Leaders need to inspire frontline health workers to drive quality improvement

It is essential that frontline healthcare staff‚ such as doctors and nurses‚ is empowered to take ownership for quality and the safety of patients‚ delegates at the Hospital Association of South Africa (HASA) 2015 conference in Cape Town heard on Monday.

“Regulations are important to provide a framework‚ but a culture of safety needs to be created‚” said Dr Peter Lachman‚ deputy medical director at Great Ormond Street Hospital.

“When standards are sent down to the front line and they feel they don’t own it‚ it is very difficult to implement.”

He said the education of doctors and nurses needed to be reformed to include quality improvement‚ alongside other disciplines such as anatomy‚ physiology and pathology.

“There are a number of challenges including the conservatism of the medical profession as well as hierarchies that operate in hospitals that means the patient is not always listened to.

“There is a belief that harm is inevitable and that safety is resource related‚ but often by improving safety one patient at a time that you’ll start a movement.”

Lachman said healthcare workers seldom set out to intentionally harm patients and it was possible to make small changes with sustainable results.

Former CEO of the Office of Health Standards Compliance (OHSC)‚ Dr Carol Marshall said the National Core Standards had been designed to protect patients from harm.

Marshall said mock inspections in public sector hospitals and clinics conducted by the OHSC found large variations in the quality of health services delivered between the types of health establishment‚ provinces and individual establishments.

“Quality problems often have an underlying cause such as weak leadership and accountability‚ bureaucracy and capacity constraints relative to workloads and budgeting‚" said Marshall.

“In the public sector‚ centralised authority is a major challenge as it means it’s often difficult to hold people accountable for problems over which they have no control.”

She said regulation was just one of the many mechanisms government was using to manage quality in hospitals‚ including certification‚ councils‚ monitoring indicators and strengthening the voice of users through an ombud.

Dr Dena van den Bergh‚ director: quality leadership at Netcare told delegates that hospital managers played a critical role in leading organisations. They needed to declare patient experience a personal priority and transparently discuss results with their frontline teams to continue improving.

“You can have tools and data‚ but unless you understand your process and you make quality improvement a culture‚ you’re unlikely to change the system‚” she said. “It’s essential to discuss both the successes and failures‚ create focus and energy and leadership at every level.”

According HASA CE‚ Dumisani Bomela‚ the addition of quality care in the conference demonstrated the emphasis private hospitals were placing on constantly improving quality care.

He said‚ “In a highly competitive sector‚ it is a non-negotiable that private hospitals constantly improve patient care – the sessions we have set aside at this conference are designed to help private hospitals share their successes‚ and to learn from each other.”

RDM News Wire.