IHK meets international standards a second time around

Entrance to the International Hospital Kampala in Uganda

by Marilyn Keegan and Nancy Akullo

The International Hospital Kampala (IHK), a 100-bed private hospital in Uganda and part of the International Medical Group, has noticed a significant drop in hospital-acquired infections (HAI) and more successful monitoring of continuous quality improvement and adverse events since its second accreditation with COHSASA.

This is according to hospital staff who have been working with the accreditation programme since 2014 and with the Council’s Patient Safety Information System (PatSIS) since May 2015.They have been collecting data to back up their claims. 

IHK is the only COHSASA-accredited hospital in Uganda. The hospital has now been accredited for a second time for three years after achieving a score of 97 out of 100 at its external survey.

The Council for Health Service Accreditation of Southern Africa (COHSASA) is the only internationally accredited quality improvement and accreditation body for healthcare facilities based in Africa. In the past 23 years over 550 facilities throughout the continent have entered the COHSASA programme to improve the quality and safety of the healthcare services provided to patients. 

IHK first entered the COHSASA programme in April 2014 and received its first full accreditation award in August 2015 with a score of 86 out of 100. The hospital re-entered into the programme soon afterwards and in November 2017, the COHSASA Board accredited IHK for three years when a score of 97 was achieved.

Dr Ian Clarke, Chairman of the International Medical Group, the umbrella organisation under which IHK falls, says:  “COHSASA accreditation has been a very worthwhile exercise for International Hospital Kampala since it is one of the few specific medical accreditations and benchmarks that can be carried out by a hospital in Africa. Previously we had ISO certification which was non-specific. We are happy to have full COHSASA certification for the second-time around.”

Commenting on the Accreditation process, Ms Jackie Nabukeera, Head of Quality Assurance for IHK says:

“The International Hospital Kampala (IHK) enrolled in the COHSASA programme in 2014.  This decision was taken because COHSASA standards were specific to a healthcare setting. We wanted to know how different departments in a hospital were supposed to be operating to implement the relevant internationally-accepted standards.

“As a hospital, we had specific quality problems which included, but were not limited to: documentation, measuring hospital acquired infections, risk identification and mitigation and measuring quality improvement. It was important for us to respond to these issues so that continuity of care and appropriate interventions for the patients could be made. 

“In addition, the web-based CoQIS quality information programme generated data that could be collected and analysed to inform different quality improvement projects.

“However, as with any new programme, there were challenges: poor staff buy-in and lack of adequate knowledge to drive the hospital’s QI programme to mention but a few. This meant we had to make concerted efforts to communicate the importance of the quality improvement programme at staff meetings and training staff to equip them with the knowledge they needed to steer the QI programme. We also needed to collar the support from the executive and senior management team. 

“Being consistent in spreading the message and providing training has proved to be fruitful and has resulted in our second COHSASA accreditation.”

The ICU Unit at IHK Hospital in Uganda

Ms. LILIBET BYAKIKA, Unit Manager, ICU

“The Quality improvement and accreditation programme has positively impacted patient care in our unit in various areas. Many measures in relation to infection control have been implemented since 2017. They include hand washing and the use of checklists for both placement and monitoring of indwelling devices. Audits have been done to ensure compliance with these new measures. 

“Infection control has been a great success because we have been pushing hand washing, where techniques have been mastered and practiced by staff and the patients’ attendants. Through hand washing audits we have been able to monitor compliance among the staff. This has reduced cross infection in our patients and there is a massive reduction in the rates of nosocomial infection. 

“Similarly, the use of central venous catheter checklists and protocols and monitoring of all other invasive lines have aided greatly in the prevention and reduction of infections.

“Notably, medical errors are too often a cause of death. Monitoring and reporting of critical events using COHSASA’s Patient Safety Information System – PatSIS – and morbidity and mortality audits have greatly improved our knowledge of critical care and made us better practitioners than before.”

