We are using every opportunity to publicise and promote the ISQua Conference 2019 in Cape Town. I had the privilege of chairing the Quality Management Conference at the Africa Health Congress in Johannesburg on 29 and 30 May.
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.
The good thing about chairing this conference is that I got to choose all the speakers. Even better was that all those that I invited, accepted!
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 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 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 keynote 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 talked about the work being done in Uganda linking the public and private healthcare sectors and trying to establish common standards and assessment thereof. 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.
I spoke about external evaluation and accreditation being a driver for improvement – standards provide part of the 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 keynote address asking us to ‘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. 1) Dare to be different – if we keep doing the same, we shall continue to get the same. 2) Accountability to the communities that we serve. 3) We need to treat patients and staff with dignity – to give us dignified health systems
Look out for some of these speakers on the programme for ISQua 2019 in Cape Town.