done in close consultation with business unit MAQs through calls, feedbacks and pilot phase in Q3 2023 to further refine the technical definitions to ensure smooth transition before full implementation in 2024. The review is also a proactive measure to maintain the relevance of indicators which are crucial steps in our ongoing commitment to delivering the highest standards of patient care and clinical excellence. These actions are meticulously IHH Healthcare Berhad 112
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