Category: Hospitals

Categories : HospitalsTags : Leave a comment

Why Doctors and Nurses Keep Leaving

On By ModernMedia

Healthcare leaders say generational differences are making it more difficult to retain doctors and nurses

Source: Pixabay CC0

By Lesley Henton, Texas A&M University Division of Marketing and Communications

Healthcare leaders say retirements, burnout and changing workforce expectations are making it complicated to keep experienced clinicians in place. A new study published in the Joint Commission Journal on Quality and Patient Safety suggests the reasons go beyond staffing shortages. Leaders from four major health systems in one of the United States’ largest metropolitan areas say generational shifts are reshaping who enters healthcare, who stays and why clinicians leave.

“We’ve talked about clinical workforce shortages as a numbers problem involving training and retention,” said study co-author Dr William Sage, founding director of the Texas A&M University Institute for Healthcare Access in Fort Worth. “What these leaders described was something more complicated, as healthcare organisations are struggling to meet growing patient needs while accommodating five distinct generations of clinicians with different needs and perspectives about work, well-being and career longevity.”

Why keeping clinicians is getting harder

Study participants, 17 leaders from four major healthcare systems in the Dallas-Fort Worth metroplex, repeatedly described the departure of clinicians as one of their biggest concerns, whether the higher turnover now common among young physicians or an older physician’s lack of transitional options short of full retirement. Some said replacing a highly experienced physician could require hiring multiple younger clinicians, given the way that the healthcare system measures and rewards productivity.

“When a veteran clinician leaves, healthcare organisations lose more than just a position,” said Keegan Warren, co-author and the institute’s executive director. “They can lose years of institutional knowledge, mentoring relationships and practical experience that are difficult to replace. For physicians in particular, departure carries a high institutional price tag. Treating clinicians as people whose lives and contributions matter is not just the right thing to do; it’s a critical strategy for protecting both continuity of care and the financial health of the system.”

Participants also pointed to burnout and shifting workplace expectations. Younger physicians and nurses are more likely to discuss mental health, work-life balance and scheduling flexibility, and they expect employers to play a major role in addressing those concerns.

Sage said the findings should not be interpreted as a simple clash between generations but as the shifting and mixing of expectations over time, including as the result of discrete events such as the introduction of work hours regulation for medical trainees, the reduction of physician-owned practices in favour of employment by hospitals and other large organisations and the COVID pandemic.

“This isn’t a story about one generation being right and another being wrong,” Sage said. “It’s about how the profession is changing and how healthcare organisations can adapt while continuing to provide excellent patient care.”

Clinicians are people first, with lives, families, identities and limits. They’re not just ‘providers’ or FTEs.

Keegan Warren, Executive Director, Texas A&M University Institute for Healthcare Access

Building the healthcare workforce of the future

The researchers say addressing these challenges will require more than simply hiring more clinicians.

The study identifies several approaches that could help strengthen the healthcare workforce:

  • Create more intentional mentorship programs to transfer knowledge from experienced clinicians to younger colleagues.
  • Reduce early career turnover through retention-focused benefits, continuous career development and workplace flexibility.
  • Include multiple generations in leadership and decision-making, ensuring workplace policies reflect different career stages and perspectives.
  • Give human resources leaders a larger role in workforce planning, retention strategies and succession planning.
  • Develop flexible late-career roles for experienced clinicians, allowing them to continue mentoring and contributing even as they reduce clinical workloads.
  • Improve communication across generations to address workplace tensions before they affect morale, retention or patient care.

A stable, capable clinical workforce is foundational to patient access to care, say the researchers, and if healthcare organizations can better support each generation of clinicians throughout their careers, patients will benefit.

“We’re seeing healthcare organizations recognize that retention can no longer be an afterthought,” Warren said.

“Clinicians are people first, with lives, families, identities and limits. They’re not just ‘providers’ or FTEs. When leaders design roles and cultures that honour that humanity, they strengthen commitment, stabilise teams and build a more resilient healthcare system.”

