For the latest in QI head on over to the Gallagher Estate in May. Details are available here:
Conference Name: Quality Management Conference
Venue: Gallagher Convention Centre, Johannesburg
Theme: Public or private healthcare – quality is everyone’s business
Download the full programme here
The Decontamination & Sterlisation (CSSD) conference will take place from the 28-30 May 2019 at the Gallagher Convention Centre, Johannesburg, South Africa.
Developed with the support of CFSA and APPSA attend to:
Debate the implementation of current standards – who is getting it right?
Identify and mitigate risks existing within CSSDs
Discover best practice from hospitals operating outside South Africa and benchmark your hospital’s CSSD practices
Hear from leading field experts including:
Marietjie du Toit, National Infection Prevention and Control Specialist Nursing, Life Healthcare Group; Chairperson, Gauteng Infection Control Society, Johannesburg, South Africas
Xana Jardine, National Chairperson, CFSA, Johannesburg, South Africa
Marilyn de Meyer, President – Gauteng Chapter, Association for Peri‐operative
Practitioners in South Africa (APPSA); Theatre Manager, Life the Glynnwood Hospital, Johannesburg, South Africa
Terry McAuley, MSc Medical Device Decontamination, Director, STEAM
Consulting, Melbourne, Australia
Dr Londa appointed as Quality Improvement Manager
Imagine the scene: you are suturing a rebel in the war-torn Democratic Republic of Congo. The theatre table wobbles and there is no operating light. Nor is there antiseptic. Under these conditions, you might want to change the status quo.
Thus it was that Dr Leonard Londa, who has joined the senior management team at COHSASA as the Quality Improvement Manager, became intensely aware that he wanted to change and save lives by improving the safety and quality of healthcare in any situation in which he found himself.
Dr Londa arrived as a refugee from the Congo in 2010. He obtained his medical degree at Lubumbashi University in the Democratic Republic of the Congo (DRC) in December 2008 and afterwards worked at the academic teaching hospital in Lubumbashi.
Promoted to superintendent of a hospital in a rural area, the Malemba-Nkulu Territory in the Haut-Lomani Province of the DRC, Londa had to start flexing his muscles as a clinician under pressure. This area, in the South East of the country, was also slap-bang in the middle of fighting between factions: a perennial feature of the DRC political landscape.
Says Dr Londa: “The maternal and infant mortality ratios were very high. We had one ambulance but that was out of order. So pregnant woman had to get to hospital by any means possible. They rode bicycles and we swept them up from canoes on the Congo River! Unfortunately, some arrived too late and presented with a ruptured uterus and sepsis.
“Worse, the hospital was dirty, the theatre was dirty and there was no equipment. There was a chronic shortage of staff.”
Determined to make changes
Dr Londa, who has quality improvement imprinted in his DNA, made some changes. For one, he trained many community health workers to undertake tasks to assist mothers. He gave radio talks to educate and create awareness of potential problems in pregnancy.
“I was determined to make changes for the better. I had to change the mindset of my peers and the community. I worked with NGOs in the area and recruited villagers to be health workers.
“Communication was a big issue and we never had enough air-time for our phones! I renovated the theatre and secured equipment. I tried to make changes. However, I had to flee eventually because of the war.”
After a long and winding road, Dr Londa arrived in South Africa. In October 2010, he worked as a medical officer at the Maluti Adventist Hospital in Lesotho. Here, he was involved in a wide range of clinical work including the management of HIV/AIDS/TB patients. He also took care of trauma cases and worked in the orthopaedic and gynaecology sections. He was the Quality Improvement Officer.
Since 2013 (and until he joined COHSASA) Dr Londa worked as the South Region programme manager and the Clinical and Quality Assurance Master Trainer at JHPIEGO in Lesotho. He was the manager at an HIV/AIDS/TB clinic and a trainer of voluntary medical male circumcision providers. He also took care of surgical emergencies.
