Division of Family Medicine, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and, False Bay District Hospital, Metro District Health Services, Western Cape Department of Health, Cape Town, South Africa; and, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
Afr J Prim Health Care Fam Med. 2021 Nov 18;13(1):e1-e4. doi: 10.4102/phcfm.v13i1.3226.
This short report describes three family physicians (FP)-led clinical governance interventions to strengthen the care access and coordination in an urban district hospital in Cape Town, South Africa. The actual experiences and their effects on health services are captured here. The report also describes a range of interventions from enhanced access to timely computer tomographic scans to determine definitive care, to creating a local referral forum between levels of care, which resulted in a renewed appreciation for the scope of services and illness burden managed by the district health system and to the establishment of an onsite echocardiology service at the local district hospital to enhance the identified burden of disease of the local community. Each of these interventions were planned and implemented based on local data in partnership with the team members at the different levels of care. By applying an inclusive and distributed leadership style as informed by care access to scarce resources was better coordinated for the local communities served. The importance of the building trusting relationships between FPs and referral hospital colleagues cannot be overemphasised. Family physicians should be integrated and collaborated in the clinical governance platforms across levels of care. The FP's roles as primary care consultant and clinical governance leader are pivotal in enhancing service delivery efficiency and in providing quality healthcare.
本简短报告描述了三位家庭医生（FP）主导的临床治理干预措施，以加强南非开普敦市区医院的医疗准入和协调。这里记录了实际经验及其对卫生服务的影响。该报告还描述了一系列干预措施，包括增强对及时计算机断层扫描的获取以确定明确的治疗方案，以及在不同护理水平之间建立本地转诊论坛，这导致对服务范围和该地区卫生系统管理的疾病负担的重新认识，并在当地地区医院建立现场超声心动图服务，以加强对当地社区疾病负担的认识。这些干预措施中的每一项都是根据当地数据并与不同护理水平的团队成员合作进行规划和实施的。通过应用包容性和分布式领导风格，更好地协调了对服务的稀缺资源的医疗准入。强调家庭医生和转诊医院同事之间建立信任关系的重要性再怎么强调也不为过。家庭医生应整合并合作参与各级护理的临床治理平台。家庭医生作为初级保健顾问和临床治理领导者的角色对于提高服务提供效率和提供优质医疗保健至关重要。