Source: Texas A&M University

Categories : HospitalsTags : Leave a comment

Long-term Relationships with Family Physicians Linked to Fewer Urgent Hospitalisations

On By ModernMedia
Photo by Cottonbro on Pexels

A new study published in the American Academy of Family Physicians finds that keeping patients connected to the same practice and physician over time may help reduce avoidable hospital use.

This retrospective cohort study using longitudinal data from 100 450 patients across 48 general practices in and around Amsterdam found that patients registered with their practice for longer than 5 years had 9% to 21% lower odds of urgent hospital admission and 17%-28% lower hospital costs compared to those registered for 0 to 5 years.

Consistently seeing the same general practitioner was associated with 6% to 7% lower hospital costs, but not with fewer urgent admissions. Researchers measured continuity associations with urgent hospital admissions and hospital costs in two ways: duration of the general practitioner-patient relationship and how concentrated a patient’s visits were with one physician. 

The researchers concluded, “Our study suggests an association between continuity in general practice and hospital use and costs. Although there is an overwhelming amount of evidence regarding the benefits of continuity of care for both patients and GPs, this study shows that continuity is also associated with fewer urgent admissions and lower hospital costs.”

Source: EurekAlert!

Categories : Hospitals Surgeries & ProceduresTags :

Scheduling Surgeons: Researchers Identify Factors for Hospital Efficiency

On By ModernMedia

Booking operating rooms with surgical precision starts with more accurate predictions of how surgeons spend their time

Photo by Piron Guillaume on Unsplash

Researchers at the University of Massachusetts Amherst have analysed nearly 86 500 surgeries at Baystate Medical Center to identify the top factors that influence inefficiencies in surgeon schedules. Having an efficiently organised surgical schedule has the potential to lower costs and reduce surgeon burnout, which would also improve patient outcomes.

As shortfalls in the availability of surgeons grow, the ability to meet surgical demands will only worsen, with implications for both healthcare delivery and costs.

This illustrates the timeline of two surgeries performed by the same surgeon. The blue area represents the duration of the actual surgery itself, while the white blocks represent pre- and post-surgery activity.  Surgeon gap time is the time interval between two operations where the surgeon is not actively working.

“The most expensive part in this process of getting a surgery is the surgeon,” says Muge Capan, assistant professor in the Riccio College of Engineering at UMass Amherst and an author of the new paper published in the Journal of the American Medical Informatics Association. “Surgeons are highly skilled and they perform high-risk tasks. When we think about utilising a resource, we don’t want them to sit idle – but we also don’t want to overutilise them because these are not machines, these are people. Finding that right balance is a challenging problem.”

However, to efficiently schedule, hospitals need to predict how long a procedure will take. This includes the surgery itself as well as many other factors that surround an operation – has the surgeon recovered from their previous operation? Is the room clean? Is the proper equipment in place? “There is a lot of uncertainty there at the system level,” says Capan.

Currently, surgeries are scheduled in blocks, which is not compatible with the unpredictable nature of a hospital. “If you’re scheduling tennis lessons, it works because a tennis lesson is exactly one hour,” says Capan. “You block the court for one hour, you play, you leave, next group. But blocks don’t make sense for surgeries, because they’re so uncertain.” As a result, operating rooms (ORs) can sit empty since any block of time less than two-and-a-half hours is unusable for most surgeries.

In the pursuit of engineering a better schedule, Capan and her team collaborated with surgeons to predict their schedule by focusing on the person, not the operating room.

Surgeons are highly skilled and they perform high-risk tasks… we don’t want them to sit idle – but we also don’t want to overutilise them because these are not machines, these are people. Finding that right balance is a challenging problem.

Muge Capan, assistant professor in the Riccio College of Engineering at UMass Amherst

“There’s so much research on the operating room itself – what happens between the time a patient leaves the OR to the time the next patient enters the OR,” says Jonathan Akhagbosu, first author on the paper and UMass Amherst industrial engineering Ph.D. candidate. “But we wanted to look at it from a surgeon’s point of view: What happens between when a surgeon finishes one case and proceeds to the next case?”