Taking COHSASA’s mission forward
He hopes to take COHSASA’s mission forward.
“I want to give input into the COHSASA mission and make sure that whatever COHSASA stands for is being applied in the field.”
He will be overseeing the activities of all the COHSASA quality advisors. He has an interest in clinical research and wants to examine what obstacles stand in the way of a successful accreditation programme.
“I want to improve the quality and safety of health to change lives and thus lead to the creation of a more productive society. Many HIV patients only work 10 days in a month. This must change.”
Dr Londa is married with two children.
The CEO of The Council for Health Service Accreditation of Southern Africa (COHSASA), Jacqui Stewart, has been selected as one of the 100 Most Impactful Healthcare Leaders by the World Health & Wellness Congress for 2019 scheduled for 14th February in Mumbai, India.
The World Health & Wellness Congress is a not-for-profit body that organises the annual meeting with the objectives of learning and development, networking and recognising leaders who have contributed value to the profession or their organisation and who, through a positive impact, have made a difference.
The Congress attracts leaders from the continents of Asia, the USA, Africa and the Gulf Cooperation Council (GCC), an alliance of six countries in the Arabian Peninsula: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates.
The organisers have informed Ms Stewart as follows:
“Our approach is towards thought leadership and along with thought leaders international we would like to confer on you the “100 Most Impactful Healthcare Leaders – Global Listing”
“The award reflects your professional achievement and our belief that you are a thought leader in healthcare industry and a valuable contributor.
“To reach to this conclusion we have approached your peers who have recommended your name. This recommendation has been vetted by the advisory board of World Health & Wellness Congress.”
The Health and Wellness Conference takes place on 14th and 15th Feb 2019 at The Taj Lands End, Mumbai, an iconic venue overlooking the Arabian Sea.
Responding Ms Stewart said, “I am deeply honoured and very humbled. Thank you very much to you and the advisory board for this great honour.”
Says Chair of the COHSASA Board, Ms Sharon Slabbert, “The COHSASA board congratulates Jacqui on another great achievement which is testament to her dedication to quality assurance internationally, but, particularly in Africa.”
Unable to accept the award in person in Mumbai since the dates clashed with COHSASA’s Annual General Meeting and Board Meeting, Ms Stewart has asked that Mumbai resident, Mr Anisur Rehman Jagrala, accept on her behalf.
The healthcare facilities listed in the table below have recently been awarded accreditation by The Council for Health Service Accreditation of Southern Africa (COHSASA), a not-for-profit company (NPC) based in Cape Town.
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.
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.
|MedAhead@Wilgers in Pretoria||2 Years Full Accreditation||15 February 2019 to 14th February 2021||Die Wilgers, Pretoria, Gauteng|
|Mediclinic Kloof||4 Years Full Accreditation||15 February 2019 to 14th February 2023||Erasmuskloof, Pretoria, Gauteng|
|Mediclinic Newcastle||3 Years Full Accreditation||15 February 2019 to 14th February 2022||Newcastle, KwaZulu-Natal|
|Mediclinic Paarl||4 Years Full Accreditation||15 February 2019 to 14th February 2023||Paarl, Western Cape|
|Mediclinic Vergelegen||4 Years Full Accreditation||15 February 2019 to 14th February 2023||Somerset West, Western Cape|
|Queen Mamohato Memorial Hospital in Lesotho||3 Years Full Accreditation||15 February 2019 to 14th February 2022||Maseru, Lesotho|
|Selebi Phikwe Government Hospital in Botswana||2 Years Full Accreditation||15 February 2019 to 14th February 2021||Selebi Phikwe, Botswana|
The Council for Health Service Accreditation of Southern Africa NPC (COHSASA), has achieved its fifth accreditation from the International Society for Quality in Health Care (ISQua), the global authority with a mission is to improve the quality and safety of healthcare worldwide.