Staff Members of IHK Accident Emergency Department (from left to right): Ms Angwena Charlotte, Dr. Precious Ndomerire, Ms. Immaculate Ndagire, Ms. Dorah Nakamwa, Ms. Peace Kwiocwiny and Ms. Damalie Nalugwa.

Ms. EVA NAMBUGU, Ward Manager Obstetrics & Gynaecology

“COHSASA standard assessment manuals specify what needs to be in place and how it should be done. From a multidisciplinary point of view, the standards have helped our department to receive prompt and efficient services from other essential service areas and departments of the hospital.

“When it comes to assessments, the standards have helped the department to do self-assessments to identify gaps and find possible ways of closing them; for example: protocols, guidelines, tools and checklists have been developed to correct the gaps and reduce mistakes. Risk assessment registers have helped to quantify risks and incidences and inform us to what extent protocols are being followed.

“The programme has also improved our ability to obtain meaningful data collection and analysis which has set a basis for continuous improvement.

“We have been able to monitor performance competence by using the checklists we have put in place. Due to the care tools, guidelines and protocols we have developed we are able to assess the quality of care we render to our clients. When incidents occur, we investigate the root cause and then work to mitigate them.”

Maternity Unit Staff (front row from left): Ms Victoria Nambaziira, Ms Juliet Nagulani, Ms Tedy Nabasajji, Ms Florence Nambakire, Ms Resty Nansubuga, Ms Sophia Namaganda and Mrs Kyeyune Eva Nambugu. (Back row from left): Ms Annet Nakaddu, Ms Ray Clara Rijoo, Ms Betty Sharon Awubire and Medical Officer, Dr Ivan Kabuye.

Ms. PEACE NATIMBA, Unit Manager, Medical-Surgical Ward

“The COHSASA Patient Safety Information System – PatSIS – has created transparency in the medical-surgical ward and challenges in the unit are being sorted out with ease. For example, because of reporting these near-misses and incidences, the administration has helped fix our nurse-call system and currently they are purchasing new equipment for the unit. 

“More so, near-misses and adverse incidences are being managed head-on since the unit members feel free to report them in the system.  These have all aided the provision of quality care to our patients as well as increased their satisfaction with our service.”

Issued March 2018

For more information contact Marilyn Keegan – marilyn@cohsasa.co.za

Latest accreditations awarded to healthcare facilities by COHSASA

The healthcare facilities listed in the table below have been awarded accreditation by The Council for Health Service Accreditation of Southern Africa (COHSASA), a not-for-profit company (NPC) based in Cape Town.

A COHSASA accreditation award means the healthcare organisations have entered a rigorous quality improvement programme and have been assessed against, and comply with, standards recognised by the International Society for Quality in Health Care (ISQua), the global body overseeing accreditation and quality improvement programmes in healthcare organisations in 70 countries around the world. COHSASA itself is accredited by ISQua as are its standards and its surveyor training programme. 

Hospitals and clinics that initially enter the programme and meet standards are awarded two-year accreditations and as the journey in excellence continues, awards of longer duration are given. A four-year accreditation award from the Council should signal to patients that a facility has sustained standards over a commendable period.

Latest accreditations of hospitals and clinics from COHSASA

The healthcare facilities listed in the table below have been awarded accreditation by the Council for Health Service Accreditation of Southern Africa (COHSASA), a not-for-profit company (NPC) based in Cape Town.

A COHSASA accreditation award means the healthcare organisations have entered a rigorous quality improvement programme and have been assessed against, and comply with, standards recognised by the International Society for Quality in Health Care (ISQua), the global body overseeing accreditation and quality improvement programmes in healthcare organisations in 70 countries around the world. COHSASA itself is accredited by ISQua as are its standards and its surveyor training programme.

Hospitals and clinics that initially enter the programme and meet standards are awarded two-year accreditations and as the journey in excellence continues, awards of longer duration are given. A four-year accreditation award should signal to patients that this facility has been involved in improving the quality and safety of care provided over a commendable period.