The researchers named this time between operations “gap time.” In their study, they used machine learning to analyse three years of medical records from Baystate Medical Center in Springfield to determine the characteristics of a surgery that can predict these gaps in a surgeon’s schedule. 

A selection of the top factors associated with larger gap times are: if the surgeon’s previous or following case is an emergency, the preceding surgery is related to the chest (thorax), the following procedure is on the heart, or the surgery is highly demanding. 

Also, the last factor on the list – the assessment of how taxing an operation is on the surgeon – the researchers used mathematical models to create a new measurement called surgical case demand. Cases fall into one of three tiers. Type 1 consists of short, scheduled procedures of low-severity illness and elective surgeries, such as the removal of fatty lumps from the skin (lipoma excision) or simple dental rehabilitation. Type 2 events are more demanding, such as a mastectomy or knee replacement. And type 3 surgeries are the most onerous: the condition is more severe and they happen during off-hour times. Examples include emergency brain or abdominal operations and spine procedures.

It’s also worth noting that eye (ophthalmology) and orthopedic surgeries were associated with shorter gap times.

Capan envisions that predicting schedules can help recapture some of this lost time. “If there’s going be a gap, let’s figure out if that gap is long enough that I could squeeze in something else,” says Capan. “This is called ‘collectible time’ in the literature. Collectible time means it’s a useful gap. So what we learned about gap time could potentially help us understand collectible time.”

By Julia Westbrook 

Source: University of Massachusetts

Categories : HospitalsTags :

The Charlotte Maxeke Fire Should Have Been a National Turning Point – Is SA Now Ready to Listen?

On By ModernMedia
Charlotte Maxeke Johannesburg Academic Hospital. (Photo: Gauteng Department of Health)

By Haseena Majid and Mogie Subban

The fire that engulfed parts of Charlotte Maxeke Johannesburg Academic Hospital was never just a fire, it was a warning, argue Dr Haseena Majid and Professor Mogie Subban. Five years later, the real question they say is whether South Africa is prepared to listen.

The fire that ripped through parts of Charlotte Maxeke Johannesburg Academic Hospital in April 2021 should have been a national turning point. Instead, five years later, we were confronted with explosive findings from the Public Protector confirming that the Gauteng Department of Infrastructure Development and the Gauteng Department of Health delayed repairs, fought internally over responsibilities, and failed to spend almost half of the approximately R666.7 million budget allocated to restore the hospital.

The Public Protector’s report revealed that by March 2024, only about 49% of the ringfenced funds had been spent despite the hospital’s catastrophic service disruptions. At the same time, Charlotte Maxeke’s Head of Internal Medicine Professor Adam Mahomed, who lodged the complaint with the Public Protector, publicly described overcrowded wards, exhausted clinicians, and a hospital effectively surviving through improvisation rather than recovery.

These are not isolated failures. They point to deeper governance weaknesses within public administration.

The question that inevitably arises is how these failures have persisted for so long, given that South Africa’s governance framework is not lacking in legal safeguards.

South Africa’s governance framework already contains extensive mechanisms for oversight and accountability. Section 195 of the Constitution demands accountability, transparency and efficient resource use. Section 217 governs fair and cost-effective procurement. The Public Finance Management Act regulates expenditure and financial accountability. The Public Administration Management Act strengthened ethics, norms and oversight within public administration. The Auditor-General and Public Protector both play critical roles in identifying maladministration and safeguarding accountability. These frameworks are designed to ensure that information flows upward, warning signs trigger intervention and accountability occurs before systems fail.

Yet, the reality tells a different story. Five years after the Charlotte Maxeke fire, hundreds of millions of rand allocated for restoration remained underutilised. Procurement scandals at Tembisa Hospital allegedly operated for years before attracting national attention. Medicine stockouts continue despite multiple reporting structures. More than 240 000 people are reportedly waiting for cataract surgery in one province, while public hospitals continue to lose skilled personnel as infrastructure deteriorates.