This fifth accreditation, valid from 2018 to 2022, means that COHSASA itself, as an organisation, has been independently assessed by the most credible authority in the world in this field and has had its existing systems and operations validated. The process does not end there as the aim is to drive continuous quality improvement throughout the organisation.
COHSASA is the only health services accreditation body in sub-Saharan Africa to be accredited by this ISQua.
COHSASA has achieved accreditation from ISQua in 2002, 2006, 2010, 2014 and now in 2018. This latest accreditation further focuses attention on this not-for-profit organisation that will be co- hosting ISQua’s 36 th International conference in Cape Town, the first time that the conference will be held on African shores.
Furthermore, the COHSASA Healthcare Facility Standards (First Edition) has also achieved ISQua accreditation for the period of 2018 to 2022.
The ISQua surveyors gave the COHSASA Healthcare Facility Standards a rating of 89% and described the result as “excellent”. This was the first survey of this suite of standards which includes: Generic Service Elements, Inpatient Care standards and Ambulatory Care standards. These standards are an amalgamation of six existing sets and they have been combined to provide consistency and reduced duplication.
Based in Cape Town, the Council was founded in 1995. In the past 23 years, it has worked with 594 healthcare institutions across 35 clients in 11 countries in Africa. Using professional standards, COHSASA identifies gaps in service provision and assists healthcare staff to meet those gaps.
The Council empowers health workers to ensure that there are systems and processes in place, underpinned by professional standards, so that patients are provided with safe, quality care.
Commenting on the latest accreditation, CEO of COHSASA, Ms Jacqui Stewart said:
“I am absolutely delighted that COHSASA has been accredited by the International Society for Quality in Health Care (ISQua) for a fifth time and has achieved accreditation for twenty consecutive years. This accreditation is an indication of excellent team work within the organisation, high quality systems, a commitment to our mission, vision and values and most important, a commitment to our clients.
“I am pleased that our healthcare facility standards have also been accredited for four years. We now have just two sets of standards, healthcare facility standards for inpatient care and ambulatory care. These two flexible sets enable us to better respond to requests to accredit facilities delivering new approaches and models of health care. We are committed to maintaining high quality programmes and services for all our clients for many more years”.
Chairperson of COHSASA, Ms Sharon Slabbert said of the latest accreditation: “The Council of Health Services Accreditation of Southern Africa has for the fifth time been accredited by the ISQua following a rigorous process of evaluation. This clearly indicates that the Council is striving towards its vision of being the leading health service accreditation organisation globally. This is only possible through the total dedication and hard work of the CEO and staff. It is through absolute adherence to the principles of the highest standards of quality in the provision of healthcare that this remarkable achievement has been made possible.”
Elaine O’ Connor, ISQua Head of the International Accreditation Programme and Strategic Partnerships CC, said: “ISQua warmly thanks and congratulates all who were involved with this process and offers best wishes for the continuing success of Council for Health Service Accreditation of Southern Africa.”
Highlights of the evening…
The Katrin Kleijnhans Quality Trophy is awarded to an individual, a unit, a department or a discipline in a healthcare facility that 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 appropriate authority at the healthcare facility.
At Jwaneng, the award was jointly shared by Victoria Phenyo Botlhole, the Quality Assurance Coordinator of Jwaneng Hospital and the Occupational Therapy Department of the hospital, represented by Dr Keletso Maribe (pictured here together holding the trophy).
After its initial presentation, it is hoped that the trophy will become an annual internal floating trophy, given to a deserving recipient at the facility. It is also envisaged that the name on the trophy will become synonymous with the values, efforts and rewards involved in continuing quality improvement and serve to encourage and acknowledge all such efforts in the future.
Welcoming guests, the General Manager of Jwaneng Mine, Mr Albert Milton said, “This re-accreditation bears testimony to Jwaneng Mine’s strong commitment to providing safe healthcare practices of a reputable quality. This resonates well with our value system ‘Putting Safety First’ and caring for our people.”
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