“The past year has seen a number of significant developments at COHSASA. One of the most noteworthy of these is the fact that COHSASA achieved its third international accreditation, awarded in January 2011 by the International Society for Quality in Healthcare (ISQua).

“In addition, four sets of COHSASA’s standards and our surveyor training programme have achieved international recognition and accreditation from ISQua.

“COHSASA remains the only African organisation carrying out formal, recognised accreditation and consequently we have taken the strategic decision to make this resource available to other countries in Africa. We are currently operating in Namibia, Lesotho, Botswana, Nigeria and Rwanda.

“We continue to enjoy support from South Africa’s private sector hospitals and 36 Mediclinic hospitals have extended their contracts for a further two years and will continue in a rolling programme that includes self-evaluation and quality improvement components using the web-based CoQIS information system.  All the hospitals have undergone accreditation surveys, with the majority achieving accreditation status.

“As far as the public sector is concerned, COHSASA continues to support the National Department of Health in the implementation of the National Core Standards (NCS). We are assisting 20 hospitals in the Limpopo Province to meet the National Core Standards developed by the Office of Health Standards Compliance of the Department of Health in South Africa.

“The hospitals are being assessed against both the NCS and the COHSASA standards. The NCS evaluate whether key outputs are being produced as they should be, using a quality assurance approach. The COHSASA standards evaluate whether systems and processes are in place to ensure that key outputs are produced on a regular basis. COHSASA  employs a continuous quality improvement approach.

“The data from the assessments of both the NCS and the COHSASA standards are captured to CoQIS. The system generates a number of key reports which guide quality improvement plans based on priority issues. CoQIS allows for on-going monitoring of performance, leading ultimately to improving levels of compliance with the NCS.

“COHSASA continued to build its international reputation by co-operating with other international bodies: close collaboration was maintained with the WHO and the International Society for Quality in Health Care (ISQua).

"To ensure that quality improvement and accreditation programmes meet the needs of clients, COHASA has continued to evaluate its programmes as part of its on-going internal research programme.  

“The CoQIS system has been further developed to assist clients to implement quality improvement activity programmes and move towards accreditation.  COHSASA puts great emphasis on helping clients in South Africa and other countries to develop local capacity and embed ownership of the quality improvement process. The self-evaluation programme, backed up by regular validation visits by COHSASA staff, has helped greatly with this. 

“Healthcare workers in client organisations are trained and empowered to understand the content and the intention of the standards, to evaluate their compliance and implement continuous quality improvement programmes in order to achieve standard compliance. To do this work COHSASA requires a work-force with medical, nursing and allied health professional skills who have been trained in quality improvement and assurance methodologies, evaluation and monitoring techniques and who have strong training and facilitation skills.

“COHSASA has continued to operate as the sole distributer in South Africa of the Advanced Incident Monitoring System (AIMS) under licence from CSC( iSoft).  In the Free State, the major research project with the Department of Health on quality improvement and patient safety in 24 healthcare facilities reached its conclusion. The Department of Health took the decision to expand the programme to other facilities and as of April 2012, 45 facilities are in the programme. In addition to the research carried out in the province, COHSASA has been analysing the data with a view to publishing research papers.

“The year 2011 will be remembered as a year in which a number of important opportunities presented themselves, were picked up and acted upon.  The results of these decisions will become manifest in the years that lie ahead.

“An important decision was taken when COHSASA entered into a collaboration agreement with PharmAccess, a Netherlands-based NGO that assists facilities in resource-restricted settings with upgrading of technology and infrastructure, quality improvement and micro-financing. Arising from this collaboration was an agreement among three organisations from three continents – COHSASA, PharmAccess and the Joint Commission International of the USA – to assist in addressing the issue of the health service quality in resource-restricted countries.

“In March 2011 the SafeCare Initiative was launched at a conference held at the Cape Town International Convention Centre.  The conference was attended by 150 international healthcare leaders. This initiative has now grown into a tripartite agreement to establish a SafeCare Foundation.

 “COHSASA enters 2012 with continued determination to support its clients in their quest to provide the highest quality patient care through the implementation of quality improvement and patient safety programmes using the CoQIS system and the AIMS programme.

“It will also endeavour to demonstrate its commitment to the South African health system by actively analysing and comparing the national core standards and COHSASA standards information captured in the Limpopo hospitals, to assist the Department of Health to develop a practical system for quality assurance in healthcare facilities.”