GAUTENG DEPARTMENT OF HEALTH

GAUTENG DEPARTMENT OF HEALTH CPSI HEALTH-SPECIFIC INNOVATIVE SOLUTIONS WORKSHOP 24 NOVEMBER 2015 DR. M.R. BILLA CEO: HELEN JOSEPH HOSPITAL

Introduction OBJECTIVE: - Provide an overview on the TeleRadiology system - Report on current status quo of the TeleRadiology project at Helen Joseph & Rahima Moosa hospitals

TELE-RADIOLOGY PROJECT Tele-Medicine can be defined as the exchange of health care information and the delivery of clinical health care at a distance. Tele-Radiology- transfer of radiologic images such as CT scans, MRI or U/Sound across set destinations with the use of network matrix or other communication mediums. Basically, enables vast medical communication between distant centres and clinicians

ICT Needs for Teleradiology Wide range of ICT media that can support the system Implementation can be done through: ADSL connection line (cost effective method) ISDN connection (very unreliable & expensive) Fibre optic connection transfer very reliable Micro-wave point to point connection Strong ICT staff support Data/Information safety VPN & Firewalls

Current Problem Continuing shortage of equipment & staff (Radiology & Radiographers) one radiologist on call for 2 hospitals HJH CT Scanner Out-patients are done at Rahima Moosa Hospital (RMH) Films get printed at RMH= HJH sends a box of films monthly NO MORE with T/Radiology X-ray get lost in the process of managing the patient = DILEMMA = Repeat the examinations = costs to the hospital

BENCHMARK PROCESS Visits to other institutions: Locally: Private hospitals Garden City Clinic Tshepo-Themba Clinic Milpark Hospital Nationally Kwa-Zulu Natal (KZN): Inkosi Albert Luthuli Hospital Literature reviews Journal Articles & Review reports from other users

Benefits Can be integrated with any modality and any Radiology centre in the province Offers clinical efficiency Permits extensive multi-disciplinary interaction Radiology context - Cost effective no lost films & unnecessary radiation to patients Fast tracks service delivery

Benefits Patient comfort no need for moving patients around, e.g. Neurosurgery cases Elevates the quality of services offered as all procedures are integrated when reporting is done Reduce departmental running costs as there will be no printing of CT Scan films at RHM Films will be printed on Paper Printer at HJH

Legal Framework Number of legislatures guide the process Policy Acts such as: POPI Protection of Patient Information Act PAIA - Promotion of Access to Information Act Bandwidth allowance, locally & provincially Safety & Regulatory policies such as HPCSA rules

Stakeholders Involved Helen Joseph CEO-Dr. M.R. Billa & Rahima Moosa CEO- Ms. S. Jordaan Helen Joseph Management team Gauteng Health Management need to provide permission for the system CPSI & Partners ICT teams from HJH & RMH Clinical Teams of both HJH & RMH Radiography & Radiology teams of HJH & RMH

Status of the Project Conceptualising stage - Completed Site visits done at HJH & RHM Benchmark visits done provincially & nationally The relevant equipment has been donated by CPSI Application was made to Telkom for the ADSL line installation with Rahima Moosa & HJH hospitals ADSL lines installed at both hospitals The sending & receiving workstations installed in CT Scanner Voice recognition system installed for Radiology reports Going live in mid- December 2015

Future with Tele-Radiology Future looks very bright because of: Synergistic relationship amongst all stakeholders Benefits of the system for patients and institutions are realistic Connection with other referral hospitals

Cont

CPSI DONATION OF TELERADIOLOGY EQUIPMENT TO HJH

AGENDA GREEN AGENDA

LEADERSHIP The CEO office Prioritizing Environmental Health The Hospital Forum The Hospital Committees

WATER Joburg Water 440092299 Jan-15 R 2,183,727.65 Feb-15 R 1,230,965.90 Mar-15 R 1,103,728.24 Apr-15 R 1,248,390.03 May-15 R 1,114,673.66 Jun-15 R 954,475.92 Jul-15 R 1,374,454.60 Aug-15 R 843,062.21 Sep-15 R -519,561.73 Joburg Water 440091023 Jan-15 R 39,175.40 Feb-15 R 30,784.36 Mar-15 R 34,393.77 Apr-15 R 36,999.78 May-15 R 68,913.74 Jun-15 R -35,859.52 Jul-15 R -84,803.82 Aug-15 R -83,919.00 Sep-15 R -83,064.00 Water Quality- Routine water sampling and testing at the Wits laboratory. Water Pipes- Routine inspections on water pipes to check for leaks. Water Bill- Monitoring our water expenditure on our budget.

