NEWSLETTER NOV 2017 OUR OBJECTIVES FOR 2018 The DHA represents a footprint of day hospital facilities in South Africa modern healthcare facilities focused on the provision of same-day surgical services diagnostic procedures which need to be performed in an operating theatre on a same-day basis. IN THIS ISSUE THE NHN DAY HOSPITAL SUB-COMMITTEE DOH & THE NATIONAL CORE STANDARDS HMI & HEALTH OUTCOME MEASUREMENTS PATIENT SERVICES ADMINISTRATION THE SOUTH AFRICAN DAY HOSPITAL LANDSCAPE DHA CONFERENCE OCTOBER 2017 FEEDBACK: EFFECTIVENESS OF DAY HOSPITALS IN CHALLENGING TIMES CURRENT DHA MEMBERSHIP To be recognised as a major role player to reduce the cost of private healthcare. To grow the national day hospital footprint. Promote the development opening of new day hospitals. Stimulate growth utilization. To generate support for day hospitals from Medical Schemes, Patients Specialists. To work with, support the NHN Day Hospital Sub- Group Committee in their efforts to grow the day hospital market share by being actively involved in tariff negotiations & tenders. To actively market our members with the focus on cost effective quality service. Active participation in key issues facing the day hospital industry investigating sustainable growth opportunities. (e.g. The Health Market Inquiry, NHI & Public Private Partnerships). The development & submission of a Health Outcome Measurement & Reporting System for day hospitals. Implementation of the DOH National Core Stards at all member day hospitals retain your license to trade. Specific media releases & articles. Marketing of the DHA Members to the medical aid industry be a priority. Contact: Marti Gelderblom Email: admin@dhasa.co.za Website: www.dhasa.co.za Cell: 082-776-1186 1
THE NHN DAY HOSPITAL SUB-COMMITTEE DEPARTMENT OF HEALTH & NATIONAL CORE STANDARDS The Day Hospital Association is not allowed to negotiate tariffs on behalf of our members as we do not have exemption from the Competition Commissioner. However, a NHN day hospital subcommittee was formed this group assist NHN during tariff negotiations. At least one of the committee members be present when NHN meets with funders on tariff discussions. Current committee members are; Bert von Wielligh (Chairman of the DHA), Bibi Goss-Ross (Director DHA). The committee drives the process to ensure the recognition of the value that day hospitals can add They meet on regular intervals. They schedule regular visits to medical aids. Why the implementation of National Core Stards? User confidence Regulations, stardization, certification Expert designed evidence based practise Reduction of cost effective & efficient Improved safety & quality Value for money & many, many more (Fasie Smith: Advanced Health DHA Conference 2017) The National Core Stards cover the following seven domains; Patient rights, Patient safety, clinical governance care, Clinical support services, Public health, Leadership corporate governance, Operational management Facilities infrastructure. DHA Directors: Bert von Wielligh (DHA Chairman) Cure Day Clinics Bibi Goss-Ross Advanced Health Raymond Foster Ekurhuleni Surgiklin Dr Bernard Snyman Kango Clinic Louis Siemens Citymed If you have any concerns /or suggestions feel free to email Marti Gelderblom (admin@dhasa.co.za) who escalate your communication directly to the committee. NHI represents a substantial policy shift that necessitate a massive reorganisation of the current health care system. One of the steps was the establishment of a new governmental body, the Office of Health Stards Compliance (OHSC), to enhance maintain the quality of health services. During the last four years, the results of the Inspectorate s work revealed a critical situation concerned the quality of South Africa s health facilities services. Addressing this issue, however, has been a difficult task for the OHSC due to capacity restrictions the absence of quality stard regulation. The urgent need to increase quality of care across the whole health system drove onward the development of the National Core Stards (NCS) for Provincial Health Authorities in South Africa. Quality of healthcare needs to be adequately addressed in both the public private sector. The NCS be a milestone document for the assessment of health care quality. It aims to achieve three main goals. First, develop a common definition of quality care health stards. Second, establish a benchmark against which health establishments can be assessed, gaps identified strengths appraised; finally introduce a national accreditation system based on the stards. 2
