About Us

The Problem

The Response

Routine practice is difficult to change but improvement science makes it possible to achieve world class outcomes with available resources. The Best Care…Always! Campaign (‘BCA’) (2009-2015) was inspired by successful application of specific improvement methods in other countries e.g. the Institute for Healthcare Improvement’s (IHI) “100K lives” campaign, and the Canadian “Safer Healthcare Now” initiative which reduced HAIs and other complications of medical care that occur in hospitals.

In SA we decided to focus on 4 specific healthcare-associated infections (HAIs) – surgical site infection, urinary tract infection, pneumonia and bloodstream infection from intravenous lines, along with antibiotic stewardship. These infections harm many patients, are costly to patients and to the health care system. We promoted frontline improvement capability across public and private health care sectors, using the Institute for Healthcare Improvement’s Method for Improvement.

Learning Sessions in private hospital groups and provincial hospitals and three annual Quality Improvement Summits (2013-15) in Cape Town and Johannesburg were enthusiastically received. Participants learned from each other, and from experts, and took their enthusiasm and new knowledge back to their home base to implement change. The intention was for this capability to be applied to all sorts of local and system-wide problems, not only antibiotic use and HAIs.

Although much has been learned, and improvement has occurred, much is left to do.


“To support and drive the implementation of best care to every patient, always, expanding the reach of quality improvement initiatives throughout the country and across the continuum of care, through learning and collaboration in those areas of practice where with joint, concerted action we can accelerate progress.”

Guiding Principles included:

  • Enlist the endorsement of leadership at the highest levels of each hospital or hospital group in supporting and monitoring the work of improvement
  • Define measurable objectives so that we know we made a difference. Encourage simple, consistent, improvement-oriented measurement
  • Healthcare facilities improve at their own pace and choose their own goals. We see the process as progressive and as a journey of improvement
  • Healthcare facilities may choose a single intervention initially and work towards implementing further interventions later
  • Collaborate using a non-punitive, all-learn, all-teach approach. Share learnings and achievements
  • Provide encouragement through acknowledgment of early success
  • Encourage a team approach across all interventions
  • Find solutions that are sustainable and review and evaluate campaign effectiveness regularly

QI Summits

Who is BCA?

A group of “quality activists” initiated and ran the campaign, with the support of the participating organisations with whom they were affiliated or employed. They are listed in alphabetical order:

  • Farzaneh Behroozi
  • Sandra Brenon
  • Lauren de Kock
  • Dr Gareth Kantor (co-founder)
  • Dr Lloyd Kaseke
  • Isabella Mphuthi
  • Dr Dumani Kula
  • Dr Paul Soko
  • Dr Dena van den Bergh (co-founder)
  • Dr Michele Youngleson
  • Yolanda Walsh

The participating organisations included:

  • Major private hospital groups: Life Healthcare, Mediclinic, Netcare, NHN, Clinix
  • Hospital Association of South Africa (HASA)
  • Public sector representatives from Gauteng, W Cape and other provinces
  • Discovery Health

During the campaign, many experts provided advice to the Best Care Always Campaign. They are listed in alphabetical order, with their primary institutional affiliation at the time of the campaign:

  • Prof Andrew Argent – Red Cross War Memorial Childrens’ Hospital
  • Dr Zameer Brey – UCT
  • Dr Adrian Brink – AMPATH, Milpark Hospital
  • Dr Gerry Capatos – Life Glynwood Hospital
  • Prof Marc Cotton – University of Stellenbosch, Tygerberg Academic Hospital
  • Dr Johan De Jager – Netcare Unitas Hospital
  • Prof Adriano Duse – National Health Laboratory Service (NHLS)
  • Dr Gene Elliot – National Health Laboratory Service (NHLS)
  • Prof Norman Faull – Graduate School of Business, UCT
  • Dr Kim Faure – Independent consultant
  • Mr Andrew Gray – Nelson R Mandela School of Medicine, UKZN
  • Dr Adri Kok – Union Hospital, Alberton
  • Dr Carol Marshall – National Department of Health
  • Prof Shaheen Mehtar – Unit for IPC, Tygerberg Hospital
  • Prof Marc Mendelson – Division of Infectious Disease and HIV Medicine, UCT
  • Prof Mervyn Mer – University of Witwatersrand, Charlotte Maxeke Hospital
  • Dr Johan Moolman – Lancet Laboratories, Pretoria
  • Dr Olga Petrovic – National Health Laboratory Service
  • Prof Guy Richards – University of Witwatersrand, Charlotte Maxeke Hospital
  • Dr Marthinus Senekal – Pathcare Laboratories
  • Dr Andrew Whitelaw – National Health Laboratory Service (NHLS)
  • Prof Stuart Whittaker – COHSASA
  • Dr Inge Zietsman – AMPATH National Laboratories

Sponsors were vital to the campaign. Discovery Health was the principal founding sponsor. HASA – the Hospital Association of South Africa – hosted and subsidised the BCA Improvement Summits. Sponsors are listed here in alphabetical order, with amounts they contributed.

  • Discovery Health Platinum  (R1.5 million)(Founding Sponsor)
  • Hospital Association of South Africa (HASA) Founding Sponsor & administrative support
  • Astra-Zeneca (R500,000)
  • Fresenius Kabi (R250,000)
  • AICC (R250,000)
  • Janssen (R100,000) (Founding Sponsor)
  • B.Braun (R100,000)
  • J&J (R150,000)
  • 3M (R50,000)
  • Aspen
  • Medical Chronicle provided publication support

Applying scientific improvement methods to health systems.