Facility Country Status Award dated Date Lapse
Kriel Colliery Health
Centre
RSA 4 Years Full Accreditation 24 November 2017 23 November 2021
New Denmark Colliery
Health Centre
RSA 4 Years Full Accreditation 24 November 2017 23 November 2021
Jwaneng Mine Hospital Botswana 3 Years Full Accreditation 24 November 2017 23 November 2020
Orapa Mine Hospital Botswana 4 Years Full Accreditation 24 November 2017 23 November 2021
Breede River Hospice RSA 4 Years Full Accreditation 24 November 2017 23 November 2021
International Hospital Kampala Uganda 3 Years Full Accreditation 24 November 2017 23 November 2020
Mediclinic Victoria RSA 3 Years Full Accreditation 24 November 2017 23 November 2020
Mediclinic Highveld RSA 4 Years Full Accreditation 24 November 2017 23 November 2021
Block 6 Clinic(Botshelo Diabetes Clinic) Botswana 2 Years Full Accreditation 24 November 2017 23 November 2019
Nairobi Women’sHospital Kenya 2 Years Full Accreditation 24 November 2017 23 November 2019
Roman CatholicHospital Namibia 2 Years Full Accreditation 24 November 2017 23 November 2019
Mediclinic Potchefstroom RSA 4 Years Full Accreditation 26 May 2017 25 May 2021

 

Experiencing the ISQua conference: a delegate’s view of London 2017

The hulking torso of Winston Churchill catches edges of grey in the sunrise in Parliament Square, London. I feel nervous because I am not quite sure where I am going. I have a Google Map to guide me but my parochial Cape Town feet are coy on this Sunday morning. I am on my way to the Pre-Conference sessions of the 34th ISQua (International Society for Quality in Health Care) Conference at the QE11 Centre in London.

To a country girl, London is overwhelming. I look at Google Maps, I am in Broad Sanctuary – the road that supposedly leads to the conference centre where over 1500 delegates from 70 countries will soon gather. They are all leaders in healthcare and they have come here to network and learn more about improving quality and patient safety.

I feel a little ill. Not much breakfast. But then I spy a bank of ISQua flags billowing in the wind at the entrance to the QE11 and I feel, at last, the comfort of the familiar – even if it’s just ISQua logos blowing in the air.

It takes 45 seconds to register my attendance (a record in my experience) and I head for the coffee bar to examine the impressive 180-page programme covering the next four days (October 1-4, 2017).

The overall theme of the conference is “Learning at the System Level to Improve Healthcare Quality and Safety” but tucked under that headline is a mammoth amount of knowledge. There are various theme tracks, including, significantly, one for Lower and Middle-Income Countries (LMIC) – South Africa is one of these.

Over cappuccino, I thumb through the “book” and decide what sessions I am going to attend. It’s overwhelming: this is only the pre-conference material and there is so much to choose from!

I decide to attend the 9h00 to 15h40 session (with tea and lunch breaks between). It’s on the 4th floor. There are plenty of lifts, plenty of loos, plenty of smiling and delightful ISQua staffers to tell you where to go, but still there is anxiety.

In the lift is a tall man from Norway, a short woman from China, a large woman from Turkey and a statuesque beauty from India. You don’t know them but you know their names and where they come from because of their conference ID tags. You also know that you have something in common with them: you are sharing the global mission to make health care safer and better. 

I sit down in the Rutherford Room and start noticing some familiar faces, the veteran quality warrior, Charles Shaw, the crisply intelligent and articulate Wendy Nicklin (elected President of ISQua for the coming year), the energetic Stephen Clark, my CEO, Jacqui Stewart, Lena Louw of Australia – and many others.

Chatting at the Pre-Conference session (from left): Dr Lena Low, Executive Director of the Australian Council on Healthcare Standards (ACHS); Professor Ethelwynn Stellenberg Associate Professor of Nursing in Department of Nursing and Midwifery at University of Stellenbosch and COHSASA Board Member, Ms Jacqui Stewart, CEO of COHSASA and Dr Christine Dennis, CEO of ACHS.

