This means that the hospital meets over 3,800 rigorous criteria to provide safe, quality care to its patients. This is especially important during the current coronavirus pandemic where hospital systems are under strain, particularly in the Western Cape where there appears to be a higher caseload than in other provinces.
A COHSASA accreditation award means the healthcare organisation has entered a rigorous quality improvement programme and has been assessed against, and complies with, standards recognised by the International Society for Quality in Health Care (ISQua), the global body overseeing accreditation and quality improvement programmes in healthcare organisations in 70 countries around the world. COHSASA itself is accredited by ISQua as are its standards.
The healthcare facilities listed below have also been awarded accreditation by The Council for Health Service Accreditation of Southern Africa (COHSASA), a not-for-profit company (NPC) based in Cape Town.
Healthcare facilities that initially enter the programme and meet standards are awarded two-year accreditation and as the journey in improving quality continues, awards of longer duration are given. A four-year accreditation award from the Council should signal to patients that a facility has sustained an excellent level of standards over a commendable period.
In the table above, it is thus possible to safely assume that the standards of quality and patient safety in both Mediclinic Durbanville and King Faisal Hospital in Rwanda have reached long-term and institutionalised levels. Mediclinic Cape Gate has been accredited a commendable three times since it opened. Nairobi Women’s Hospital, Adams Branch has been accredited for a second time and is the first hospital in Kenya to achieve COHSASA accreditation. The rest of the hospitals in this private Kenyan group are working towards accreditation.
King Faisal Hospital is a public sector hospital in Rwanda, and this is the hospital’s sixth accreditation award.
All facilities that receive accreditation awards must undergo either a remote or onsite interim survey halfway through the period to ensure that standards are being maintained.
The Council for Health Service Accreditation of Southern Africa (COHSASA), a not-for-profit organisation in Cape Town, South Africa, assists a wide range of healthcare facilities to meet and maintain quality standards. This process enables the facilities to provide safe, quality services to their patients and families.
In the past 25 years of operation, COHSASA has worked in over 600 facilities in both the public and private sectors in 14 African countries including South Africa, Botswana, Swaziland, Lesotho, Namibia, Rwanda, Nigeria, Uganda, Zambia, Tanzania, The Democratic Republic of the Congo, Ghana, Egypt and Kenya. COHSASA runs programmes in hospitals, clinics, hospices, emergency medical services, environmental health offices and rehabilitation/sub-acute establishments.
There is a strong focus on building capacity. The COHSASA programme helps healthcare professionals to measure themselves against standards. This approach teaches healthcare workers how to monitor improvements using quality improvement methods, internationally accredited standards and a web-based information system.
COHSASA has achieved global recognition and is the only sub-Saharan health facility accrediting body that is accredited by the International Society for Quality in Health Care (ISQua). Since it achieved its first accreditation award from ISQua in 2002, the Council has maintained its accredited status with four further accreditations. Its current ISQua accreditation status is valid until December 2022.
COHSASA’s new set of healthcare facility standards is also currently accredited by ISQua until 2022.
The programme developed by COHSASA builds capacity in local organisations so that they can take ownership of the programme from the outset. Initial training is followed by a baseline assessment, where all departments in a facility are assessed against the standards. In an average hospital (+/- 100 beds) about 3,500 measurable elements are evaluated. Quality Advisors (QAs) then train and support staff in quality assurance concepts, quality improvement methods and self-evaluation so that ownership of the data and the overall programme is quickly established.
The Council has introduced a graded recognition process where incremental levels of progress in achieving compliance with standards are recognised through certification. COHSASA certifies departments within facilities and facilities that do not achieve full accreditation but have achieved acceptable and safe levels of standards compliance and service delivery. This has the effect of encouraging efforts towards full compliance with standards and institutionalising quality improvement.
The web-based electronic COHSASA Quality Information System (CoQIS) allows facility staff to have access to a continuous, easy-to-use management tool that assists them to run their establishments efficiently. CoQIS captures all the evaluation data compiled by surveyors and quality advisors during a baseline survey. This enables users to understand the baseline situation in healthcare facilities, identify deficiencies, prioritise interventions and monitor improving compliance with standards at individual facilities and across groups of them.
The information system enables personnel in healthcare facilities to have direct access to quality improvement data so that they can monitor their performance against standards. CoQIS supports on-going quality improvement programmes in all areas of healthcare facilities and enables management at all levels to make informed decisions when responding to deficiencies. CoQIS guides hospital management and clinical staff to make targeted, realistic and sustained interventions that will improve quality in a facility.
In addition to its own programmes, the Council also uses the extensive knowledge and experience of its quality advisors to support and train clients using other quality programmes such as the SafeCare Programme and the National Core Standards. The capacity building approach is used to develop skills in quality improvement and quality assurance methods, including self-evaluation against standards and developing quality improvement plans and programmes to address identified deficiencies. The level of assistance provided to clients is determined by client need.
Patient Safety is an integral part of quality health care. In 2006, the Council became the distributer for the Australian Advanced Incident Management System (AIMS) and successfully supported the implementation of a major patient safety programme in the Free State Province.
A similar electronic system, PatSIS, has been developed by the Council. The patient safety programme currently uses a call centre, located at the Council, where all reported incidents are captured into the system. As soon as the incident is captured, the information is available to the users. When the most serious incidents occur, the hospital CEO and relevant officials are immediately notified by a text message.
The users are required to manage each incident according to agreed protocols, which vary according to the severity of each incident. The process is monitored by the call centre team and by the relevant officer in the facility. The local Department of Health oversees the whole process. The setup of PatSIS can be configured to meet client needs – either with a remote or local call centre or with centralised or remote technical assistance.
The quality improvement and patient safety programmes together offer a highly efficient and effective mechanism for improving patient and staff safety. They enable staff to take responsibility for the quality of patient care and provide invaluable data for research to identify trends that can further improve the care of patients. With staff doing the right thing first time and avoiding errors, the cost effectiveness of care is also improved.
COHSASA offers its services to meet individual client needs so that healthcare facilities are equipped for the long-term to meet the safety and quality health needs of the population they serve in the most efficient and cost-effective manner possible.