To help assess interest in reviving the Best Care Always campaign we polled the BCA database and asked “what are your QI needs?” More than 50% of respondents indicated the need for training in QI methods, for connecting with others doing similar work, for help with data and measurement and access to scientific evidence in journals. No surprises there?
Of this limited survey sample (n=51), the majority are based in the South African public health sector – either exclusively (45.8%) or in both private and public (17.8%).
Their comments unearth more themes and emphases.
“If it’s not measured it’s not managed”. The importance of measuring health care-associated infections as a quality measure for health facility performance is remarked upon – “once measured and improvement is started, infection rates can be improved, cost can be reduced, efficiency can increase and patient satisfaction is improved.”
Other comments emphasise leadership – “Senior staff taking on the responsibility”.. “be the example who lead the nurses in QI” and “senior public sector managers to get out of fire fighting and into serious problem solving.” “Hospital leadership support to involve the clinicians is essential”.
Learning is seen as key – “The opportunity to network with and learn from health care professionals overseas who are doing similar work.” “Definitely more on the job coaching around setting up the measures and data collection.” Medical students are emphasised by one respondent -“would love to include some QI and Best Care practices into their training. We are currently re curriculating the degree, it is an ideal time to become involved.”
BCA was focused on hospital safety but one respondent commented that “The biggest impact for SA from QI will comes from the PHC [primary health care] system. It’s harder and much more complex but necessary.” One respondent pointed to other system factors – “De-bureaucratisation of management and procurement systems. Sufficient resources. Sufficient patient time” – and made an appeal “Not more audits and auditors!!!”
Access to commercial support from QI professionals appears to be a low priority. Whether this is due to lack of availability, budget or other factors is not known. One respondent has a company that “co-ordinates and trains multi-disciplinary teams in delivering patient-centred, value-based care” with the comment “Best Care Always is a foundational programme in delivering such care.”