Browsing by Author "Hendricks, Gavin"

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    Improving the quality of hypertension care at Cloetesville Community Day Centre (CDC) : a quality improvement cycle
    (Stellenbosch : Stellenbosch University, 2015-12) Hendricks, Gavin; Mash, Bob; University of Stellenbosch. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Family Medicine and Primary Care.
    ENGLISH SUMMARY: Background: Hypertension is one of the most common chronic diseases worldwide and is estimated to contribute 9% of all deaths in South Africa, where it is also the commonest condition seen in ambulatory primary care. Despite advances in treatment of this disease and clear guidelines, quality of care is still lacking. Aim: To improve the quality of hypertension care by means of a Quality Improvement Cycle. Setting: Cloetesville Community Day Centre, Stellenbosch, Western Cape Methods: Two hundred folders were randomly selected and audited. Following this, interventions to improve clinical practice included training of nursing staff on taking blood pressure measurements accurately, teaching sessions on the latest evidence based hypertension guidelines and promoting standardised quality of care. A re audit was done one year later and the results compared. Results: Fifty nine per cent were women with a mean age of 58 years. In both audits all of the structural target standards were met. During the re-audit only 3/12 process target standards were met, but there was a significant improvement (p<0.05) in 9/12 criteria. Blood pressure control was achieved in 61% of patients showing a slight improvement from the baseline audit of 57%. Conclusion: The quality improvement cycle demonstrated significant improvements in the process and outcome of care following relatively simple interventions and changes to clinical practice. It is recommended that the quality improvement process should continue with new interventions, be expanded to other health centres in this sub district and beyond and to other chronic diseases.
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    The quality of feedback from outpatient departments at referral hospitals to the primary care providers in the Western Cape : a descriptive survey
    (AOSIS, 2019) Mash, Bob; Steyn, Herma; Bello, Muideen; Von Pressentin, Klaus B.; Rossouw, Liezel; Hendricks, Gavin; Fouche, Germarie; Stapar, Dusica
    Background: Coordinating care for patients is a key characteristic of effective primary care. Family physicians in the Western Cape formed a research network to enable them to perform practical research on key questions from clinical practice. The initial question selected by the network focused on evaluating the quality of referrals to and feedback from outpatient departments at referral hospitals to primary care providers in the Western Cape. Methods: A descriptive survey combined quantitative data collected from the medical records with quantitative and qualitative data collected from the patients by questionnaire. Family physicians collected data on consecutive patients who had attended outpatient appointments in the last three months. Data were analysed using the Statistical Package for the Social Sciences. Results: Seven family physicians submitted data on 141 patients (41% male, 59% female; 46% metropolitan, 54% rural). Referrals were to district (18%), regional (28%) and tertiary hospitals (51%). Referral letters were predominantly biomedical. Written feedback was available in 39% of patients. In 32% of patients, doctors spent time obtaining feedback; the patient was the main source of information in 53% of cases, although many patients did not know what the hospital doctor thought was wrong (36%). The quality of referrals differed significantly by district and type of practitioner, while feedback differed significantly by level of hospital. Conclusion: Primary care providers did not obtain reliable feedback on specialist consultations at referral hospital outpatients. Attention must be given to barriers to care as well as communication, coordination and relationships across the primary–secondary interface.