Even more troubling is the time it takes before these failures become visible for some form of action to follow. The asbestos scandal in the Free State, corruption at Transnet and Eskom, and the alleged procurement networks at Tembisa all reveal the same pattern: accountability mechanisms kick in long after the damage has already been done.

These failures point to deeper systemic weaknesses. They reflect institutions that have struggled to respond effectively and correct themselves. And every delayed intervention carries human consequences. Cancelled operations, interrupted treatment, avoidable disability, burnout among healthcare workers, lost productivity and preventable deaths are not abstract administrative failures. They are the lived consequences of governance failure.

What to do

The question confronting South Africa is not whether another report or task team is required. The country has already produced no shortage of investigations, commissions and oversight findings. The real challenge is whether institutions are willing and able to act on what is already known.

A capable health system rests on several pillars: skilled staff, functioning infrastructure, sustainable financing, effective programmes, reliable procurement systems, coherent policy implementation and operational coordination. Yet even when these pillars exist, the entire structure remains vulnerable if the systems responsible for integration, oversight and accountability are weak.

Modern health systems are increasingly complex institutions requiring both clinical excellence and strong governance capability. Expertise in organisational systems, budgeting, monitoring and evaluation, procurement and institutional accountability should therefore be viewed not as alternatives to clinical expertise, but as interdependent capabilities essential for institutional resilience.

Money matters. Infrastructure matters. Human resources matter. Technology matters. But without institutions capable of coordinating, overseeing and acting, crises simply repeat themselves.

What South Africa needs is more than another cycle of crisis management. It needs a renewal of governance itself. That means stronger alignment between roles, competencies and institutional responsibilities, protected oversight pathways and consequence management that operates before catastrophe rather than after it. It means rebuilding a public service culture in which accountability is not treated as an inconvenience, but as the moral backbone of a constitutional democracy.

*Majid is a postdoctoral researcher at the University of KwaZulu-Natal specialising in public administration and systems governance. She is a Global Atlantic Fellow for Health Equity and Social Justice at Tekano. Her research focuses on stakeholder mapping, disaster resilience and strengthening governance systems through collaborative public-sector approaches. Subban is an Academic Mentor and Public Governance Expert, at the College of Law and Management Studies, University of KwaZulu-Natal.

Note: Spotlight aims to deepen public understanding of important health issues by publishing a variety of views on its opinion pages. The views expressed in this article are not necessarily shared by the Spotlight editors.

Republished from Spotlight under a Creative Commons licence.

Read the original article.

Categories : Hospitals Mental HealthTags :

Emergency Doctors Are Stressed out – And Patient Irritation Plays a Significant Role

On By ModernMedia

Research finds physicians with peevish patients were more likely to become disengaged in the patients’ care

Photo by Usman Yousaf on Unsplash

HBO’s emergency-department drama “The Pitt” has become a smash hit in large part because it shows the deeply human toll that emergency medicine exacts from those who practice it. While researchers have long known that real-life ER doctors are affected by many of the stresses that “The Pitt” has so effectively captured, a recent study led by the University of Massachusetts Amherst and published in BMJ: Quality & Safety is the first to design an interactive and controlled experimental method to test how irritable patients – those displaying frustration or anger – affect the emotions of those treating them, and thus, potentially, the effectiveness of care they receive.

The emergency department has always been one of the most stressful places to work in any hospital – one never knows what sorts of injuries, or how many of them, each shift will hold. Additionally, these spaces have increasingly been on the frontlines of various economic and social crises, including the lack of health insurance and skyrocketing medical costs, immigration and law enforcement and increasing needs for mental health and addiction services. One of the results of all of this is that patients are increasingly irritable, and too often take their frustrations out on caregivers.

“Emotions are an inherent part of our lives – they’re what makes us human,” says Linda Isbell, Feldman-Vorwerk Family Professor in Social Psychology at UMass Amherst and the paper’s lead author. “But for too long, the medical culture has expected doctors to leave their emotions at the door. This is just unrealistic.”

