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Auditing healthcare facilities against the National Core Standards for occupational health and safety and infection prevention and control: compliance, reliability and impact
Auditing in health care has been recommended by many national organisations to improve patient safety and quality of care, despite inconclusive evidence to support its effectiveness. In South Africa, the National Core Standards for health establishments in South Africa (NCS) was published in 2011. T...
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| Format: | Thesis |
| Language: | English |
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Department of Public Health and Family Medicine
2017
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| _version_ | 1867613289253437440 |
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| access_status_str | Open Access |
| author | Cloete, Brynt Lindsay |
| author2 | Ehrlich, Rodney |
| author_browse | Cloete, Brynt Lindsay Ehrlich, Rodney |
| author_facet | Ehrlich, Rodney Cloete, Brynt Lindsay |
| author_sort | Cloete, Brynt Lindsay |
| collection | Thesis |
| description | Auditing in health care has been recommended by many national organisations to improve patient safety and quality of care, despite inconclusive evidence to support its effectiveness. In South Africa, the National Core Standards for health establishments in South Africa (NCS) was published in 2011. The NCS recognises that staff are vital to ensuring that the health system delivers quality health care and therefore require protection against the risk of injury, infection and other occupational hazards, consistent with the South African Occupational Health and Safety act of 1993. The aim of this study was to determine: (a) the compliance of public sector primary healthcare (PHC) facilities with the NCS for occupational health and safety (OHS) and infection prevention and control (IPC), (b) the impact of the audits three years after baseline audits, at follow up self-assessment audits and (c) the reliability of self-assessment audits when compared to external audit results. This dissertation is divided in three parts. Part A is the study protocol which received ethics approval in March 2015. Part B is a structured literature review covering standards for health care, the impact and effectiveness of accreditation/certification/auditing in health care, interrater reliability and factors associated with OHS/IPC compliance. Previous studies have failed to address whether evaluating occupational health and safety or infection prevention and control standards using accreditation/certification in a primary healthcare, low and middle income setting is effective or reliable. Part C is the journal ready manuscript presenting the results of the study in the form of a manuscript for an article for a named peer reviewed journal. This was a cross-sectional study of NCS OHS/IPC audit data, with a longitudinal component, of a sample of public sector PHC facilities in the Western Cape province of South Africa between 2011 and 2015. Baseline PHC facility compliance with OHS/IPC measures was low. There was no significant improvement in compliance after three years. Poor inter-rater reliability indicates a large degree of measurement error. Practical implications of these results are the need to improve reliability of assessments and a process to convert low compliance scores into implemented improvement actions. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/22763 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:45.686Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | Department of Public Health and Family Medicine |
| publisherStr | Department of Public Health and Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/22763 Auditing healthcare facilities against the National Core Standards for occupational health and safety and infection prevention and control: compliance, reliability and impact Cloete, Brynt Lindsay Ehrlich, Rodney Yassi, annalee Occupational Medicine Health Systems Public Health Auditing in health care has been recommended by many national organisations to improve patient safety and quality of care, despite inconclusive evidence to support its effectiveness. In South Africa, the National Core Standards for health establishments in South Africa (NCS) was published in 2011. The NCS recognises that staff are vital to ensuring that the health system delivers quality health care and therefore require protection against the risk of injury, infection and other occupational hazards, consistent with the South African Occupational Health and Safety act of 1993. The aim of this study was to determine: (a) the compliance of public sector primary healthcare (PHC) facilities with the NCS for occupational health and safety (OHS) and infection prevention and control (IPC), (b) the impact of the audits three years after baseline audits, at follow up self-assessment audits and (c) the reliability of self-assessment audits when compared to external audit results. This dissertation is divided in three parts. Part A is the study protocol which received ethics approval in March 2015. Part B is a structured literature review covering standards for health care, the impact and effectiveness of accreditation/certification/auditing in health care, interrater reliability and factors associated with OHS/IPC compliance. Previous studies have failed to address whether evaluating occupational health and safety or infection prevention and control standards using accreditation/certification in a primary healthcare, low and middle income setting is effective or reliable. Part C is the journal ready manuscript presenting the results of the study in the form of a manuscript for an article for a named peer reviewed journal. This was a cross-sectional study of NCS OHS/IPC audit data, with a longitudinal component, of a sample of public sector PHC facilities in the Western Cape province of South Africa between 2011 and 2015. Baseline PHC facility compliance with OHS/IPC measures was low. There was no significant improvement in compliance after three years. Poor inter-rater reliability indicates a large degree of measurement error. Practical implications of these results are the need to improve reliability of assessments and a process to convert low compliance scores into implemented improvement actions. 2017-01-17T12:24:55Z 2017-01-17T12:24:55Z 2016 Master Thesis Masters MMed http://hdl.handle.net/11427/22763 eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Occupational Medicine Health Systems Public Health Cloete, Brynt Lindsay Auditing healthcare facilities against the National Core Standards for occupational health and safety and infection prevention and control: compliance, reliability and impact |
| thesis_degree_str | Master's |
| title | Auditing healthcare facilities against the National Core Standards for occupational health and safety and infection prevention and control: compliance, reliability and impact |
| title_full | Auditing healthcare facilities against the National Core Standards for occupational health and safety and infection prevention and control: compliance, reliability and impact |
| title_fullStr | Auditing healthcare facilities against the National Core Standards for occupational health and safety and infection prevention and control: compliance, reliability and impact |
| title_full_unstemmed | Auditing healthcare facilities against the National Core Standards for occupational health and safety and infection prevention and control: compliance, reliability and impact |
| title_short | Auditing healthcare facilities against the National Core Standards for occupational health and safety and infection prevention and control: compliance, reliability and impact |
| title_sort | auditing healthcare facilities against the national core standards for occupational health and safety and infection prevention and control compliance reliability and impact |
| topic | Occupational Medicine Health Systems Public Health |
| url | http://hdl.handle.net/11427/22763 |
| work_keys_str_mv | AT cloetebryntlindsay auditinghealthcarefacilitiesagainstthenationalcorestandardsforoccupationalhealthandsafetyandinfectionpreventionandcontrolcompliancereliabilityandimpact |