Ideal Clinic and Ideal Hospital framework Flashcards
1. Policy environment 2.Public health expenditure 3. Progress in achieving health outcomes 4. Challenges in the health sector 5. Health sector reforms. (45 cards)
Ideal clinic status elements:
The elements are weighed as Vital, Essential, and important
In order for a facility to obtain ideal clinic status it must:
- Have minimum score 90% of vital elements
- 70 % essential elements
- 69% of important elements
# A facility can get high average and still fail to obtain ideal clinic status, because of failure to obtain the minimum per category.[above]
Weighting of measures. [elements]
- Non-negotiable vital
- Vital
- Essential
- Important
Non-negotiable vital elements
These are elements that can cause loss of life or prolonged period of recovery
Vital elements
Extremely important [vital]. Require immediate and full correction. These affect direct service delivery and clinical care of patients and without these there may be immediate and long-term adverse effects on the health of the population.
Essential elements
Very necessary. Require resolution within a given time period. these are process and structural elements that indirectly affect the quality and safety of clinical care given to patients
Important elements
Significant elements that require resolution within a given time period. they are process and structural elements that affect the quality of the environment in which healthcare is given to patients
How is the Scoring of the Elements done?
-Each element is scored according to the performance of the facility
GREEN - performance achieved
AMBER - performance partially achieved
RED - performance not achieved
An Ideal Clinic has:
- Range of services
- Provides quality integrated health services
- A clinic with good infrastructure
- Adequate staff
- Adequate medicine and supplies
- Good administrative processes
- Applicable clinical policies, protocols, guidelines and partner and stakeholder support.
Operation Phakisa
A Presidential initiative in 2014 to bring experts, managers and frontline workers to collaboratively find innovative solutions to respond to barriers and challenges in the health system
ICRM is a systems response to initial National Core Standards (NCS) assessment findings and challenges. What were the key findings?
Key findings focused on: Facility classification Health technology Physical infrastructure Medicines and supplies management Quality of care Functioning of services
Primary Health Care Clinics?
Is the first point of contact between the population and the health system.
It acts as a gatekeeper to higher levels of care
Need to promote good health outcomes, rather than just serve ill-health by offering a curative service
Primary Healthcare Re-engineering?
- Aims to increase access of health services to the general public and to improve the quality of health services in general.
- District health system model with PHC as a platform for delivery of health services is the Main implementation mechanism.
Why do patients bypass the clinics and just go to hospitals?
- Overcrowded facilities
- Long waiting lines
- Medication stock out
- Insufficient and inappropriately trained HR with poor attitudes.
- Poorly structured
- Inaccessible PHC clinics
Operational inefficiencies
Inefficient process flow at all facilities:
All patients wait in one area for vital signs monitoring, resulting in bottlenecks and extending patient waiting times
No signage directing patients to appropriate area for waiting
No patient scheduling mechanism in place (patients only given return dates for follow-up, thus inappropriate staff allocation)
No mechanism for tracing defaulters
Poor quality of clinical records/multiple records for same patient
Very little health promotion
Numerous challenges faced by Primary Health Care:
- The patients experience low-quality service delivery
- 80% of clinics are not fit for purpose
-Lack of strong financial management causes PHC facilities to run out of funds early into the year - ## 2-5 hours waiting
Primary Healthcare Re-engineering
- District Clinical Specialist Teams,
- Integrated School Health teams
- Ward based PHC outreach teams
- Contracted General Practitioners
Challenges in the Health sector:
- Ineffective and inefficient health system
- Impact of social determinants of health
- Complex quadruple burden of disease
- Quality of public health services
National Department of Health Goals:
Goals are to:
Prevent disease and the reduce its burden, and promote health
Improve quality of care
Re-engineer primary healthcare
Universal health coverage
What is the Vision and Mission of National Department of Health?
Vision: A long and healthy life for all South Africans
Mission: To improve health status through the prevention of illness and the promotion of healthy lifestyles and to consistently improve the healthcare delivery system by focusing on access, equity, efficiency, quality and sustainability
What are the four outputs [strategic priorities] of the National Service Delivery Agreement?
- Increase life expectancy
- Decreasing maternal and child mortality?
- Combating HIV and AIDS and decreasing the burden of diseases from TB.
- Strengthening health system effectiveness
What is the National Development Plan (2030)?
-It states that by 2030 South Africa should have:
=Raised life expectancy of at least 70 years
= Produce a generation of under 20s that are largely free of HIV
= Reduced the burden of disease
= Improved TB prevention and cure
= Achieved infant mortality rate of fewer than 20 deaths per 1000 and an under-5 mortality rate of less than 30 per 1000
= Equality, efficiency, effectiveness and quality of health care provision
= Universal health coverage
= Reduce risks posed by social determinants of disease.
District Health System
- Comprises a well-defined population, living within a clearly delineated administrative and geographical area, whether urban or rural.
- It includes all institutions and individuals providing health care in the district, whether governmental, social security, non-governmental, private or traditional.
The Ten Point Plan
- Provision of Strategic leadership and creation of a social compact for better health outcomes;
- Implementation of National Health Insurance (NHI);
- Improving the Quality of Health Services;
- Overhauling the health care system and improve its management;
- Improving Human Resources Management, Planning and Development;
- Revitalization of infrastructure;
- Accelerated implementation of HIV & AIDS and Sexually Transmitted Infections National Strategic Plan 2007-11 and increase focus on TB and other communicable diseases;
- Mass mobilization for better health for the population;
- Review of the Drug Policy; and
- Strengthening Research and Development