It seems reasonable to conclude that when physicians experience stress in response to patient irritation, the quality of patient care suffers, and there is good anecdotal evidence to support that. But until Isbell and her co-authors, including emergency medicine doctors from the UMass Chan Medical School and the Harbor-UCLA Medical Center, began their study, there were no reliable controlled experiments that had rigorously studied how patient behaviour affects physicians’ emotions and patient care.

For too long, the medical culture has expected doctors to leave their emotions at the door. This is just unrealistic.

 Linda Isbell, Feldman-Vorwerk Family Professor in Social Psychology at UMass Amherst and the paper’s lead author

The team designed a novel approach that began with professional “standardised patients”, people who are specially trained to play patients with realistic, specific medical conditions. Four standardised patients were each trained to perform in one clinical case that corresponded to one of four different diagnoses. Each “patient” was trained to perform two different roles: someone calmly seeking medical care, and someone behaving irritability with their physician. 

“What’s most important here is that each standardised patient, no matter whether they were playing their calm or irritable role, provided the same exact medical details,” says Isbell. “The only thing they changed was their emotional condition.” 

Isbell and her colleagues video-recorded these patient encounters and then recruited 134 emergency medicine physicians from 46 U.S. states. Each physician was randomly assigned a set of four recorded patient encounters, two of which were from calm patients, two from the far more irritable group. 

The physicians were then asked to order clinical tests, for which they received results, and continuously assess their patients, just as they would do in a real-life setting. 

Finally, Isbell and her team asked the physicians to report on their emotional state and engagement with each patient. With this information, researchers examined whether or not physicians’ emotional responses, clinical assessments or clinical behaviours shifted when they were assessing irritable patients versus calmer ones.

What they found is that irritable patients make physicians feel worse. Those physicians reported increased levels of anger, anxiety and fatigue. Doctors were also less engaged in their irritable patient’s care, and much more likely to find their patients unreliable in terms of reporting their own symptoms. Physicians with irritable patients were more likely to interpret their patient’s pain as exaggerated, find them less cooperative, less engaged in their own care or willing to adhere to a treatment plan, and less likely to return to work.

Furthermore, those physicians who were more susceptible to finding medical uncertainty stressful experienced a greater emotional toll when their patients were difficult.

More research is needed to better understand how all of this affects patient care, but, as Isbell put it, “the interaction between a patient’s behaviour and a doctor’s ability to tolerate stress associated with medical uncertainty is critical.” Doctors who are especially vulnerable to stress are likely to experience their difficult patients as more challenging and emotionally taxing – fuelling a cycle that could lead to worse patient outcomes.

“Medicine is inherently uncertain and emotional,” says Isbell, “especially in the ER. We need a systemic shift that acknowledges the human reality of uncertainty and emotions in medicine and supports both doctors and patients as they work toward a common goal: health and well-being for all.”

Source: University of Massachusetts

Categories : Hospitals Infection ControlTags :

Brushing Your Teeth in Hospital Could Reduce the Chance of Catching Pneumonia

On By ModernMedia
Photo by Stephen Andrews on Unsplash

Brett Mitchell, University of Newcastle; Allen Cheng, Monash University; Nicole White, Queensland University of Technology; Peta Ellen Tehan, Monash University, and Philip Russo, Monash University

You go to hospital for treatment and to get better. But sometimes, you get something much less welcome: an infection.

Pneumonia, an infection of the lungs, is one of the most common and deadly infections people develop in hospital. Around 50 000 patients contract pneumonia in Australian hospitals every year. Around 1900 of them die from it.

It’s rarely monitored and rarely reported. And to date, few studies have looked at how it can be prevented.

But our new trial, published today in The Lancet Infectious Diseases, shows a surprisingly simple action can make a major difference: brushing patients’ teeth.

We found this can reduce the chance of getting this type of pneumonia, called non-ventilator hospital-acquired pneumonia, by 60%.

What is this type of pneumonia?

Non-ventilator hospital-acquired pneumonia occurs in patients who aren’t on a ventilator, usually outside of intensive care settings.

Patients are infected when bacteria from the mouth or throat are breathed into the lungs.

Patients who develop this type of pneumonia stay in hospital between ten and 48 days longer, and are around eight times more likely to die during their admission.

