Intervention plans and strategies to tackle and reduce cases of medical negligence are beginning to bear fruits. The North West Department of Health MEC Dr Magome Masike has commended the effort as a progress that the department will build on and substantially further bring down the numbers.
A comparative analysis of the cases from 2017 validates MEC Masike’ statement. The total number of new cases registered between January and June 2017 was 46 with a total of R378 868 540 amount claimed. Compared to the same time, January to June 2018 there is a total of 37 claims and the amount claimed comes to R147 673 733 which is a sharp decline comparatively.
Health MEC, Dr Magome Masike attributes decline in medical negligence claims to various intervention strategies which he has introduced since he began to pay attention to this issue. One such intervention strategy is to review all maternal and infant mortality cases at the Provincial Mother, Child and Women Health (MCWH) Forum which is a platform chaired by the MEC himself.
“I am pleased with the progress we are making though I believe opportunity still exist to do more. Since we began to deal with these cases directly at the MCHW Forum we are beginning to see the difference. The Forum affords health care practitioners and managers an opportunity to discuss and review causes of deaths, missed opportunities, avoidable factors and recommendations to prevent and avoid future occurrence and each of them accounts on the spot”, said MEC Masike.
The following are some of the other plans that are being implemented to mitigate maternal and infant mortality which are major contributors to medical negligence cases:
- Emergency blood of 2 units minimum must be available at all Hospitals conducting deliveries.
- All Obstetric and Gynecological (O&G) Specialists should refrain from telephonic orders and must respond immediately when called to see the patient.
- All Obstetric and Gynecological Specialist undergo the Essential Steps on Management of Obstetric Emergencies (ESMOE) training to acquire more skills.
- Junior Doctors monitored and coached when performing Caesarean Section and trained on Caesarean Section monograph.
- High Risk patients managed at appropriate level of care.
There has also been considerable initiatives/programmes aimed at improving services at public health institutions in order to reduce the number of medical negligence claims which include among others introducing quality improvement projects.
The quality management projects include dealing with problems identified, e.g. prior to anesthesia all patients must get pre-op exam by anesthetist, and have X-rays taken. The Department also ensures that all health facilities have clinical guidelines which the nurses and doctors can adhere to as a preventative measure. Doctors and nurses are trained on adverse events management and the Department ensures that there is competency testing and certification for doctors and nurses which is done before performing clinical procedures.
A policy on Health Adverse Incidents Management has been developed. The policy focuses on proactive management of patient safety by identifying causes and strategies for prevention. It also proposes redesigning organisational systems and behavioral choices based on learning through analysis of adverse incidents.
This implies when an adverse incident has occurred the department will look for ways in which its health care system can be improved, and managerial and staff behavioral choices adapted, so that the likelihood of a recurrence of the same event is significantly reduced.
Clinical guidelines have since been distributed to all health facilities across the province and orientation of health professionals is continuing. They are made available for staff to use, and to ensure re-training when required.
“We are doing the best possible to attend to all factors contributing to medical negligence claims. It is important to note that not all cases reported, are concluded as cases of negligence. However, even if a case is concluded as a case of no negligence, the client may still be complaining that the service did not meet his/her expectations.
Therefore a case may be a case of no negligence and at the same time be a case of poor quality service rendered, e.g. when the desired clinical outcome was not realised, or when the waiting time was far too long”, said MEC Masike.
Enquiries:
Tebogo Lekgethwane
Tel: 018 391 4195
Cell: 082 929 9958
E-mail: tlekgethwane@gmail.com
