DEVELOPING HPH STANDARDS IN DEVELOPING HPH STANDARDS IN PUBLIC HOSPITALS IN PUBLIC HOSPITALS IN

SOUTH AFRICASOUTH AFRICA

RAMDASS PD, JINABHAI CC, CASSIMJEE MH, GEDDES R

Kwazulu-Natal HPH CommitteeDept. of Health &

School of Public Health.

BACKGROUNDBACKGROUND• The WHO Health Promoting

Hospitals (HPH) project aims to incorporate health promotion into the culture and management of hospitals to improve patient and staff health.

• The Department of Health, Kwazulu-Natal, piloted the WHO self-assessment tool, in six public hospitals, as part of the international collaboration.

70% of global total

SOUTH AFRICANDEVELOPMENTCOMMUNITY (SADC)

KWAZULU-NATALSOUTH AFRICA

SUB – SAHARANAFRICA

SAHARA

The hospitals are distributed over an area of about 93 000 km²but access is difficult due to poor roads.

Although the KZN Province inherited a number of disadvantaged hospitals from the previous apartheid government, it is working at improving them.

Objectives of Pilot Project in Objectives of Pilot Project in S AS A

Adapt & contextualise the Self-Assessment Tool (SAT) performance standards & indicators

Assess existing Hospital Information Systems

Develop quality improvement plans based on Indicator assessment & compliance with standards

Integrate the HPH data sets into the local Hospital Information Systems

Recommend the implementation of HPH in all Public Hospitals in South Africa & Africa

METHODSMETHODS

• Permission & authorization from policy makers to undertake pilot in 6 hospitals

• Consultations with Hospital staff• Establishment of KZN HPH committees• Mobilsation & allocation of resources• Integrate indicators into Hospital

Information Systems• Submission of Reports to policy makers /

WHO

The process The process in KwaZulu in KwaZulu NatalNatal

The implementation of the pilot phase involved

the following processes :

1. Infrastructure Development2. Hospital enrolment and information sharing3. Data collection, collation & analysis4. Presentation of Draft Report to policy

makers5. Formulation of Recommendations for full

implementation

InfrastructureDevelopInfrastructureDevelopmentment

• Senior General Manager - Dr S.M. Zungu• Principal Specialist Health Service - Dr P Ramdas• Chief Specialist - Prof M. H. Cassimjee• Analytical, technical support Prof Jinabhai / Dr R Geddes

School of Public Health University of KwaZulu-Natal

• Provincial PATH (Performance Assessment Tool-WHO) Coordinator for the Hospitals

Dr. S. Sirkar• Office space at Northdale Hospital• Employment of a data Capturer – Mr S. Rungasami• Allocation of IT equipment for the Project

Pilot implementation of Pilot implementation of Self-Assessment ToolSelf-Assessment Tool

TimelinesTimelines• Phase 1:Phase 1: Preparation – March 2004

• Phase 2:Phase 2: Assessment of standards compliance – April and May 2004

• Phase 3:Phase 3: Data collection for -indicators – June to Dec 2004

• Phase 4Phase 4: Development of quality improvement plans – Sept to Dec 2004

• Phase 5:Phase 5: Reporting results – 2005

Pilot project Pilot project processprocess

Phase 1: Preparatory - March 2004March 2004

Provincial coordinating team established: Department of Health including Sub-

Directorates Nelson R Mandela School of Medicine

Participating Hospitals / Institutions selected: Inkosi Albert Luthuli Central Hospital Greys, Edendale, Northdale Hospitals, Ngwelezana Lower Umfolozi

Provincial coordinator: Dr P.D. Ramdass Institutional coordinators: Quality Improvement

team coordinators

Phase 2:

Assessment of standards compliance (April-May2004).

Consult with Quality Improvement

(QIP)teams at institutions (applicability and areas of clarification).

Indicator development (identification and data collection)

Pilot project process Pilot project process (cont.)(cont.)

Phase 3: QIP plan development (June -December 2004)

Based on the gaps after the assessment of compliance to standards

Phase 4: Reporting to World Health Organsiation (Sept-Dec 2004)

Meta-analysis form (results to be computed by WHO and feedback given)

Finalisation of tools by WHO

Benefits:Benefits: FOR KZN DOH, FOR KZN DOH, South AfricaSouth Africa

1. Monitoring & Evaluation Unit has a WHO Standard HPH tool & strategy

2. Able to monitor trends in change / improvements in HPH over time

3. Has potentail to offer leadership for Public Health sector in S A

Benefits:Benefits: FOR KZN DOH, FOR KZN DOH,

South Africa South Africa

4. Participation in the International arena of Quality Improvement, HPH & Performance Measurement

5. Participation in the global HPH network

6. Decentralisation of data capturing to institutions

7. Empowering hospitals to use their own data

8. Methods to expand existing QIP projects

Benefits:Benefits: FOR KZN DOH, FOR KZN DOH, South Africa South Africa

9. A self monitoring tool to identify areas of need

10.Adaptable to all levels of care

11.Encourages participation by all categories of staff + management

12.A data base for different areas eg Human resources, Employee Assisstance Programmes, Occupational Health,PATH Tool from WHO.

ConclusioConclusionn

Hospitals were encouraged to use the adapted self-assessment tool to

improve health promotion activities,

accelerate continuous quality improvement for improved quality of care; and

expand the scope for participatory research.

AcknowledgementAcknowledgement

Dr S. Sirkar – Path Technical Co-ordinatorDr C. Bhagwandeen – Human Resource Support Unit

Ms V. Moodley – Health Promotion Unit Mrs A. Khathi – Quality Assurance & Accreditation UnitMs J. Maher – Quality Assurance & Accreditation UnitMr C. Shawe – Quality Assurance & Accreditation UnitDr V. Maistry – Edendale HospitalMs H. Findlay – Greys HospitalMs. V. Bawany – Lower Umfolozi War Memorial HospitalMs R. Jele – Ngwelezana HospitalMs U. Sooruth – Northdale HospitalMs N. Mbambo – Inkosi Albert Luthuli Central Hospital

THE ENDTHE END

HEALTH PROMOTING HEALTH PROMOTING HOSPITALS HOSPITALS

SOUTH AFRICASOUTH AFRICA