THE HEALTH MARKET INQUIRY THE HEALTH MARKET INQUIRY & HEALTH OUTCOME Health outcomes MEASUREMENT measurement & REPORTING & reporting for day hospitals The Day Hospital Association established a committee to develop The Day Hospital present Association a register established of measurable a committee outcomes: to This develop must include present process, a register of structure measurable outcomes: clinical outcomes, This must to meet include our current process, business structure care models. clinical If we outcomes, do not have to meet this our in place, current we business might find others care models. be doing If we this do for not us have we this in place, have no we input might find others have to comply. be doing this for us we have no input have to comply. This initiative is based on The Health Market Inquiry, Healthcare This initiative outcomes is based measurement on The Health & reporting Market seminar Inquiry, held Healthcare in Pretoria outcomes on the 22 nd measurement of September & 2017. reporting seminar held in Pretoria on the 22 nd of September 2017. Committee members are: Dr Bernard Snyman Kango Clinic Committee (director members of DHA) are: Dr Fasie Bernard Smith Snyman Advanced Kango Health Clinic Day (director Hospitals. of DHA) Information Fasie Smith be shared Advanced with members Health Day during Hospitals. the process Information input be be shared required with from members all before during finalisation the process presentation input of be the required model to from the HMI. all before finalisation presentation of the model to the HMI. An introduction from the committee The overarching goal of healthcare in any system including the private healthcare sector in South Africa, is to improve the health outcomes of the population by ensuring that value-for-money, appropriate, high quality of care is available to patients, at affordable prices that neither under- nor over-treatment is provided. One way in which a competition based health system can promote improved health outcomes, is for providers to compete on these very outcomes for funders patients to choose, based on validated relevant information on healthcare outcomes. Every planned day surgery patient should be considered on the classical main issues: procedure, patient factors, social factors facility possibilities. Each of these should be compatible with Day Surgery. Indicators need to focus on continuous quality improvement for facility management purposes as well as regional national usage instead of just benchmarking. The proposed register of measurable outcomes be distributed to our members for their comments before finalisation. An introduction from the committee The overarching goal of healthcare in any system including the private healthcare sector in South Africa, is to improve the health outcomes of the population by ensuring that value-for-money, appropriate, high quality of care is available to patients, at affordable prices that neither under- nor over-treatment is provided. One way in which a competition based health system can promote improved health outcomes, is for providers to compete on these very outcomes for funders patients to choose, based on validated relevant information on healthcare outcomes. Every planned day surgery patient should be considered on the classical main issues: procedure, patient factors, social factors facility possibilities. Each of these should be compatible with Day Surgery. Indicators need to focus on continuous quality improvement for facility management purposes as well as regional national usage instead of just benchmarking. The proposed register of measurable outcomes be rolled out to all member day hospitals once approved by the HMI. 3