The brain fest begins. Hours later with new knowledge spinning around in my head, I have conversations around the coffee table with more and more colleagues. It’s a waterfall of words and numbers; a monsoon of concepts.

One of the main themes emerging from these pre-conference sessions (and carried throughout the coming days as one of the major issues) is that the voices of patients need to be heard and acted upon in shaping standards and accreditation programmes. Patients need to be involved in the evaluation and delivery of health services. 

DAY 1

I get there early and wind my way through the trade exhibitors on the 3rd floor. There’s a decent cup of coffee to be had and the official opening ceremony is about to begin.

Left: The giant screen welcomes delegates to ISQua’s 34th annual international conference at the QE11 Centre in London. Right: Delegates wait for ISQua London to begin.

Peter Lachman, CEO of ISQua, outlines how to make the most of the ISQua conference and emphasises the role of social media – Twitter takes centre stage. In fact, Twitter is to become a bit of a nuisance for speakers who can’t seem to engage fully with delegates. Their heads are buried in their smart phones and they are tweeting…

The morning plenary again emphasises the importance of listening and hearing patient voices. Evidence is presented of how, when patients actively take part in their treatment, outcomes are better.

The rest of the day offers a menu of intriguing patient safety systems presented by a panel of stalwarts including Professor Charles Vincent (below left) and Professor Jeffrey Braithwaite (President Elect of ISQua, below right).

At lunch, delegates have a bewildering choice of extra information sessions and E-poster presentations. The corridors of the QE11 are abuzz with the duck and dive of delegates clutching bag lunches with an imaginative variety of walkabout food. The soup, on every day, is a firm favourite.

A love of films draws me to a session showing how cinema can affect patient safety culture and empathy. The British actress, Emma Thompson, wins the first-ever ISQua Film Award for her role as cancer patient, Professor Vivian Bearing, in the Emmy-winning 2001 film Wit. Ms Thompson was scheduled to accept the award but a last-minute change meant she could not receive it in person. It was an exciting, lively presentation and born out of a “mad” idea by president elect, Jeffrey Braithwaite and Riccardo Tartaglia.

At the end of the day, delegates headed out to the Museum of Transport in the Covent Garden Piazza (above left) and from there via the famous London Black Cabs (if they could afford it) to chat some more with colleagues at late-night dinners around London (above right). 

DAY 2

My CEO, Jacqui Stewart, is up with the birds to take part in a debate about whether to use more, or less, indictors to measure improvements in the complicated universe of health care. Her team – Jason Leitch and Rashad Massoud – win the argument for less.

More tea, more coffee, more meals, more chats – a day of whirling information, exciting discoveries, contentious arguments and a few damp squibs. But the standout talk for me in the day is Sir Liam Donaldson chairing a panel to introduce the WHO’s Third Global Patient Safety Challenge: Medication without Harm. 

Unsafe medication practices and errors in administering medication are a leading cause of avoidable harm in healthcare systems around the world. These errors cost more than US$42-billion each year globally. The panel discusses how to change this narrative and who would be involved in making the change happen.

Although I run out of time to participate, I notice and speak to those who are manning a very interesting “exhibition”. Entitled “A Mile in My Shoes”, participants are invited to step into someone else’s shoes and embark on a 90-minute imaginative audio journey into their world. The Empathy Museum teamed up with the Health Foundation to develop a collection of stories from those working in health and social care and they produced a wide range of experiences which one can choose by selecting a shoe-story.

 

After lunch, I whip upstairs to the St James Room on the 4th floor where COHSASA CEO, Jacqui Stewart (above left) is chairing a session on Sustainable Quality Improvement for LMIC. CEO of ISQua, Peter Lachman (above right), presents a fascinating initiative in Mozambique where the Ministry of Health has teamed up with the Irish health service (a North-South partnership) to develop a national quality improvement programme. The drive for quality has come about due to a realisation that Sustainable Development Goals (SDGs) cannot be achieved in resource-poor countries without improving the quality of health services. One of the participants, Jonas Chambule, of Mozambique who could not be present is linked up using video conferencing. The marvels of modern technology!

