Gauteng Health says it has put measures in place to address the cancellation of theatre procedures at the province’s academic hospitals, reports The Times. According to the department, two of the province’s major central hospitals, Charlotte Maxeke Academic Hospital and Chris Hani Baragwanath Academic Hospital (Bara), continue to see a large number of patients.
“In 2018 Charlotte Maxeke Johannesburg Hospital admitted 43,529 patients, while Chris Hani Baragwanath Hospital admitted 104,495 patients. Due to various reasons, such as a high number of acute and intensive care unit (ICU) beds, patient-related issues, infrastructure and equipment-related issues, both hospitals had to cancel or defer planned theatre procedures,” said spokesperson Kwara Kekana. She said Charlotte Maxeke hospital cancelled 2,036 procedures in 2018, while Baragwanath hospital deferred 1,979. “These procedures are then rescheduled at the earliest suitable time, taking into consideration factors that led to deferment,” Kekana said.
Kekana said in the report that the department had put systems in place to improve patient outcomes. These included introducing an electronic communication system for bookings, reminders and cancellations, as well as “evaluation of patients for major elective surgical procedures at pre-anaesthetic clinics before bookings are made”. Other measures being put in place by the department included performing some of the operations in cluster hospitals.
Kekana said in her statement: “For 2018 the CMAH cancelled 2,036 whereas the CHBAH deferred 1,979 procedures. These procedures are then rescheduled at the earliest suitable time taking into consideration factors that led to deferment.
“It should be noted that facilities have put systems in place to improve patient outcomes including active participation of patients in scheduling of operations by introducing electronic communication system for booking, reminder and cancellation.
“Evaluation of patients for major elective surgical procedures at pre-anesthetic clinic before booking is made.
“Patients scheduled for elective surgical procedures to be in hospital on time (7pm) to ensure uninterrupted supply of consumables for elective surgical procedures and cutting time for elective surgical procedures across to be at 8pm.
“Other measures being put in place to ensure that fewer procedures are cancelled or deferred include strengthening the cluster system and outreach, performing some of the operations in the cluster hospitals, extending arthroplasty list to 7pm during the week. Improving patient outcomes and patient experience in Gauteng health facilities remains a top priority of the 6th Administration.”
Democratic Alliance (DA) shadow minister of Health in Gauteng Jack Bloom said that Gauteng Health MEC Bandile Masuku, in a written reply to his questions in the Gauteng Legislature, said the reasons for cancellation were as follows: overbooking – 1,262; shortage of ICU beds – 926; patient related – 559; shortage of consumables – 210 equipment related – 115; and infrastructure related – 312.
Bloom writes that most of these factors are avoidable, caused by poor management that overbooks patients or fails to ensure working machinery and surgical supplies. The shortage of ICU beds for post-operative recovery is also of concern.
He says the high number of cancellations is distressing for both patients and staff and worsens the long waiting times for surgery – more than 6,000 patients currently wait more than six months for surgery at this hospital.
According to Masuku, the following steps are being taken to reduce cancelled operations: improving booking systems, indicating the operating time; creating ward 7 High Care dependency for surgical department = 22; performing some of the operations in cluster hospitals; Saturday elective list (Extra list); extending arthroplasty list to 7 to 7 during the week; and strengthening of cluster systems and outreach.
Bloom writes: “I hope that better management cuts the unacceptably high cancellation of operations at this major hospital.”
News24 reports, meanwhile, that 24 Chris Hani Baragwanath Academic Hospital employees have been disciplined for absenteeism that cost the hospital thousands of workdays last year alone.
According to Gauteng Health, absenteeism affects service delivery at the hospital. Kekana said the hospital lost 6 547 workdays last year alone. Ill health accounts for 0.82% of the reasons given for absenteeism, abscondment accounts for 4.52% and incapacity for 94.6%.
“Reasons for the high levels of absenteeism are general absence without prior arrangements with supervisors, abscondment from service – ultimately leading to dismissal – ill health and the impact of the HIV pandemic, and lifestyles. “Substance and alcohol abuse, in addition to habitual truancy, are the observed patterns in the rates of absenteeism,” she said. Kekana said hospital management implemented various measures to reduce the number of absentees.The Times report Kekana statement Bloom statement News24 report