PATIENT SERVICES ADMINISTRATION AND THE EFFECT ON YOUR CASH FLOW Patient services administration includes functions such as: Admissions Confirmations / authorizations Billing (stock & tariffs, etc.) Coding Auditing of files Releasing & EDI Credit control Debtors administration; journals, etc. Month-ends Tariff updates, etc. CREDIT MANAGEMENT PRINCIPLES Patient services administration can be seen as the conversion of doctor nursing input into collectable revenue a healthy cash flow. Each one of these functions has critical activities that need to be performed to ensure that revenue is During the DHA annual conference in October 2017, a maximised bad debt minimized. workshop was held that unpacked the patient 042-292-0129 services /082-776-1186 administration function. The management of the patient services administration cycle is all about; knowing your The presentation is available on the DHA website business, ensuring you get the right reports to can add a lot of value to your administration staff. analyse, having best operating practices in place, the measurement of performance, the If you have any queries or specific challenges, please understing of the implications should there be contact Marti Gelderblom flaws in the cycle. Website www.dhasa.co.za Email admin@dhasa.co.za Contact number 082-776-1186 4
THE SOUTH AFRICAN DAY HOSPITAL LANDSCAPE During our annual conference in October it was absolutely clear that the dem for day hospitals is growing, Day hospitals are now recognized for their quality, costeffective services many of the medical aids that presented at the conference mentioned the lack of a big enough national footprint. We, as an industry can embrace this opportunity to take hs under one umbrella (the DHA) ensure that the funders have the footprint that they need to shift same day surgical procedures from private hospitals to day hospitals. Source: Discovery Health DHA Annual Conference Oct 2017 presentation According to Discovery there are one hundred twenty eight day hospitals in South Africa, with ninety six totally independent day hospitals which are not part of one of the big three hospital groups. Fifty three of the ninety six day hospitals are members of NHN forty four of the NHN day hospital network is also members of the DHA. The DHA is the only association in South Africa that represents focus on the day hospital industry, to grow the network of DHA member day hospitals is of utmost importance if we want to be seen as a national footprint which can be utilized as a cost effective alternative to same day surgery. Source: Discovery Health DHA Annual Conference Oct 2017 presentation It is very clear that there are not enough day hospitals in North West, Limpopo, Northern Cape, Free State, Eastern Cape Mpumalanga. 5
DHA: 4 TH ANNUAL CONFERENCE HELD ON THE 16 TH & 17 TH OF OCTOBER IN PRETORIA The 4 th annual DHA conference was a huge success. It was held over two days at The Farm Inn. We want to thank the following funders for their participation in this years conference for embracing the theme; partnering for sustainable growth: Discovery Health - Vuyokazi Mnikathi Medscheme - Dr Jenni Noble Medihelp - Heyn van Rooyen Bonitas - Gerhard van Emmenis Polmed - Jessica Le Goabe Sizwe - Ntombifithi Manyoni GEMS - Dr Vuyo Gqola Momentum - Dr Belinda Richards For the first time we also included workshops which covered the following topics: Take control of your business performance The importance of the National Core Stards The healthcare quiz show The effectiveness of day hospitals in challenging times Day hospital credit management principles Mr Nkonzo Hlatshwayo from Hogan Lovells talked about the promotion of competitiveness day hospital industry. Jacqui Steward from Cohsasa talked about day hospital accreditation Susan Liebenberg Smith from NHN talked about the medical aid industry. Our 4 th Annual General Meeting was held on the 17 th of October 2017. The conference feedback forms completed gave us a good indication of the over-all experience of the delegates. The following requests/suggestions received be considered for future conferences: More on nursing procurement Marketing GP, specialist perspective on day hospitals Stards procedures More time to discuss industry concerns MediKredit participation Sponsors like medical reps Major equipment suppliers Small group workshops NHI Competition Commissioner On the question; what is the most important value that the DHA can add, the following were the most common suggestions: Assistance with stards quality & other Collective negotiations Industry news feedback Procurement arrangements buying power Marketing Discussions with DOH & preparation for NHI Conference presentations are available on our website. Our sponsors at this years event were: Lexmed: Sponsored the Gala Dinner S Buys Wholesale Silverguard GoodX Mmed Distribution 6