DAY 3

During the plenary session in the morning, delegates are introduced to the ISQua’s 35th conference due to be held in Malaysia’s capital city, Kuala Lumpur in 2018. The country has mounted an impressive welcome exercise to entice delegates there and their exhibition stand draws many of the curious to begin forming an appetite to attend the 2018 conference. In the plenary session, two countrymen sing a “Welcome to Malaysia” song to all the gathered delegates: there is no doubting the sincerity of their sentiment…

There are 20 people manning this stand – some from the Malaysian Society for Quality in Health (COHSASA’s counterpart in that country). They hand out pamphlets, brochures, key rings and maps to interested by-standers and ensure a successful promotion of the ISQua conference at the Kuala Lumpur Convention Centre from 23-26th September 2018. The theme of next year’s conference is Heads, Hearts and Hands: “Weaving the Fabric of Quality and Safety”. Call for papers opened on 4th October 2017 and close on 12th February 2018 – so get those papers in!

That afternoon, I head for a panel discussion in the Westminster room on the 4th floor. This is the distracting view:

The session under the general theme of “Sustainable Quality Improvement for LMIC” is entitled, “Sustainability of Quality Improvements in Public and Private Sectors in South Africa”. The speakers are Jacqui Stewart, Shivani Ranchod and Gareth Kantor. The presentation outlined the challenges facing both private and public sectors in the RSA, particularly the challenges associated with sustaining quality initiatives and suggestions on how to strengthen the sustainability.

Some of the South African panel members at ISQua; above left: Ms Shivani Ranchod and above right Anaesthetist Dr Gary Kantor, Co-founder of Best Care Always, and consultant to Discovery Health and Insight Actuaries.

As the conference ends, delegates are wired but tired. Some have left the QE11 centre which is a pity because Jishnu Das from India presents an eyebrow-lifting paper on studies in India, Kenya and China which reveal new insights into the care the poorest receive at clinics.

This final plenary session is chaired by COHSASA CEO, Jacqui Stewart, who – realising that people have conference fatigue – keeps it short and to the point. Many appear very grateful for that. With a brief summary of the conference the ISQua President Wendy Nicklin bids everyone farewell and safe travels. As everyone files out of the large hall, there is a flatness in the afternoon, a sudden realisation that rent cheques and root-canal work – the everyday banality of reality – wait outside. 

But hold it right there… here is a happy band – the tireless, ever-polite, ever efficient ISQua staff who made the conference so seamless, convenient and accessible. Their smart blue uniforms were everywhere – not a corner, not the tiniest of side rooms was not covered by their waiting hands and willing attitude to help.

We celebrated the end of the conference with them and the knowledge that after Malaysia, the 36th conference will be held in CAPE TOWN SOUTH AFRICA in 2019. Below, CEO Jacqui Stewart of COHSASA celebrates with the ISQua staff. All in all, a wonderful experience.

Better Quality Healthcare on the Horizon for Africa

The Council for Health Service Accreditation of Southern Africa (COHSASA) has been appointed as an institutional member to the International Society for Quality in Health Care (ISQua) Board.

COHSASA is the first quality accreditation body from Africa to be voted to the board. The announcement was made last night during the ISQua annual general meeting (AGM).

COHSASA has been working throughout Africa for the past 22 years across 600 healthcare facilities to improve the quality and safety of healthcare services provided to patients.

According to the CEO of COHSASA, Jacqui Stewart, the organisation’s appointment presents new opportunities for low and middle-income countries (LMIC) to improve quality in their healthcare facilities.

ISQua is a global organisation driving quality and safety improvement in healthcare worldwide. As a member of the Board, COHSASA will have access to a global network of experts and organisations to share learnings, external evaluation and health system support.

“There’s an undeniable need for healthcare quality in LMIC, so I was pleased to learn that COHSASA had been nominated and voted in to join the ISQua Board by other members. By having a seat we’ll not only have greater insight into what’s happening internationally, but we’ll also be able to represent LMIC and our unique challenges when it comes to quality, safety and accreditation,” said Stewart.

