GAUTENG DEPARTMENT OF HEALTH

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GAUTENG DEPARTMENT OF HEALTH

• Presents the BP campaign

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BACKGROUND INFORMATION

• In 2003 CIETAfrica recommended that while 82 of
  patients were satisfied with the care they
  receive, something needed to be done about the
  attitudes of many health professionals.
• Attitudes are displayed as behaviours hence the
  decision to employ a behaviour change model.

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How was this done?

• A group of staff from the sites identified by
  CIET as best practice sites was assembled to
  share what they do to keep patients satisfied
• That material was taken to the Summit in 2003 to
  verify and expand this information
• The expanded material was then used as a basis
  for the BP course to encourage other sites to
  employ these best practices

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WHAT IS THE BP CAMPAIGN?

• It stands for Batho Pele
• It stands for Best Practice
• It stands for energizing healthcare

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AIMS OF CAMPAIGN
To improve the relationship between
HEALTH CARE WORKERS
HEALTH CARE USERS
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By means of strengthening

• Leadership
• Teambuilding
• Organization
• Communicating and informing
• Redress
• Community involvement in governance

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Outline of programme

• Facilitators receive package with detailed notes,
  visual aids, evaluation material incentives.
• Facilitators trained to run programme which lasts
  6 months one module per month - in their own
  unit
• Each module consists of theory and practice. Mini
  QA projects most important part

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ELEMENTS OF THE PROGRAMME

• Getting going
• Learning
• Implementation
• Monitoring
• Mentoring
• Rewarding
• Sharing

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GETTING GOING

• In this element of the module, the facilitator
  and group members are guided through exercises to
  prepare for the module

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LEARNING

• In this element of the module, the facilitator
  and group members are introduced to the
  guidelines given by the best practice group and
  summit participants who developed the material

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IMPLEMENTING

• In this element the group is guided as to how to
  implement the learning in their facility. They
  are practical things to do to improve the aspect
  under development

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MONITORING

• In this element guidance is given as to how to
  monitor the particular aspects under development,
  both before the improvement start and during and
  after.

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MENTORING

• This element assists the members of the group to
  help one another to ensure that the aspect under
  development receives continual attention.

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REWARDING

• This element suggests ways in which to reward
  members of the group and the group itself to
  recognize achievement relating to the aspect
  under development.

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SHARING

• This element suggests ways in which achievements
  and set backs can be shared with members of the
  community and other facilities to assist in
  further development.

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WHO ARE THE FACILITATORS

• Facilitators are health workers chosen by each
  institution
• They need to have post-school formal education,
  be enthusiastic, good role models and accepted by
  their peers
• Approximately 1 facilitator is needed for each
  unit e.g. a hospital ward or a small clinic
• The facilitator will run groups of 10 15 staff
  members each.

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WHAT WILL THE FACILITATORS HAVE TO DO?

• They are trained to use the start up packs to run
  the programme in each unit in a hospital or
  section in a CHC, or in a clinic
• This involves spending approximately 1 ½ hours
  introducing each module, and two ½ hour sessions
  to follow up on progress, and a 1 hour final
  session per module
• Between times staff will have to implement their
  chosen mini project in their own unit
• This is done for each of the six modules

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WHAT WILL THE FACILITATORS HAVE TO DO?

• Facilitators need to introduce the learning
  material and keep the groups motivated and
  working
• They also need to keep data and report regularly
  to the Institutional Coordinators
• Each module should run over a period of a month
• Total programme should be complete in 6 months.

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WHAT DOES THE INSTITUTIONAL COORDINATOR DO?

• Institutional coordinators will coordinate the
  programme in their institution i.e. a hospital or
  group of clinics
• They will support and guide facilitators and feed
  back to Project Manager at Central Office
• Institutional coordinators will receive full
  training with the facilitators
• Each region will also have a regional coordinator
  to support the institutions.

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What is the difference from this campaign and the
Batho Pele campaign?

• Other Batho Pele campaigns concentrate on sharing
  knowledge about the principles of Batho Pele
• This campaign concentrates on how to
  institutionalize Batho Pele so the principles
  become part of everyday working life in the
  institution.

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What recognition will there be for following this
course?

• Although the main aim of this programme is to
  improve care, an important part is motivating
  staff to follow the programme. This will be done
  as follows

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RECOGNITION SYSTEM

• On signing up for the programme and committing to
  follow it, individuals receive participants
  starter pack
• On completion of all modules, individuals receive
  certificate of attendance. Must attend 80 of
  meetings.
• On completion of all modules, and providing
  evidence of compliance and improvement is
  received, unit gets Best Practice unit
  certificate

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RECOGNITION SYSTEM

• Once 80 of units in hospital have complied with
  requirements for Best Practice Unit certificates,
  the health care institution will receive
  accreditation as a Patient friendly hospital,
  providing that the patient satisfaction rating is
  gt80

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Who will assess the health care institution for
compliance?

• The QAD Directorate organizes baseline patient
  satisfaction surveys on or before commencement of
  programme and again on completion of the
  programme.

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Results of baseline surveys
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Costing

• Intensive facilitator training 3 full days out
  of workplace
• Facilitator packs cost R165 each
• Participant packs cost R25 each
• Printing initially done in house now outsourced _at_
  gtR350 per facilitator pack

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Has it worked?

• Two hospitals in pilot
• In hospital A, 79 of staff signed up
• In hospital B, 81 of staff signed up
• Drop out of between 20 and 25 at each hospital
  before even commencing course

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Has it worked?

• 80 of those who started at hospital A, and 88
  of those at hospital B completed course within 9
  months.
• This translates into 59 and 51 respectively of
  total staff number. 80 now complete after
  another 7 months.
• Aim was 80 of staff to complete course

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Has it worked?

• Recruitment and retention need a lot more
  attention
• Follow up patient satisfaction survey not done as
  only just completed 80 of staff through course
• Participants were asked opinion of course
  overwhelmingly positive

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What the participants said

• We are getting more compliments fewer
  complaints now
• I have noticed changes in some staff members
  patient care. They relate better to each other
  are therefore nicer to the patients
• The clerks are so much more friendly now as they
  are not under so much stress

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What the participants said

• This programme is so simple but it works
• Building a team was not easy but we worked out
  the problem was poor communication and fixed it
• People are happier now. They are more motivated
  look forward to the next session

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What the participants said

• I enjoyed the course. It helped me understand
  some of the things I was doing were not
  constructive and I have changed my behaviour
• This BP is fantastic
• We are now talking to each other
• I feel good now

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Problems experienced by participants

• 80 attendance rule is too difficult shifts
  make it impossible
• The mentor system doesnt work because of the
  shifts
• We started this when staff were angry about PMS
  which made it very difficult
• Life in the wards is very unpredictable so the
  facilitator needs to be flexible

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Problems experienced by participants

• The participants take such a long time to choose
  a mini-project it wastes time
• Doctors are not cooperating they are too busy
  and not interested maybe CPD points would help
• The rewarding part of the programme is a problem
  as the facilitator lands up paying for all the
  cake and sweets

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Recommendations

• Mix groups between wards to allow some to attend
  and some to stay
• Consider taking out groups for one whole day at a
  time once a month fro 6 months
• Have backup facilitators to assist those who have
  missed a module due to night duty
• Choose projects that are quick, simple and fun to
  do
• Link the programme to PMS

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Current roll out

• 9 additional institutions now on programme
• Appointed a P/T coordinator to drive the
  programme
• Sponsorship necessary to sustain if QIG grant
  dried up

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Thank you