Carte Blanche insert puts medical malpractice under the spotlight

01 Feb 2016 | Admin Author

An insert on investigative journalism program Carte Blanche on Sunday the 9th of November over the 2012 death of 13-year-old KwaZulu-Natal boy Tristen Burn has again placed the spotlight firmly on malpractice at South African hospitals.
Tristen's case made headlines around the country after the teenager was first admitted to St Mary's Hospital in Mariannhill, Pinetown, with a foot injury, but died three days later at RK Khan Hospital in Chatsworth.

A pathologists' report showed that he died from septic shock and multiple organ failure from staphylococcal septicemia, a treatable condition if managed in time. It was also alleged that staff had attempted to treat his twisted ankle with tuberculosis drugs.
The insert, watched by millions of viewers across Africa, showed that Tristen's parents Vanessa and Tim Burn were no closer to finding out the truth about their son's death, as investigations by police inquest or the hospitals' and the KZN Department of Health's probe had still to be concluded.

Communications Manager of the Council for Health Service Accreditation of Southern Africa (COHSASA), Marilyn Keegan, says the non-profit company has developed an adverse event monitoring and reporting programme which has considerable success in similar instances and may provide the opportunity to reduce the number of adverse events occurring in healthcare facilities.

This programme, the Patient Safety Information System (PatSIS), provides a computerised system for the voluntary reporting of adverse events and near-misses by hospital, primary care and medical emergency staff to a call centre where trained medical professionals capture and analyse the incidents.

The system allows incident details to be captured in less than seven minutes and serious incidents are instantly relayed to a named contact person to ensure an immediate response. Online reports are also provided to assist staff in managing adverse events and near-misses.

The PatSIS system has been rolled out extensively in the Free State, and already has yielded good results.
Having identified inter-facility transport as a problem in the maternity service, the Free State health department issued 18 more vehicles specifically for the purpose of maternity care.

According to an article in the South African Medical Journal, a before-after analysis was performed of data from 2 separate databases for a 12-month prior- and 10-month post-intervention period using descriptive and correlation statistics. Within this period, maternal mortality dropped by an incredible 48%.
Asked to comment, COHSASA chief executive, Professor Stuart Whittaker, said he believes that he adverse event reporting and monitoring programme has a number of important features.

"It allows adverse events to be reported rapidly; it allows them to be addressed immediately to reduce harm and allows healthcare staff to understand why it happened and prevent recurrences.

"The programme also allows staff to feel they have control over their situation by giving them an opportunity to report on events as they occur and identify reasons for this which can be a motivating factor for resources to further reduce occurrences of the same mishap occurring again," COHSASA chief executive Professor Stuart Whittaker said.

http://www.cohsasa.co.za/