Introduction: Continuous Professional Development (CPD) has been defined as a continuing process, outside formal undergraduate and postgraduate training, that allows individual doctors to maintain and improve standards of medical practice through the development of knowledge, skills, attitudes, and behaviour. However, CPD is not popular for Sri Lankan health professionals. The aim of this article is to conduct a SWOT analysis aiming at the formulation of implementation strategies for CPD for medical doctors in Sri Lanka. Methods:The root causes analysis on CPD was done using Ishikawa diagram aided by the literature. SWOT and TOWS matrix analysis was performed to identify the strengths, weaknesses, opportunities and threats using literature and formulated CPD implementation strategies.Results: Lack of financial incentives, CPD infrastructure and training programmes by professional colleges, remoteness of doctors from main education centres, lack of time for doctors, CPD being noncompulsory by law have been identified as leading causes against CPD implementation. Availability of considerable fund allocation at Ministry of Health (MOH), good perception towards lifelong learning among doctors as strengths; availability of international jobs for doctors, SLMA initiative to establish island wide CPD, availability of funding agencies and political influence as opportunities were identified to overcome threats and weaknesses. Conclusion:The MOH should start a National CPD steering committee with a representation of the SLMC, SLMA, all professional colleges, Medical Faculties, Provincial Directors, Institutional Heads and representation of the Government Medical Officers Association to ensure implementation of compulsory CPD in Sri Lanka.

Healthcare organizations' greatest challenge is the restriction of new recruitment and employee retention in the context of the prevailing economic crisis. Sri Jayewardenepura General Hospital (SJGH) experienced a high turnover rate of employees leading to a great deficiency, especially in the minor category.Objective: To reduce the adverse impact of minor staff shortages on service delivery at SJGH. Methodology:Caregiver training was initiated in collaboration with the Sri Lanka Bureau of Foreign Employment (SLBFE) for unskilled recruiters awaiting foreign employment. SJGH was registered under the Tertiary Vocational Educational Commission (TVEC) and possesses the expected standard National Vocational Qualification (NVQ) frame level 3. Adhering to TVEC's standards, a comprehensive 12-module curriculum was formulated. The roles and responsibilities between SJGH and SLBFE were defined through a memorandum of understanding. Pre-placement Key Informant Interviews (KIIs) were conducted to identify the required units. Forty trainees were trained by competent trainers in forty-five days with real practical exposure under the supervision of unit heads. Results:Service delivery disturbances of SJGH were minimized. The evaluation found that all forty trainees were competent in caregiving. Post-KIIs revealed high satisfaction levels of the patients and unit heads regarding the performance of the trainees. Assigned duties were well carried out by them according to the rules and norms. Trainees were also satisfied with the positive experience obtained. SLBFE possesses a competitive advantage over other recruiting agencies.Discussion: As a relief for the current financial crisis, foreign currency inflow can be encouraged by deploying these skilled workers in foreign countries creating an improved positive image of the country. This project demonstrated how the challenges could be well addressed through inter-sectorial collaboration. Conclusion and recommendation:Both parties benefited from this project achieving win-win status. Further, this cost-effective intervention assured uninterrupted service. Therefore, it can be recommended as an applicable alternative solution to mitigate service disruption due to the scarcity of staff.

