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

Introduction Tender NDOH 20 / (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 2

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 3

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)

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 5

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 6

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 7

Facilities Audited

COMPLIANCE SCORE FOR VITAL MEASURES ON 6 PRIORITY AREAS OF QUALITY

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

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

Functional Areas

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

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

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

Infrastructure Scores - Average overall infrastructure score

DISTRICT RANKING ON INFRASTRUCTURE SCORES

Base Line Audit using the DHIS Core Standards Module

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

Available Ad Hoc Reports

Geo Spatial use of the data

Thank you