Leaders need to inspire frontline health workers to drive quality improvement

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

RDM News Wire, 21 September 2015

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

Lachman said there are a number of challenges including the conservatism of the medical profession as well as hierarchies that operate in hospitals that mean the patient is not always listened to. He 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. She 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.

Marshall said quality problems often have an underlying cause such as weak leadership and accountability‚ bureaucracy and capacity constraints relative to workloads and budgeting. She said that in the public sector‚ centralised authority is a major challenge as it means it is often difficult to hold people accountable for problems over which they have no control. Marshall 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 ombudsman.

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. 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 that in a highly competitive sector‚ it is a non-negotiable that private hospitals constantly improve patient care.