Earlier this year it was announced that COHSASA was successful in its bid to host the 36th annual ISQua Conference in Cape Town in October 2019. This will be the first time in 30 years that the conference will be held in Africa. “This is an example of ISQua’s growing interest in Africa,” said Stewart. “Part of ISQua’s mission is to foster innovation, and Africa is full of innovation due to its resource constraints.”

The emphasis on quality healthcare continues to gain momentum in the move towards National Health Insurance (NHI). Stewart, who was appointed to the Lancet Global Health Commission on High Quality Health Systems in the SDG Era (HQSS Commission), believes that it is critical to engage in quality improvement as health services expand access under universal healthcare coverage.

In May 2017 the South Africa National Commission for High Quality Health Systems was established as a local body under the Lancet HQSS Commission to look at how to develop high quality healthcare systems in South Africa under NHI and how to share that learning globally.

“It’s been made very clear that quality is the cornerstone of NHI, so I think this Lancet Commission will really feed into how we prepare for NHI – what needs to be done, what’s doing well, what still needs to be done and how we are going to do it,” concluded Stewart.

Accreditation is one of the marks of good quality and, according to Stewart, COHSASA is setting the gold standard in healthcare quality in Africa helping people and facilities achieve that excellence.

Credits: Image and article content courtesy of Taryn Springhall and Terri Chowles of EHealthNews.

Clinical Management of Mediclinic Morningside receives Quality Award

COHSASA CEO, Jacqui Stewart (left) presents the Katrin Kleijnhans Quality Award to Sister Margaret Lidovho who heads up the Quality Improvement Programmes in the hospital. According to Mediclinic Morningside, Margaret provides leadership, guidance and excellence in her task to the Clinical Management team.

Above: Jacqui Stewart with the Clinical Management Team of Mediclinic Morningside which constantly strives to drive clinical quality improvement. From left (front row): Sr Karuna Jamalooden, Sr Jean Erasmus, Sr Margaret Lidovho, Sr Kombi Katuta. From left to right back row: Sr Patricia Gcabashe, Sr Joanne Madeley, Sr Joanne van Rensburg, Sr Anna Matela and Sr Dudu Mabaso.

Proud members of the Mediclinic Morningside Clinical Management Team received the Katrin Kleijnhans Quality Trophy from the CEO of The Council for Health Service Accreditation of Southern Africa, Jacqui Stewart.

In presenting the award, Ms Stewart, said that it was an honour for her to present the award to the clinical management team personally. It is obvious that the team is committed to quality and works hard to maintain very high standards.

The Quality Trophy is awarded to an individual, a unit, a department or a discipline in a healthcare facility that has made the most impressive or substantial contribution to quality improvement during the COHSASA accreditation process. The recipient is not selected by COHSASA but is chosen by the facility management.

Hospital Manager, Richard Brett said that it was an easy decision to nominate the Clinical Management Team.

“This beautiful trophy, with its shape echoing the COHSASA logo, honours the memory of our COHSASA colleague, Dr Katrin Kleijnhans, who died on September 28, 2016 after a long illness. It is intended that the trophy carry forward her legacy and encourage others to share her enormous passion for ensuring quality and safety in health care.

“We hope that after its initial presentation, the trophy will become an annual internal floating trophy, and will encourage others to strive for excellence,” she said.

Ends

For more information: Marilyn Keegan @ marilyn@cohsasa.co.za or Mobile: 083 703 7789

COHSASA throws centre-pass for netball players

The Netball Team from the West Coast District that COHSASA is helping to get to SA Championships

As a corporate social responsibility initiative, COHSASA makes an annual donation to the West Coast Netball District Management Team to assist players elected to play for provincial teams or chosen to represent the Western Cape u/19 and u/21 teams at the Spar National Championships.

COHSASA’s donation assists players with clothing, travel and accommodation needs.

