New surgical ward and CT scan part of Khayelitsha Hospital improvement plan

 

Today the Minister of Western Cape Health, Dr Nomafrench Mbombo, officially opened a new surgical ward and a CT scan suite at Khayelithsa District Hospital (KDH). 

 

These improvements form part of the key interventions to continuously improve service delivery at KDH.

 

Six years after its opening in 2012, KDH serves a population of over 403 000 people, with 95% of the facility’s feeder area population dependent on public health care. 

 

Fuelled by alcohol and substance abuse (often resulting in interpersonal violence) and the rapid escalating quadruple burden of disease, KDH has at times been stretched beyond its available resources – something which is not unique to KDH, but to the entire international public health system.

 

The Department acknowledges the service is under pressure and that there is a huge demand for beds resulting in patients with non-life threatening conditions sometimes having to wait longer. KDH has 300 beds and currently operates at a 130% bed occupancy rate, as it provides both district and regional health care services. 

 

We work hard to ensure good service but due to the pressure, the experience is not always as good as we would like it to be, particularly at peak times in the Emergency Centre (EC). 

 

To address service pressure and improve our service delivery to the Khayelitsha community, the Western Cape Department of Health has implemented the following:
 

• New surgical ward: A new surgical ward with 30 beds was implemented on 20 July.
 

• CT Scan Suite: Is already in use and will operate at full capacity from 13 August 2018, resulting in no transfers of patients to Tygerberg for CT scans and quicker diagnostics.
 

• Mental Health: A long term plan for a new 72-hour mental health unit with 32 beds is in design. An interim mental health unit has been established and is fully operational. 
 

• 15 Intermediate Care Beds: These beds are separate to those at KDH and has been made available at the Zandvliet Intermediate Care facility from 1 September 2018. Patients from KDH who are not acutely ill but require further rehabilitation prior to being discharged, will be transferred to the facility and receive ongoing care, which will free up beds at KDH.
 

• Reduced waiting period at the EC: In order to reduce the long waiting period at the KDH Emergency Centre, patients who are triaged with non-life-threatening conditions (yellow and green) are redirected to the Outpatients Department. 
 

• Outpatients Department: To improve patient referrals and decongest the EC triage area, an Outpatients Department is being established and is envisioned to be in operation from 1 September 2018. 
 

• Blood Bank: An on-site blood bank will be established which will allow doctors to get blood test results quicker and commence with appropriate treatment quicker. 
 

• Staffing: All vacant clinical, nursing, administration and support posts are in the process of being filled. It is envisaged that 11 new professional nurses will commence duty on 1 September 2018. A surgeon, as well as a second orthopaedic surgeon, have been appointed, which will improve access to orthopaedic and general surgical operative procedures. It should be noted that vacancies constantly arise as a result of high staff turnover.
 

• Night Nursing Office:  This is being strengthened by Nursing Staff to manage the hospital’s after-hours services, including patient and public complaints, more effectively.
 

• Accessing health care correctly: The Department has an ongoing drive to educate the public on the use and meaning of the Triage scale, as well as promoting the correct use of primary health care facilities in the area. Often the primary healthcare facilities (clinics) are “bypassed” due to perceptions of better or faster care at hospitals, which brings about additional pressure on the Emergency Centre. While we work hard to improve our hospital, we are also putting effort into the improved services and the quality of care offered at our surrounding health facilities.

 

“Public healthcare is collapsing in many parts of the country, but in the Western Cape we continue to use public money to the full benefit of citizens – as the clean audits on our Department’s financial statements show. Healthcare receives the largest slice of the provincial budget, which has ceased to be the norm elsewhere in the country. This is why we can continuously improve service delivery at our flagship facilities, such as KDH, as part of our mission of quality, patient centred care,” said Minister Nomafrench Mbombo.

 

With community support and co-operation from the community leaders and organisations we can find solutions together to also address the social factors that lead to clients accessing our emergency centre for incorrect reasons. 

 

We also acknowledge that our staff work under pressurised conditions. We continue to work towards ways of improving working conditions in support of our mission to provide quality patient centred care. 

 

Since this world-class hospital opened its doors it has made a positive impact on health outcomes which is evident in the fact that:
 

• Still birth rate has dropped from 2.1% in its first year to 1.5% in its last year
 

• Neonatal death rate has dropped from 0.8% to 0.5% in its last year. The maternity unit has been accredited as a Mother Baby Friendly service. A second obstetrician has been appointed and a registrar program initiated to improve maternal services.
 

• Mortality rate at KDH is 0.5% - lower than the provincial average death rates in 2018. It is 0.6 percentage points lower than the average for the other large district hospitals in the metro in 2018.