While COHSASA’s 10 years have been marked by triumphs and setbacks, it’s moments like these when Wentworth Hospital in Durban celebrated its THE COUNCIL accreditation at the start of the new millennium FOR HEALTH that linger forever… SERVICE ACCREDITATION OF SOUTHERN We’ve come a long way AFRICA COHSASA HAS been working in demonstrated the value of this local recognition that COHSASA meets the field of quality improvement in approach in improving the delivery of agreed international standards South African healthcare facilities quality health care to all our citizens. specifically developed and tested for over 10 years. Part of the for healthcare external evaluation In the past ten years of operation, Proudly South African movement, bodies. with COHSASA’s work in 595 COHSASA has achieved global In August 2004 COHSASA facilities in both the public and recognition and is one of only a became the first organisation in private sector, the following handful of internationally accredited the world to undertake the milestones have been reached: accrediting bodies recognised by development of standards for the the International Society for Quality In 1994, the Pilot Accreditation evaluation and management of HIV in Health Care (ISQua). Programme for South African and AIDS within a district and Health Services was launched as a across the continuum of care – from Since its inception, COHSASA has research and development prevention and VCT to terminal care. focused on providing South African programme in the Faculty of (Continued on page 2) solutions for South African problems. Medicine at the University of This has resulted in the development Stellenbosch under the of facilitated accreditation directorship of Dr Stuart programmes for South African Whittaker. The programme grew healthcare facilities that enable rapidly and, in October 1995, specific identification of areas of COHSASA was registered as a strength and deficiency. Through a not-for-gain organisation. process of ongoing training, The first hospital to be accredited monitoring and evaluation, skills in South Africa – the Medi-Clinic transfer to local staff enables facilities Group’s Louis Leipoldt Hospital in to become accredited as centres of Bellville – was issued with a two- excellence for healthcare provision. year COHSASA accreditation Because of the legacies of the past, certificate on June 1, 1995. many facilities in South Africa face The first public sector hospital New Chairman significant obstacles in provision of to be accredited – Addington for COHSASA health care, including problems with Hospital in Durban – was awarded finance, physical infrastructure, a two-year accreditation on Mr Albert N Ramukumba, medication and consumables supply, November 21, 1997. B.Dent.Ther (Hons), AMP as well as staffing shortages. To COHSASA signed the first major (Manchester), PDH (UCT), assist facilities to overcome these contract to accredit 29 public PG Dip. in HIV/AIDS deficiencies and acting in response sector hospitals in KwaZulu-Natal (Medunsa), formerly Chief to local needs, COHSASA developed on November 12, 1998. Executive Officer of the the graded accreditation process – In May 2002, COHSASA’s Hospital Association of unique in the world – that allows all standards were recognised by the South Africa (HASA), facilities in the country to access International Society for Quality in has been appointed as world-class accreditation processes Health Care (ISQua) as meeting its Chairperson of the that are tailored to their specific principles. COHSASA Board of Directors. Cohsasa Bulletin requirements. Responses to In September 2002 COHSASA Speaking soon after his these programmes over the was accredited by ISQua for four election, Mr Ramukumba last decade have repeatedly years. This is formal, worldwide May 2006 said he believes in teamwork and aims to encourage full North West participation from Board Province Quality members to carry COHSASA Summit into the future. New Chief Operations Manager In December 2005, QI evolution in windblown staff Free State Hospitals celebrated COHSASA’s 10th birthday in Injection safety inside Cape Town. North West Province Quality Summit SENIOR OFFICIALS and hospital staff of the North West Province assembled at a hotel near Rustenberg during the November 2005 Quality Month to take stock of service provision in their facilities. The province has just completed its first contract with COHSASA. Eight of its hospitals earned Progress Awards, seven received Entry Awards and one achieved an Intermediate Award. Klerksdorp/Tshepong Hospital was awarded a three-year accreditation and Witrand Psychiatric Hospital was accredited for two years. The aims of the summit – Restoring Dignity through Quality Health Service – were to create a common understanding and awareness of quality and quality assurance and to gain clarification of the role of quality assurance and its relationship to other programmes initiated in the province. The rationale was to give impetus to QA activities and mark Quality Month in South Africa. COHSASA was invited to attend