The Council for Health Service Accreditation of Southern Africa (COHSASA) assists a range of healthcare facilities to meet and maintain quality standards. It does so by enabling healthcare professionals to measure themselves against these standards and monitor improvements using our quality improvement methods, internationally accredited standards and a web-based information system.
Our work shows us that strictly applied quality improvement methods can improve patient safety and the quality of care by guiding interventions, monitoring progress and identifying improvements. We also identify impediments to improvement and develop strategies to overcome them.
Because COHSASA has worked primarily in developing countries, it has created strategies to help facilities stay on the path to accreditation. In 2001, COHSASA pioneered a Graded Accreditation Programme to encourage and assist many South African hospitals with disadvantaged backgrounds that did not initially achieve accreditation, but which had made significant strides since entry into the quality improvement process.
Staff at Lebowakgomo Hospital in Limpopo with fistfuls of accreditation certificates – ongoing motivation to excel.
This is an approach where COHSASA rewards improved service provision by issuing Pre-Accreditation certificates at Progress, Entry and Intermediate levels. Progress certificates are also issued to individual departments within a facility, and to the facility as a whole, and these provide an incentive to continue the process of meeting increasing levels of compliance with standards, away from an initial baseline.
The challenge is to give recognition to work already completed and encourage facilities as much as possible and the intention of this approach is to encourage and sustain the momentum towards accreditation by establishing an ethos of institutionalised and long-term quality improvement. It is also to encourage a sense of ownership in the quality improvement process so that accreditation is “the cherry on the top” of a main objective -- substantial, long-lasting quality improvement as opposed to an all-or-nothing approach. The concept is to shift the paradigm towards gradual and monitored improvement.
The other approach that COHSASA has used to help facilities towards accreditation is a facilitated approach, where staff members from COHSASA visit hospitals and provide assistance in understanding, implementing and monitoring compliance with the standards.
COHSASA provides data on the quality of health service provision to governing authorities so that it can be used for strategic decisions. In the past 16 years over 588 facilities have entered the COHSASA programme.