EFFECTIVENESS OF DAY HOSPITALS IN CHALLENGING TIMES Presented by Bibi Goss-Ross Conference Oct17 Feedback on the questionnaire completed by each table: (In no specific order) List two values of your day hospital besides costs: Personal & compassionate patient centric care Clinical safety (modern facilities & equipment) Control & flat reporting structures Consistent quality & quality of care Time effectiveness (patients & doctors) Respect & caring attitudes Teamwork Private & intimate (homely) Patient centred versus shareholder benefit Convenient comprehensive services Trained specialized staff Convenient for both patient & doctor Centre of excellence Doctor support & buy-in Exceptional patient care by professional & competent staff Hygiene & cleanliness of facility List your largest concerns: Exposure & public awareness Doctors & perverse incentives provided by big groups Scarcity of specialists / young doctors Suitably qualified staff DSP listings Procurement Lack of resources for marketing budget Convincing doctors to travel to day hospitals Unexpected surgery / anaesthetic complications Equipment failure & technical support Cancellations due to high co-payments no authorization DSP, demographic location to acute hospitals not in our favour Shrinking medical aid benefits resulting in increased co-payment, especially dentals Alternative reimbursement models Competition with acute hospitals Acute hospitals have ICU, High Care & medical wards to absorb shortage or lack of surgical patients Optimising maximum theatre stards Support from specialists Marketing - educating the public How to attract committed surgeons The difference in the medical plans Medical aids not aggressive enough Acute hospitals putting pressure on doctors Not enough price differentiation between acute hospitals day hospitals Cost of pharmaceuticals other procurement 7
MEMBER DAY HOSPITALS GAUTENG MPUMALANGA Advanced - Groenkloof Day Hospital Pretoria 012-346-5020 Advanced - emalahleni Day Hospital emalahleni 013-655-3067 Advanced - Medgate Day Hospital Roodepoort 011-768-1015 Advanced - Del La Vie Day Hospital emalahleni 013-590-0660 Advanced - Soweto Day Hospital Soweto 010-591-7306 Centurion Day Hospital Centurion 012-663-2010 WESTERN CAPE Centurion Eye Hospital Centurion 012-644-5100 Advanced - Durbanville Surgical Centre Cape Town 021-970-1440 Cure Day Clinics - Erasmuskloof Pretoria 012-003-2001 Advanced - Panorama Surgical Centre Cape Town 021-911-3555 Cure Day Clinics - Fourways Fourways 010-597-1973 Advanced - Vergelegen Surgical Centre Cape Town 087-234-9771 Cure Day Clinics - Medkin Pretoria 012-322-1230 Advanced - Knysna Surgical Centre Knysna 087-236-8508 Cure Day Clinics - Midstream Midstream 012-940-9440 Advanced - Worcester Surgical Centre Worcester 012-880-0201 Edenvale Day Clinic Edenvale 011-453-7628 Cape Dental Clinic Paarl 021-762-9941 Ekurhuleni Surgiklin Kempton Park 087-098-0660 Cure Day Clinics - Bellville Bellville 021-000-5050 Fauchard Clinic Roodepoort 011-472-2940 Cure Day Clinics - Somersetwest Somersetwest 021-824-1240 Fordsburg Day Clinic Johannesburg 011-834-4015 Cure Day Clinics - St Stephens Paarl Paarl 021-200-2309 Highveld Eye Hospital emalahleni 013-658-4040 George Surgical Centre George 044-873-2472 Intercare Day Hospital - Hazeldean Pretoria 012-880-0700 Hermanus Day Hospital Hermanus 028-312-2722 Intercare Day Hospital - Irene Pretoria 012-941-2600 Intercare Day Hospital- Century City Cape Town 021-879-0100 Intercare Day Hospital - Ston Ston 011-883-1400 Kango Clinic Oudshoorn 044-272-3405 Kilnerpark Day Hospital Pretoria 012-333-4443 Somerset Aesthetic Clinic Somersetwest 021-851-3400 Visiclin Oog Hospitaal Vereeniging 016-454-9809 The Surgical Institute Durbanville 021-976-2339 Vidamed Mossel Bay 044-690-3402 FREE STATE Citymed Day Theatre Bloemfontein 051-436-4320 EASTERN CAPE Cure Day Clinics - Bloemfontein Bloemfontein 051-072-0018 Medical Forum Theatre Port Elizabeth 041-373-0682 Welkom Medical Centre Bloemfontein 057-352-2114 Koinonia Theatre Kroonstad 056-213-1814 KWAZULU-NATAL Bethmed Day Theatre Bethlehem 058-303-5564 Lorne Street Anaesthetic Clinic Durban 031-309-5202 Website www.dhasa.co.za Email admin@dhasa.co.za Contact number: Marti Gelderblom 082-776-1186 8