Special Reports

Standards to improve health care

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core standards for health establishments in South Africa to assist in setting the benchmark for quality care.

The office of standards compliance developed the national core standards for health establishments in South Africa, which will assist in setting the benchmark for quality care against which delivery of services can be monitored.

The standards also provide details to managers of establishments about what this definition of quality means in practical terms. They are but one way of measuring performance.

These particular standards do not cover other agencies or services such as community-based care, emergency medical services or private general practitioners, although such standards will be developed over time.

What is important to note is that these standards are focused at health establishment level, where delivery of care takes place.

The national core standards are structured into seven cross-cutting domains.

The first three domains (patient rights; safety, clinical governance and care; and clinical support services) are involved directly with the core business of the health system of delivering quality health care to users or patients.

The remaining domains (public health; leadership and corporate governance; operational management; and facilities and infrastructure) are essentially the support system that ensures the system delivers its core business, although internal clients (health care staff) are key in achieving this.

The domain of patient rights sets out what a hospital or clinic must do to make sure that patients are respected and their rights upheld, in accordance with Batho Pele principles and the Patient Rights Charter.

The patient safety, clinical governance and clinical care domain covers how to ensure quality nursing and clinical care and ethical practice; reduce unintended harm to health care users or patients in identified cases of greater clinical risk; prevent or manage problems or adverse events; and support any affected patients or staff.

The clinical support services domain covers specific services essential in the provision of clinical care such as the timely availability of medicines and efficient provision of diagnostic, therapeutic and other clinical support services and necessary medical technology, as well as care monitoring systems.

The public health domain covers how health facilities should work with non-governmental organisations and other healthcare providers, along with local communities and relevant sectors, to promote health, prevent illness and reduce further complications; and ensure that integrated and quality care is provided for the whole community, including during disasters.

The leadership and governance domain covers the strategic direction provided by senior management, through proactive leadership, planning and risk management, supported by the hospital board, clinic committee and the relevant supervisory support structures; and includes the strategic functions of communication and quality improvement.

The operational management domain covers the day-to-day responsibilities involved in supporting and ensuring delivery of safe and effective patient care, including management of human resources, finances, assets and consumables, and of information and records.

The facilities and infrastructure domain covers the requirements for clean, safe and secure physical infrastructure (buildings, plant and machinery, equipment) and functional, well-managed hotel services as well as effective waste disposal.

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