The West Coast Netball District is an affiliate of the Western Cape Netball Federation, Netball South Africa as well as West Coast Sport Forum and Western Cape Sport Confederation.

With its headquarters in Moorreesburg and where all games are played, the West Coast district cover a large area. Its borders stretch from Bitterfontein, the most northern area of the Western Cape, to Atlantis in the South. These distances make travel to league games or provincial practice sessions an expensive exercise.  There are 25 clubs with 34 teams in the West Coast Netball District playing league matches.

In May 2017, three West Coast Players were selected for the Western Cape teams that participated at the SA u/19 and u/21 tournaments.

Many farm workers reside in the community that makes up West Coast Netball District and the netball management is actively involved in uplifting these players through training coaches, umpires, technical staff and teaching administrative skills.

Says Esta Visagie Team Manager for the West Coast Netball District, “Our District is proud of what has been achieved. We are privileged to have a strong management team who love the game of netball and will do anything to assist our players. There are very talented young women in our district who are devoted to their netball. Unfortunately, the financial burden of getting to practices and paying for all the expenses often prevent these young girls from making themselves available for the provincial teams. I therefore once again thank COHSASA for its contribution in helping these girls to make their dreams come true.”

COHSASA appoints quality advisor/surveyor

Dr Boitumelo Kosi

Recently appointed as a Quality Advisor/ surveyor, Dr Biotumelo (Tumi) Kosi admits that her life has changed dramatically since she joined COHSASA.

“I see things differently,” she says. As a young intern working at the Nelson Mandela Academic Hospital in the Eastern Cape she was so focused on the clinical aspects of her work with patients that she rarely had an opportunity to get to know, see or experience many of the departments in the hospital.

“Through COHSASA and attending surveys, I have now become aware of a complete picture. One begins to see a hospital as an active, operating organism with a life of its own. I now have a truly comprehensive understanding of how hospitals function. 

“I have also found that working in the field of quality improvement is changing my mindset: I am beginning to apply the principles of QI in my own life. I work out solutions to problems in my everyday life!”

Obtaining her MBChB at the University of Cape Town in 2010, Tumi completed her internship working rotations through paediatrics, internal medicine, general surgery, obstetrics and gynaecology and completing three months of family medicine. This entailed primary health care, anaesthesia, accident and emergencies and orthopaedics. She was responsible for the clinical management of a wide spectrum of patients, including those with TB and HIV and she also assisted in theatre cases – particularly Caesarean Sections.

She moved back to Cape Town to complete her Community Service year at a primary health clinic with the Department of Health in the Western Cape. Here she encountered the full range of illness including chronic and sub-acute conditions.

After her Community Service year, from 2014-2017, Tumi became a Registrar with the National Health Laboratory Service where she prepared specimens and conducted microscopic examination and diagnosis of haematoxylin and eosin stains (H&E stains) in tissue. She worked in a team to conduct cytological examination of gynaecological and non-gynaecological specimens and gave academic presentations. She also taught medical students.

Before and after her Registrar contract, Tumi also worked at a private facility, Ikhaya Lempilo (a Xhosa word that means “house of wellness”). Here she treated a vast array of patients, many with HIV and TB.

It was while she was employed in the public sector that Tumi had to come face-to-face with the harsh reality that many young doctors working in the South African public sector must endure. While she loved her work, she found the conditions extremely stressful. The patient loads are often unrealistic and burnout is not uncommon.

“At times, I was overwhelmed and I decided that I needed a change from clinical care. Many doctors in the South African public system find that the conditions are difficult and they leave the country. I don’t want to do that – I will go overseas at some stage but I will bring any expertise I gain there back to South Africa.”

She hopes to bring her sharp analytical skills to the COHSASA table. “I tend to analyse things and I have a very strong inborn sense of risk assessment and prevention before there is a calamity! I would like to invest these skills in creating safe care for patients.

“Since I joined COHSASA I have become more interested in the legal aspects of medicine and the role of human rights in patient care.”

What lies in the future for Tumi?

