Re-Engineering Health Services at the Kimberley Health Complex

KHC has risen as a giant in the delivery of health care services.  Over the past three years it has made significant progress towards realisation of its vision of being a Centre of Health Service Excellence.  Main strategic goals of the newly adopted managerial approach of KHC is as follows: improving quality of care; optimum clinical care; capacitated and motivated staff; effective HIV/AIDS strategy; effective communication; effective human resource strategy; management of financial services; integrated technical support; safe environment and an effective health information system.

Innovation

The upgrading project and providing laboratory results on- line has reduced quality of care waiting times.  This has reduced duplicated testing, reduced patient days and sped up the healing process.  Due to vastness of the Province, innovative methods of delivery service to rural areas had to be looked at; one of these is Telemedicine.  28 nurses have gone through a Nursing Scholarship, which enables them to share good practice. 

Effectiveness

The project is progressing well and provides improved quality of care.  Optimum clinical care - provision of specialist clinical services, decrease waiting times for theatre and an accident and emergency unit, increase theatre output, acquisition of modern equipment in X-rays including a 16 slice CY scanner, theatre and Intensive Care Unit and laundry, appointment of principal specialists in all clinical areas.

Poverty Impact

Malnutrition is monitored at weekly Hospital Services Management Committee meetings.  Breast Feeding Policy conforms to WHO policy and is implemented at a Breast Feeding Lodge.  Mothers at the lodge manage a vegetable garden.  Access to health care builds healthy communities, which improve the socio-economic conditions, indirectly affecting poverty.  This includes a reduction in waiting time for assistive devices, wheelchairs and hearing aids by accessing funding in the form of subsidies.  The Social Work Unit facilitates applications for social grants.  Procurement procedures adhere to the Provincial Principle of supporting Women, Previously Disadvantaged Individuals or Institutes, SMME's and by preferably procuring locally.   A learnership and Adult Basic Education and Training programme exist for employees.

Sustainability

Political buy-in and leadership was crucial to the establishment of the project.  Strategy, competent and committed staff and financial resources were also important for the success of the project.  Community buy-in, which can be seen by the increase in the number of private patients making use of the services.  Funding is a problem as the equitable share of the budget alone is not enough to sustain projects of this nature.  Grants and donor funding has to be used to sustain this project.  Another problem is that of the brain drain.  Scarce skills are even harder to attract to such a rural Province as the Northern Cape with it s vast land mass and small pockets of people spread over approximately one third of the surface area of South Africa.

Replication

Replication has already started within the Province on a smaller scale and within other provinces by means of benchmarking.  Other counties are also benchmarking some aspects of the project e.g. a Nigerian delegation has already paid the Complex a visit with the aim of learning from this project.

Partnerships

• National Government - Dept of Health 62,5% funds
• Provincial Government - Dept of Health 35,1% funds
• Private Sector - Numerous Companies 2,4% funds