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 2

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 3

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 5

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 6

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 7

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