“I hope to travel overseas in future. I would love to work in the UK and gain experience in the NHS. Then I want to return to South Africa and implement what I have learnt overseas to benefit the local population.

In the meantime, she will indulge in her favourite pastimes – walking and reading.

Welcome Tumi!

Cure Day Clinics: a vote of confidence in COHSASA accreditation programmes

To ensure that it provides safe, quality care to all its patients, the Cure Day Clinics Group is entering all its hospitals in the quality improvement and accreditation programme of the Council for Health Service Accreditation of Southern Africa (COHSASA).

Two Cure Day hospitals have recently been accredited by COHSASA and Cure Day is now placing the remaining six facilities into the programme. This is due to the firm belief of Managing Director, Bert von Wielligh, that COHSASA accreditation adds value to the services provided.

COHSASA is the only African health service assessment body accredited by the International Society for Quality in Health Care (ISQua). It has been operating on the continent for the past 22 years and has worked in all types of healthcare facilities.

(ABOVE): Bert von Wielligh, MD for the Cure Day Clinics Holdings, outlines the plans his group has for involvement with COHSASA and growing Cure Day into a national footprint. Bert is well-versed in the subject of patient safety and quality improvement and assurance. He was the MD for the Curamed Group and served as Operational Director for Medclinic’s Tshwane Region. Bert’s experience includes involvement with the National Hospital Network (NHN) and the Hospital Association of South Africa (HASA).

The philosophy that underpins Cure Day Clinics is to provide private health care that is more affordable and therefore more accessible to more South Africans.

Beginning operations at Medkin in March 2008, Cure Day Clinics – wholly owned by doctors and incorporating an authentic BBBEE partnership – has grown to eight facilities. Four of these are in Gauteng (Medkin, Midstream, Erasmuskloof and Fourways), one in Bloemfontein and three in the Western Cape in Paarl, Somerset West and Bellville.

It is the Somerset West and Bellville hospitals that have recently been accredited by COHSASA. Both facilities achieved impressive scores with Cure Day Clinics Somerset West achieving a score of 96 out of a possible 100 and Cure Day Clinics Bellville scoring 95.

Following the award of accreditation certificates to the two Cure Day facilities, Jacqui Stewart, COHSASA CEO presented CobiMarie Stander, Manager of Cure Day Clinics in Somerset West and Ezette van Braker, Clinic Manager, manager of Cure Day Clinics in Bellville with the Katrin Kleijnhans Quality Award in recognition of their teams’ commitment to improving quality and patient safety.

Included in this accreditation process is the assessment of compliance with the South African Society of Anaestheologists (SASA) guidelines on procedural sedation and analgesia.

Procedural Sedation has gained popularity as a cost-effective alternative to general anaesthesia for certain procedures. While the safety of procedural sedation is not in dispute, its administration does require strict adherence to internationally accepted practice guidelines. SASA issued the guidelines for all practitioners providing sedation. Prof James Roelofse and his colleagues in the Society of Sedation Practitioners of South Africa (SOSPOSA) developed the guidelines to incorporate all aspects of patient safety in procedural sedation. Patient safety is a key component of all COHSASA’s healthcare standards.

Same-day surgery has grown internationally due to the improvements in medical technology and anaesthesia, leading to faster recovery times and fewer side effects.

Michelle Gumede reports in Business Day, “Day hospitals are a recent addition to SA, but more and more of these convenient one-day facilities are cropping up across the country. Already 41 facilities — mostly in Gauteng and the Western Cape — are represented by the Day Hospital Association of SA (DHASA).

“Companies such as Netcare, Mediclinic, Advanced Health and the Cure Day Clinic group are among those that have taken advantage of this international trend — even though South Africans have not yet come to terms with these facilities which experts say offer patients better value for money.

“The hospitals focus on the provision of short-procedure surgical services as well as on diagnostic procedures that have to be undertaken in an operating theatre on a same-day basis. Services ideal for such hospitals include plastic surgery, gynaecological, orthopaedic, urological and maxillofacial surgery, and several dental, ophthalmic and general procedures.