Base Line Health Facility Audit

1. Base Line Health Facility Audit Presentation to the Select Committee on Social Service Date 19 March 2013

2. Introduction • Tender NDOH 20 / 2010-2011 (Nov 2010) • Feb 2011: Consortium of HST, ARUP, Exponant, HISP and MRC appointed • Governance: • National Steering Committee chaired NDoH • Provincial Steering Committees with Focal Person • Provincial and District participation • Capacity development • Local ownership

3. Audit Scope • To conduct an INDEPENDANT audit of all public health facilities: • Facility Profile • Accessibility via - road • Operating hours • Number of inpatient beds • Ownership of land and buildings • Infrastructure • Physical Infrastructure condition assessment • Physical condition (walls, roofs, floors, windows, bathrooms, laundry, kitchens etc.) • Facilities Management Maintenance of roads and buildings • Space - Meeting service and patient needs, waiting areas • Bulk Services – Electricity, water, sanitation and waste removal

4. Audit Scope • Equipment • Availability of essential equipment • Human Resources • Post filled and vacant for different staff categories • Finance management • Services provided • Support services • Technical services e.g. IT • Clinical services • Quality of care (sub-set of Core Standards)

5. Six Priority Areas of Quality • Availability of medicine and supplies • Stock control and –management • Availability of tracer medicines • Prescribing practices • Storage • Patient and staff interviews • Cleanliness • Patient Satisfaction results • Inspect records of daily inspections of cleanliness • Cleaning procedures • Toilets, Bathrooms, kitchens, laundry, grounds

6. Six Priority Areas of Quality (cont) • Improved patient safety • Physical safety measures • Emergency services response times • Packages of services • Management of adverse events, clinical audits • Infection prevention and control • Surveillance and reporting systems • Health care associated infections • Waste management • Management of infectious diseases

7. Six Priority Areas of Quality (cont) • Positive and caring attitudes • Patient perceptions of service • Patient knowledge of their rights and responsibilities • Complaints management system • Observation of staff interactions with patients • Privacy • Staff satisfaction • Waiting times • Management, monitoring, action • Patients with special needs • Physical layout of facility

8. Facilities Audited

9. COMPLIANCE SCORE FOR VITAL MEASURES ON 6 PRIORITY AREAS OF QUALITY

10. COMPLIANCE SCORE FOR VITAL MEASURES ON 6 PRIORITY AREAS OF QUALITY – Per Province

11. COMPLIANCE SCORE FOR VITAL MEASURES ON 6 PRIORITY AREAS OF QUALITY – Per District

12. Functional Areas

13. COMPLIANCE IN THE FUNCTIONAL AREAS ON VITAL MEASURES OF THE 6 PRIORITIES

14. Provision of Services Proportion of support services , off sit or on-site

15. Bulk Supplies – Facilities with no bulk services at the time of audit

16. Infrastructure Scores -Average overall infrastructure score

17. DISTRICT RANKING ON INFRASTRUCTURE SCORES

18. Base Line Audit using the DHIS Core Standards Module

19. DHIS Core Standards Module as Data Collection Tool • The DHIS has a flexible relational database structure • The DHIS Core Standard Module was used to collect and store data. • Ad hoc reporting per facility is available within the Core Standards Module • This is used for immediate Facility feedback • Quality Improvement template generated on failed measures • Facility Infrastructure overview report • Pivot reports is used to aggregate and analyse further

20. Available Ad Hoc Reports

23. Geo Spatial use of the data

24. Thank you www.doh.gov.za