WASTE Helen Joseph Hospital waste generated 2015 Dec 15 Nov 15 Oct 15 0 0 0 Sep 15 Aug 15 Jul 15 Jun 15 May 15 April 15 Mar 15 13398.41 12892.72 12430.76 10397.54 13602.41 17431.46 16416.46 waste generated 2015 Feb 15 22443.78 Jan 15 14336.98 0 5000 10000 15000 20000 25000

WASTE Pikitup 330133760 Month Inv Number Amount Jan-15 10005181676 60,025.41 Feb-15 10005256451 41,018.27 Mar-15 10005333494 41,096.88 Apr-15 10005404145 29,736.61 May-15 10005473094 100,859.79 Jun-15 10005542596 114,646.38 Jul-15 10005612501 55,871.97 Aug-15 10005680571 141,842.26 Sep-15 10005749630 87,769.78

CHEMICALS Training Safer Alternativ es CHEMICALS Disposal COST

ENERGY Electricity 220078727 Jan-15 R 2,880,499.70 Feb-15 R 172,998.77 Feb-15 R -205,007.10 Mar-15 R 675,429.26 Apr-15 R 3,749,909.81 May-15 R 1,359,308.48 Jun-15 R 1,324,945.41 Jul-15 R 1,912,306.02 Aug-15 R 1,978,335.74 Sep-15 R 1,892,340.75 Cleaner Boiler Fuels. Energy Awareness to employees- Switching off lights. Monitoring our Energy expenditure on our budget. COC-Electrical Installation

TRAINING 200 180 Helen Joseph Hospital OHS Training 2014/15 185 160 140 120 434 100 80 79 87 83 No. of Employees 60 40 20 0 0 0 0 0 0 0 0 April 14 May 14 June 14 July 14 Aug 14 Sep 14 Oct 14 Nov 14 0 Dec 14 Jan 15 Feb 15 Mar 15

TRAINING Helen Joseph Hospital OHS Training 2015/16 400 225 350 300 250 200 150 100 225 127 101 105 211 No of Employees 1193 50 44 0 0 0 0 0 0

INNOVATION BETWEEN HELEN JOSEPH & CPSI Energy efficiency project: Partnership initiated R1,6m donated to Helen Joseph towards technical support and procurement of some equipment. Project in progress

FOOD HOSTESS PROJECT

DRIVING FORCES The need to improve the quality of food service. The challenges that resulted in patients complaints were: Non-functional equipment Unskilled staff members Inadequate resources Low Staff morale High plate waste Lack of team work Patients receiving wrong diets

DRIVING FORCES Cleaners responsible for serving food to patients The patients were served water in used milk bottles.

CHALLENGES

CHALLENGES

INNOVATION Food service staff trained by FEDICS. Previous system - took 2hours to dish up the food to all wards Current system - takes 45 minutes. New food trolleys, poly carbonate domes & bases procured maintains food warmth. All food service staff members who made direct contact with the patients became more aware of the impact the presentation of food to the patients has paid extra attention on making the food more presentable. Client satisfaction survey conducted before the implementation of the project and after Patients were very happy with the new system. Project rolled out to seven (7) wards due to limited staff

IMPLEMENTATION

IMPLEMENTATION

PLATE WASTAGE STUDY Unit October 2014 BEFORE January 2015 Main Hospital 10% 5% Note: The plate wastage study of the main hospital on the 20 th February 2015, was 2.6%. This improvement is due to the introduction of the skilled cook in food service unit in the last week of January 2015.

NEW FOOD TROLLEYS

IMPLEMENTATION

BENCHMARK SYSTEMS Project benchmarking was done at Rahima Moosa Identified items needed to start with the project Manpower was a challenge Therefore, limited roll-out to seven wards

IMPROVEMENTS Patients are served in a dignified manner It ensures that patients are served the correct diets and in a proper manner. The correct utensils are used Staff serving the patients meals reports to Food Service department which makes it easier for the department to have direct control of resources. The ward hostess are not going to be responsible for cleaning the ablution facilities they will only deal with food.

OUTCOME PATIENT SATISFACTION SURVEY 90% 88% 85% 85% 83% 80% 78% 75% 75% 70% 65% Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15

SUSTAINABILITY On-going training Monitoring and Evaluation»WAY FORWARD Awaiting approval for recruitment of staff to roll-out to the whole hospital

THANK YOU