The delegation of the North West Health Department led by MEC Madoda Sambatha together with the administrator Jeanette Hunter, acting DDG for Health Services Pule Monale and the district management has concluded a fact-finding mission to the Brits District Hospital. The delegation engaged a number of stakeholders including the hospital management, the board, labour and the community organisation “Save Madibeng”. The visit follows a public outcry by the community which were sparked by a video clip posted on social media (Facebook) by a community member whose mother was admitted in the hospital on the 19th October 2020.
The department immediately acknowledged that the picture depicted in the video clips is indeed a true indication of the challenges faced by Brits Hospital. Without mincing his words, MEC Sambatha was quick to point out that the patients were not fairly treated and consequence management will be applied. “I must say I find the treatment of the complainant’s mother and other persons that were lying on the floor inhumane, unprofessional unacceptable and lacking empathy. For that I must be upfront in saying that we apologise to the patients, the family, community and the rest of South Africa”, said MEC Madoda Sambatha
A report given to the MEC is that the mother of the complainant was brought to the hospital on 19th October 2020 with history of an acute neurological event. There was up to 3 hours delay before she was attended to. It was also revealed that the person who escorted the patient was forcefully removed from the casualty by security and denied access to the unit and the mother.
The MEC considered this act unacceptable. The patient and others in the casualty unit sat on uncomfortable seats or slept on the floor for up to 16 hours. It was concluded that the care provided was sub-optimal and particularly a staff attitude towards patients and escorts was very poor. At this point, the complainant recorded the state of the casualty and posted it on social media.
A team made of the district, hospital management and system specialists from the national Health Department identified a number of key issues that contributed to the incident and they include space challenges, leadership issues, clinical governance issues, weaknesses in support services and weak quality assurance processes.
In terms of leadership, it was revealed that there is a lack of substantive appointees in key leadership positions. The department then took a decision to fast track appointment of senior managers at the hospital including the position of clinical, nursing and allied managers as well as speeding up the disciplinary hearing of the substantive CEO. The department will implement all managerial strategies and monitor adherence to executive meetings, briefings, walkabout, reviews and establishment of management structures including labour forums.
The MEC gave a background on the case of the suspended substantive CEO. “It must be known that the substantive CEO was given an option of temporarily being shifted to the district until investigations are completed. Unfortunately, the substantive CEO opted for suspension yet the impression is that we were keen on her suspension. The department bargained with her for almost a month but she refused the transfer option”, said MEC Sambatha
A challenge of low staff moral and bad attitude among employees was identified by both the management and labour. A decision has been taken to strengthen employee assistance programmes, ensure regular staff meetings and further strengthen the Labour relations unit in the hospital. The department also took a decision to conduct a staff satisfaction survey which will also cover the entire Province.
The department will further ensure prompt attention and redress of patients complaints, ensure that complaints mechanism is visible in all areas. Training of staff on customer care will also be prioritised.
Poor clinical governance was identified as key challenge for the hospital that has a big influence on the undesirable conditions at the hospital. In order to strengthen these areas, the MEC took a decision to appoint Professor John Tumbu, Professor Benu Luke and the clinical manager of JST to oversee strengthening of clinical governance prescripts and quality assurance.
Attention will be made to deal with the weak implementation of quality assurance policies. The department will appoint quality assurance officers and implement the Ideal Hospital Framework. A dysfunctional patient filling system will also be addressed through the strengthening of patient management systems. This intervention will cover filling and archiving systems.
The two, Professor Tumbu and Professor Luke have been elevated to provincial status to support all the districts. Their work will also cover the strengthening of the quality assurance unit and to ensure implementation of standard clinical governance prescripts. There will be visible systems reorganisation in the service units to improve patient flow and records management
A challenge of bed management was also identified. In this regard, a decision was taken to introduce a bed management software solution. Moreover, “quick wins” intervention like use of trolleys, beds, Lazyboys for patients instead of allowing them to sleep on the floor when there is overflow.
A decision was taken to strengthen a provincial representation in the intervention. As a result, a team led by the administrator which comprise of labour representatives, representative of staff members, hospital board and district management will oversee implementation of all resolutions of the meetings held and the decisions of the MEC.
A decision was taken to establish a gateway clinic in the vicinity of the hospital. This is because the municipal town clinic closes early at 16h00 further increasing long queues at the hospital. The district will assess either the use of a park home or fabricated build to serve as a clinic to operate 24hrs as urgent intervention measure. The department will engage the municipality to look into relocating staff members from the town clinic to be part of a 24-hour gateway clinic.
The district management together with the Province and the communication unit of both the hospital and the sub-district will oversee implementation of a communication strategy to ensure health promotion and awareness. Working together with the board, their work will extend to building a strong stakeholder relations and awareness.
An independent investigation still has to be conducted to establish who was wrong. The outcomes of such an investigation will be followed with the implementation of consequence management to everyone involved.
[link url="https://www.gov.za/speeches/north-west-health-mec-intervenes-brits-district-hospital-3-nov-2020-0000"]National Health Department material[/link]