South Africa

Gauteng Health adjusts procedures after 9 000 serious adverse events reported in 21 months

The Gauteng Department of Health (GDH) will implement a new plan to prevent unwanted outcomes at state facilities.

Since the beginning of 2023, the GDH recorded 9,390 serious adverse events (SAEs) at hospitals and clinics.

Health and Wellness Member of the Executive Council (MEC) Nomantu Nkomo-Ralehoko has been under pressure to respond after the department came under fire in recent weeks regarding patient care.

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Serious Adverse Events

SAEs are defined as abnormal results from medical procedures or the administration of pharmaceuticals.

The characteristics of the events include, but may not be limited to, birth defects, disability, prolonged hospitalisation and death.  

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The MEC outlined a five-point plan that she hoped would streamline the effectiveness of staff. They are:

  • Reporting all SAEs within 24 hours and following through with a thorough investigation
  • Specialised training for officials and managers to improve the prevention and reporting of SAEs
  • Thorough self-assessments by facility management to target risks and areas of improvement
  • Specialist governance structures that focus on learning, support and decision-making
  • Continuous monitoring and evaluation of a quality improvement implementation plan

“As part of our commitment to quality improvement, we have taken disciplinary action against 29 officials from 10 health facilities.

“We are dedicated to implementing the recommendations from investigations to improve safety protocols across our facilities,” concluded MEC Nkomo-Ralehoko.

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Year-on-year increase

Democratic Alliance Shadow MEC for Health, Jack Bloom, provided a breakdown of which facilities were churning out a high rate of SAE.

Listing the causes he believed contributed to the high number, Bloom told The Citizen there was a lack of consequence management, systemic issues within hospitals and questionable quality of leadership.

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Noting SAE numbers from 2019, 2020 and 2021, Bloom told The Citizen “the trend was ominous” as the numbers were 4 170, 4 701 and 6 910 for those three consecutive years.

While he welcomed the measures announced by the MEC, Bloom questioned why the number kept increasing.

Facilities most affected

Stressing that the numbers should be evaluated according to peer group, he listed the numbers for the flagship Academic facilities:

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  • Chris Hani Baragwanath Academic Hospital : 1 169
  • George Mukhari Academic Hospital: 613
  • Steve Biko Academic Hospital: 552
  • Charlotte Maxeke Johannesburg Academic Hospital: 447

Tertiary facilities Tembisa, Kalafong and Helen Joseph Hospitals recorded a combined 1 497 SAE, while the remainder were reported at the regional and district levels.

“Notably concerning are the 452 SAEs reported at Weskoppies Psychiatric Hospital,” stated Bloom.

Commenting on the number of professionals disciplined, Bloom questions why figures were given for only 10 facilities when the department had 37 under their guidance.

“Does that mean there was no disciplinary action at the other 27 facilities?” he concluded.

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By Jarryd Westerdale