Implementing Patient Safety Improvements
All the first wave African hospitals have held official Advocacy Days which provided opportunities to raise awareness, build wider engagement and share information and plans for the two years of implementation. Representatives of ministries of health, patient and consumer organizations, hospital leaders and staff, as well as wider health-care system representatives gathered to learn about patient safety and the work taking place in their local ‘APPS’ hospital. The second wave of hospitals who joined the programme in 2011 are now planning similar important events.
First wave partnerships have carried out almost two years of patient safety improvement work and all have now developed mechanisms for local supply of alcohol-based hand rub as a key step in their infection prevention and control plans. This includes the procurement of necessary equipment and ensuring the right environment has been established for safe and effective production to occur on site. Local production, in line with the WHO Patient Safety Hand Hygiene Guidelines (link below), allow hospitals to produce and supply their own hospital with the key resource to instigate an effective hand hygiene programme and begin to address infection prevention and control issues. Training of hospital pharmacists has been undertaken in some of the hospitals and further training is planned. Second wave partnerships have concrete plans in place to develop their own sourcing and production as appropriate.
Several partnership hospitals have rolled out the WHO Surgical Safety Checklist (link below) Partnerships are working together to address the challenges of implementation across both the African and European Partner – sharing experiences and lessons learned during the initial phase. Work has been carried out to improve waste management processes, strengthen the prescribing and distribution of medicines and training carried out in health-care worker protection. Training and education modules have been included for nursing staff and integrated into medical school curriculums.
After initial baseline assessments first wave countries have repeated the APPS situational analysis process to consider progress. Second wave partners are focussing on evaluation mechanisms from the onset based on the APPS evaluation framework that has been co-developed by partnerships.
Several partnerships have also considered areas of research potential and the importance of sharing their learning more broadly with their national health care systems – working with Ministry of Health officials and other local health care leaders.
Key to successful partnerships is ensuring that mechanisms are in place for continual, sustainable and effective communication across partnerships in Africa and Europe. Partnerships have established hospital steering groups for the programme and effective communication mechanisms with their partnership hospitals tailored to their circumstances put in place. Regular facilitated teleconferences provide additional support mechanisms for partnership learning, progress and sharing.
Sharing Knowledge and Experience
First wave partners have participated in several on-site partnership visits. These short, intensive face to face opportunities have taken place based on clearly defined objectives that support their agreed 2 year plans. Visits have taken place both to African partners and to European partners. Week long visits have included staff training on patient safety, hand hygiene, implementing the WHO Surgical Safety Checklist, building organizational momentum and evaluation and data collection and analysis. Second wave partnership visits are now underway.