If you missed the Quality Management Conference at Africa Health Exhibition and Congress at Gallagher Estate on 29 and 30 May, you missed a great deal. The two-day conference, with masterclasses from experts all over the world, was a packed-out success. Nobody left, not even in the death-throes of the last afternoon.
People interested in improving quality and patient safety heard the latest thinking on issues of quality from experts in the field. COHSASA also hosted a stand at Africa Health and manned the ISQua stand next door. The main promotion was to encourage registration for ISQua’s Annual Conference to be held for the first time on the African continent in Cape Town from October 20-23 later this year.
Both COHSASA and ISQua partnered with Informa for the conference, so there was lots of publicity for ISQua, Cape Town 2019. The theme was ‘Public or Private Health Care – Quality is Everyone’s Business’.
Nino Dal Dayanghirang, Technical Officer for Service Delivery, Quality and Safety at WHO/AFRO started the first day with an overview of WHO quality and safety initiatives. He described the challenges facing those dealing with the Ebola outbreak in the DRC. He talked about the support that WHO is giving to countries to implement National Policies on Quality and Safety as well as the huge range of resources that are available from WHO, such as the Global Learning Laboratory.
This was followed by a presentation by Pat O’Connor, Executive Director of QI Discovery in Dundee, Scotland about some of the quality developments and innovations in the UK. While working for NHS Tayside, Pat pioneered a patient safety system that became the national system for NHS Scotland. Her key message was the importance of getting buy-in from all levels of the organisation and making sure that everybody understands what is being measured and why. She stressed that we must relate the data to the reality of patient care.
Dr Siphiwe Mndaweni, the CEO of the Office of Health Standards Compliance (OHSC) in South Africa set the context of the need for regulation and the development process of national core standards to arrive at regulations. She was realistic about the challenges that the OHSC faces and how important it has been to ensure that all are clear about where the responsibilities lie for the implementation of the regulations and the application of sanctions.
The key-note speaker on the first day was Professor Laetitia Rispel, the co-chair of the Lancet National Commission on High Quality Health Systems (South Africa) and an inaugural member of ISQua’s International Academy of Quality and Safety in Health Care (IAQS). She covered the key findings of the report and emphasised the importance of good governance, leadership and management and how challenged the South African health system has been by this.
Garth Hankey, Improvement: Process Coordinator at Groote Schuur Hospital in Cape Town shared the reality and challenges of introducing change into an organisation, in this case Lean methodology, but called the Groote Schuur Project. He shared strategies for engaging staff across the organisation and the importance of getting, and keeping, the team on board.
Dr Grey Dube, CEO of Leratong Hospital in Johannesburg also talked about implementing Lean methods. He received mentoring from John Toussaint of ThedaCare in the US. He stressed the importance of being realistic and started the programme in a few departments – patient registration, laboratory, pharmacy and OPD where there were long waits for patients and lots of complaints.
Grace Kiwanuka, the Executive Director of the Ugandan Health Federation, shared the work being done in Uganda linking the public and private healthcare sectors and trying to establish common standards and assessments. She emphasised the importance of building excellent relationships and mutual understanding.
Russell Rensburg, Director of the Rural Health Advocacy Project in South Africa opened the second day with the real-life challenges facing patients trying to access services. He used the example of a patient with mental illness who could no longer afford private care and the challenges she faced trying to get into the public health system. He made the claim that 75% of patients who need psychiatric treatment in South Africa do not get it.
Jacqui Stewart, CEO of COHSASA, who chaired the conference and assembled the speakers, spoke about external evaluation and accreditation being a driver for improvement – the standards provide part of the improvement toolkit. The healthcare facility team should set their own timeline – achieving accreditation is a marathon, not a sprint and we should not be afraid to set a trajectory towards excellence.
Dr Gilbert Buckle from Ghana gave a key-note address ‘Forget about Outputs, Focus on Outcomes’. He suggested that we need outcomes that are meaningful for patients – what if surgeons were rated on the number of complications during surgery or midwives on the number of stillbirths of babies with foetal heart distress? He posed the question, “Could an outcome be happy patients?”
The two-day event gave time for three excellent master classes by Lauren de Kock, Regional Director: Continuous Quality Improvement and Training at the Aurum Institute in Johannesburg, Pat O’Connor and Gilbert Buckle.
A panel discussion gave three great take-away messages. Dare to be different – if we keep doing the same, we shall continue to get the same. Accountability to the communities that we serve. We need to treat patients and staff with dignity – to give us dignified health systems
Some of these speakers will be on the programme for ISQua 2019 in Cape Town. If attendance was anything to go by, this Quality Management Conference is a sure winner.