1. EARLY WARNING INDICATORS
OHSC CONSULTATIVE WORKSHOP ON THE WORK OF THE OHSC AS THE REGULATOR
PRESENTATION BY OHSC
VENUE: PROTEA HOTEL: POLOKWANE
DATE: 08 NOVEMBER 2018

2. Outline
How the OHSC protect and promote the health and safety of users
Functions of the OHSC - EWS
Purpose
Indicators
How indicators were developed
She does not always take us where we want to as her subordinates, but directs us where ought to be, which in some instances is not where we don’t necessarily want to go. As leader, she leads us from within.

3. How does the OHSC protect and promote the health and safety of users
Advise on the determination of norms and standards to be prescribed
Inspect and certify HEs
Investigate complaints
Monitor indicators of risk
Make recommendations for intervention
Collect or request information from HEs
Promote:
Advise on the review of norms and standards
Publish information in relation to prescribed norms and standards
Recommend quality assurance and management systems for the national health system
Issue guidelines for HEs to assist compliance
Collect or request information
Liaise with other regulatory authorities
Public

4. Functions of the OHSC
(a) advise the Minister on matters relating to the determination of norms and standards to be prescribed for the national health system and the review of such norms and standards; (b) inspect and certify health establishments as compliant or noncompliant with prescribed norms and standards or, where appropriate and necessary, withdraw such certification; (c) investigate complaints relating to breaches of prescribed norms and standards; (d) monitor indicators of risk as an Early Warning System relating to serious breaches of norms and standards and report any breaches to the Minister without delay;
(e) identify areas and make recommendations for intervention by a national or provincial department of health, a health department of a municipality or health establishment, where it is necessary, to ensure compliance with prescribed norms and standards;
( f ) publish information relating to prescribed norms and standards through the media and, where appropriate, to specific communities;
(g) recommend quality assurance and management systems for the national health system to the Minister for approval;
(h) keep records of all its activities; and
(i) advise the Minister on any matter referred to it by the Minister.
Section 79. of the National Health Amendment Act of 2013 states the following Functions of OHSC

5. PURPOSE OF EWS
Proactive in predicting risk for prompt corrective action
Contribute to ongoing research on areas of risk to patient safety
Identify and prioritise high Risk health establishments
Monitor indicators of Risk
EWS is technology and associated policies and procedures designed to predict and mitigate the harm and other undesirable events in HEs
Apple Watch fall detection works perfectly after Swedish “Gustavo Rodriguez” man collapses
The Apple watch has a fall detection which is turned on automatically in the Series 4 for customers aged 65 and older, and you can manually turn it on if you’re younger than that. By analyzing wrist trajectory and impact acceleration, Apple Watch sends the user an alert after a fall, which can be dismissed or used to initiate a call to emergency services. If Apple Watch senses immobility for 60 seconds after the notification, it will automatically call emergency services and send a message along with location to emergency contacts.
Other examples are linked to what the discovery car insurance is currently doing where they monitor driver behaviour, acceleration, cornering, use of a cellphone when driving and others.
Self reported data (24 hour and monthly reporting) – Reported by HEs
Data triangulation of available data (Complaints Call Centre Data, EWS measures linked with inspections, Annual Returns Data, data from the National Department of Health and other available data and information about HEs which is in the form of direct complaints from HEs in the media, civil society groups, researchers, other regulators and other sources.
Industrial revolutions have always dominated and changed the world in a big way. The first one happened way back in 18th century, and the second industrial revolution occurred almost two centuries later, in the 20th century. The third one happened only a half-century later, while the fourth one was observed within three decades. By the speed these transformations are occurring, a fifth industrial revolution is already around the corner.
Examples - Intelligent and interconnected administrative tools for refrigerators – in this instance; refrigerators warns you when your milk is going off and items you need to replenish. Stores that are not manned. Stores that will remind you. The EWS system is dynamic and data driven in nature and will never remain static.

6. EWS INDICATORS INDICATORS FREQUENCY OF REPORTING REPORTING MECHANISM
12 Critical indicators
Within 24 hours of the incident
Online reporting by health establishments
17 Indicators
Monthly
19 Measures that are monitored as part of inspections
For health establishments that are inspected
Generated by inspection database report
15 Indicators that are reported by health establishments as part of the monthly routine from the National Indicator Data Set (NIDS)
Sourced from the National Health Information Repository Database (NHIRD)

7. HOW WERE EWS INDICATORS IDENTIFIED
Delphi study was conducted
3 Rounds of discussions were conducted to identify indicators
14 expert panel members consisting of nurses and doctors in medical management
Delphi panel reached consensus on 29 Indicators

8. How should we take you along this journey
We shall work with all involved and move towards the end state and equip officials to work in new ways
Translate the change vision into reality for all involved across the public and private sectors and define what it means for them
Communicate the change vision and case for change and begin to create ownership of EWS monitoring and reporting
Explain the objectives, ambition and scale for change relating to EWS monitoring
Make it clear
Make it known
Make it happen
Make it Real
Make it stick
All of you involved will need to ensure there is capability in your organizations to sustain change
The concept of UHC means that that
“all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need;
of sufficient quality to be effective;
while also ensuring that the use of these services does not expose the user to financial hardship”
According to the words of Prof Mayosi on Health and Health Care in South Africa – 20 years after Mandela, and I quote “
“Working toward the goal of national health insurance to provide more equitable access to high quality individual health services has re-emerged as a popular notion. Health economists have suggested that it would be feasible to raise the additional required funding. However, expectations that equity in health care delivery could be achieved at levels close to current private-sector levels appear to be unrealistic. It is clear from the disparities in funding of the private and public sectors and the very large number of additional health care professionals required that this is unlikely and, if achievable, would take a very long time” un quote – may Prof Mayosi’s Soul Rest in Peace.

9. Thank you
A prominent figure in government twitted the following in October 2018 and I quote "I find the transition from central banking and the private sector to Government very funny. I had forgotten how Government operates! They still print documents and have no electronic board docs," unquote.
What the Experts Say According to a study by MIT Sloan Management Review and Capgemini Consulting, the vast majority of managers believe that “achieving digital transformation is critical” to their organizations. However, 63% said the pace of technological change in their workplaces is too slow, primarily due to a “lack of urgency” and poor communication about the strategic benefits of new tools. “Employees need to understand why [the new technology] is an improvement from what they had before,” “The job of a manager is to help people cross the bridge — to get them comfortable with the technology, to get them using it, and to help them understand how it makes their lives better.”
Tips - Choose technology wisely, State your case, customize training, get influencers onboard, make it routine, highlight quick wins, make it fun, consider penalties