and gave feedback on the status of the hospitals in the province participating in its programmes, and encouraged the institutions to continue with the process of quality improvement. In his presentation, Dr Stuart Whittaker, CEO of COHSASA, said his organisation could assist the province to improve the quality of health services provided to the public, but that the programmes were not a ‘magic bullet’. He said quality improvement is an investment over time and that if standards are to be fully maintained and become ingrained in everyday hospital practice, the hospitals needed to make a long-term commitment. COHSASA celebrates 10 years In 2005, the Council for Health Service Accreditation of Southern Africa celebrated a decade of involvement in quality improvement for healthcare facilities. A special dinner was held at a city restaurant after COHSASA’s Board meeting in November. Those who attended this historic event were, from left (back row): Magda van Wyk from the Board of Healthcare Funders, Professor GJ van Zyl, Head of the School of Medicine in the Faculty of Health Sciences at the University of the Free State, Dr Shadrack Mazaza, member of the QUALSA Board of Directors (Clinical Governance Executive and Chairman of the Clinical Governance Exco), Dr Louis Claassens, Director: Quality Assurance for the National Department of Health and Fanie Maritz, COHSASA’s auditor. Front row: Dr Helene Visser, Manager of Quality Assurance and Training for City Health in Cape Town, Professor Marie Muller, Dean of the Department of Nursing and Education at Johannesburg University, Dr Jill Hurst, Hospital Manager of Addington, Mr Albert Ramukumba (Chairman), Dr Stuart Whittaker (CEO) and Dr Deon Moulder (Deputy Chairman). FROM TOP Absent: Tevern Japhta from the South African Quality Institute. The two-day summit was hosted by Connie Masiangoaka of the Quality Assurance Unit of the North West Province Enjoying a tea break were (from left to right): Salvation Baloyi, Matipi Kgaje, Esther Viljoen and We’ve come a long way (Continued from first page) Eunice Abrams On December 17, 2004 COHSASA became an accredited member of the Proudly South African Participants broke into smaller groups to discuss campaign. aspects of quality care In January 2005 COHSASA assisted the World Health Organisation (WHO) to launch its World Attentive audience in the main hall Alliance for Patient Safety in Durban, which aims to conduct studies around the world to determine the Grissel Ncedana from COHSASA making friends nature and the extent of adverse events in developing countries. Key players at the Quality Summit In 10 years COHSASA has provided valuable input for global health bodies: it formed part of the Joint Commission on Accreditation of Healthcare Organizations task team to develop healthcare standards; is part of the editorial team of the ISQua Journal; and regularly provides input for the World Health Organisation on issues of patient safety, quality assurance and accreditation. 2 FROM THE OFFICE OF THE CEO IT IS DIFFICULT to fully comprehend and the maintenance of standards. It that a decade has gone by since the has become crucial to view Council for Health Service participation in an accreditation Accreditation of Southern Africa first programme not as a “one-off” hit registered as a not-for-profit with a magic bullet, but rather as a The CEO of COHSASA, organisation in 1995. long-term investment that pays huge Dr Stuart Whittaker dividends in terms of patient safety, COHSASA has enjoyed its share of credibility, avoidance of waste and both success and disappointment minimisation of costly lawsuits. over the past 10 years and like all pioneers heading out on that rough, In ten years, COHSASA has COHSASA has made New Board member rocky road due West, there have positioned itself as only one of four a difference to the been a number of obstacles along health accrediting bodies in the the way. Uncertainty has been part world to be recognised as meeting quality of health care in of this journey, but it has also been the competency requirements of the Southern Africa the reason why – at least it can now International Society for Quality in be said – that COHSASA does know Health Care Inc. (ISQua). COHSASA’s endemic weaknesses, trends that what works and what doesn’t, and professional standards – derived endanger patient safety and because of the wisdom gained and from the collective wisdom of 41 patterns of poor administration that implemented, has made a countries around the world – have result in waste and duplication. difference to the quality of health been gleaned and honed by local care in Southern Africa. representative bodies, tested locally, After an intense and extensive and have been officially recognised process, COHSASA has notched up Health facilities in COHSASA’s as meeting the principles of ISQua. a world first: the first set of standards quality improvement programme are that evaluate how effectively HIV now beginning to meet international COHSASA is a member of the disease is being managed across a professional standards.