Background: Patient safety is a major concern for all health care providers worldwide. For creating patient safety culture the attitudes, values and beliefs of the members of the health care institutions towards patient safety should be improved. The study is expected to assess the culture of patient safety at Teaching Hospital Mahamodara -Galle (THM) and, Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire was used as the study instrument. The responsibility of creating a culture of safety belongs to all employees in a hospital; however, It will be successful only the involvement of senior management. In order to understand where to focus efforts in building this environment, hospital senior management must understand the opinions and beliefs of the employees regarding the safety culture of their hospital, before initiating a health and safety program. Methodology: The study design was a hospital based descriptive cross-sectional, using HSOPSC questionnaire. It was expected to measure the 12 dimensions of the patient safety culture of THM. The data collecting instrument which was a self-administered questionnaire, distributed among heath care staff including medical consultants, nurses, midwives, and para-medical staff. A total of 279 questionnaires were returned out of 416 (response rate 67%). Data were summarized as percentages, means and standard deviations. This study used HSOPSC data entry and analyzing tool for the purpose of statistical analysis. Results:In average 56% responded positively for the 12 patient safety culture dimensions of the HSOPSC survey. It was lower than the findings of the Agency for Healthcare Research and Quality (AHRQ) (65%), in 2018. "Teamwork within unit" scored the highest positive response rate that was similar to the US findings. The lowest percentage of positive responses were obtained by the dimension "Staffing". Forty seven percent respondents graded overall patient safety as 'excellent' or 'very good' while 48% graded it as 'acceptable'. Seventy eight percent of respondents had not reported any adverse event during last 12 months. Conclusions:The HSOPSC tool is a practical avenue to understand the health and safety culture in THM when initiating health and safety programs in order to understand the critical areas that should be focused. The results show that, in general, hospital staff of THM feels positively towards patient safety culture within the hospital. In addition, THM should enhance the education and should move towards a blame-free culture to improve the adverse event reporting. The showed discrepancies between US data and THM data suggest that cultural uniqueness is an important factor to give much better attention when applying safety culture tools to gather data in different cultural settings.

Introduction: In Sri Lanka, mental health has been given a low priority, despite one out of ten in population suffering from a mental illness. Most patients are treated and followed up at psychiatric clinics at government hospitals. Methods: A descriptive cross sectional study was conducted in the psychiatric clinics in the National Hospital, Sri Lanka (NHSL). The objective of the study is to assess the quality of the services provided by the psychiatric clinics from patient's perspective and to identify the factors affecting the quality of the service. A sample of 292 clinic attendees in remission, followed up at the clinics for =1year, were selected using systematic sampling. Perception and expectations on five quality dimensions of SERVQUAL model (tangibles, reliability, responsiveness, assurance and empathy) was assessed using pre-tested, interviewer administered questionnaire with 30 items, on 05 points Likrt's scale. Results: Tangibility dimension scored the highest mean (1.4816) and assurance scored lowest mean (1.1054), for expectations. Responsiveness scored the highest mean (2.9816) and tangibility scored the lowest mean (2.1379) for perceptions. Overall perception mean (2.548) regarding quality of service was higher than over all expectation mean (1.218) with a positive gap (1.2). Perception of tangibility was significantly associated with level of education (p = 0.004), ethnicity (p = 0.010) and unemployment had a significant impact on dimension empathy (p = 0.03). Conclusions: Perception of the psychiatric services at NHSL was found to be better than their expectation. Even though results showed positive quality gap in relation to patient perspective, most of the facilities should be improved.

Introduction:The number of confirmed cases of COVID -19 informs us about the development and magnitude of the global pandemic. Confirmation of COVID-19 infection is mainly by testing with PCR. The necessity of evaluating the performance of PCR laboratories was identified to understand how the pandemic was progressing, how to respond appropriately to the threat; either as individuals or as a society, to learn where countermeasures against the pandemic worked and for planning. Reliable data on testing was therefore necessary to assess spread of the pandemic.objective: To establish a national focal point to collect quality, accurate, timely data of PCR test performance for planning and to make decision.Methods: Defining of data elements for collection and monitoring of the performance of PCR laboratories was done as the first step. Digital solution was identified after assessing the requirement. Agile development method was used to develop the digital solution, which consists of five modules. Entered data on PCR performance of laboratories were analyzed by the officer in charge of the focal point and disseminated timely, accurate, complete and compile data to the relevant officials on daily basis for further planning and implementation.Results: Performance of individual laboratories was identified on daily basis. Private sector performance was higher than public sector. Peaks showed the local clusters. Conclusion:A quality, accurate and real-time data and information helped for remarkable improvement in every step of planning and decision making to overcome the global challenge of COVID-19.Limitations: Computer literacy, close monitoring and duplication of data affected for accuracy.