A simple intervention made a big difference

We studied 8,870 patients across three Australian hospitals to see whether improving oral care – which included tooth-brushing – could reduce this type of pneumonia.

Usually, when patients go to hospital, they don’t pack a toothbrush – especially in emergencies.

In busy hospital wards, oral care isn’t always given the attention it needs, nor are oral care products always readily available. Patients don’t always get reminders to brush their teeth and many patients need help with their oral care.

The intervention in our study was deliberately simple. We:

  • gave patients in hospital a toothbrush and toothpaste in a bag when they were admitted
  • educated patients and hospital staff about the importance of tooth-brushing. The toothbrush also had a written prompt on it – “Brush away pneumonia”
  • assisted patients who needed help with tooth-brushing
  • audited how oral care was being delivered and gave feedback to hospital wards.

We introduced the intervention into one ward at a time over 12 months at each hospital. This gradual roll-out is known as a stepped-wedge cluster randomised trial. It can test new health interventions when it’s too difficult to randomise individuals without revealing who is receiving the intervention and who isn’t.

We found that this relatively simple intervention increased the proportion of people who cleaned their teeth from 16% to 62%.

This increasing oral care led to a 60% reduction in the risk of acquiring pneumonia, from the equivalent of eight infections per month on a typical ward of 30 patients, to less than four infections per month.

This is the largest trial of its kind and the first completed across multiple hospitals.

Why does brushing teeth help?

The mouth is home to billions of bacteria. Oral hygiene often deteriorates when people are unwell, sedated, immobile, or taking certain medications.

When this happens, bacteria build up on the teeth, gums and tongue. If these bacteria are breathed in – even in tiny amounts – they can cause pneumonia.

Daily tooth-brushing reduces this bacteria. It’s a simple mechanical action with a powerful protective effect.

Yet in busy hospitals, oral care is often overlooked. Patients may not know just how important oral care is. Staff are often busy with competing priorities and oral care can be de-prioritised. There is also a general lack of understanding about the importance of oral care.

Patients can help protect themselves

One of the most important messages from our research is patients aren’t powerless. While health-care staff such as nurses play a crucial role, patients who are able to brush their own teeth can meaningfully reduce their own risk.

If you or a loved one is admitted to hospital, you can:

  • bring your own toothbrush and toothpaste
  • brush your teeth twice a day if you’re able
  • ask staff for help if you can’t
  • remind staff if oral care has been missed.

These small actions can reduce the risk of a serious, life-threatening infection.

What happens next?

Pneumonia is costly – in lives, hospital days and the financial cost of care. But because non-ventilator hospital-acquired pneumonia isn’t routinely reported, it’s often invisible.

Our research challenges the assumption that hospital-acquired pneumonia is an unavoidable complication when you go to hospital.

It also highlights the need for hospitals to monitor non-ventilator hospital-acquired infections, in the same way they monitor falls, pressure injuries and other preventable harms.

Finally, our study strengthens the case for including oral care in national infection-prevention guidelines and nursing practice.

Oral care isn’t glamorous, expensive or technologically advanced – but it works. Sometimes, the simplest interventions are the most powerful.

Brett Mitchell, Professor of Nursing and Health Services Research, University of Newcastle; Allen Cheng, Professor of Infectious Diseases, Monash University; Nicole White, Associate Professor of Statistics, Queensland University of Technology; Peta Ellen Tehan, Senior Lecturer, Monas University, Monash University, and Philip Russo, Professor, Director of Research, Nursing and Midwifery, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Categories : HospitalsTags :

Air Liquide Deploys its Access Oxygen Programme in Madagascar to Improve Oxygen Access in Rural Areas

On By ModernMedia
Photo: Supplied.

Access to oxygen is an essential component of any healthcare system. Yet, more than half of the global population still lacks access to an oxygen source1. To address this public health challenge, which is supported by the World Health Organization, Air Liquide is launching its social impact programme, Access Oxygen, in Madagascar. Relying on a local ecosystem, this program, already deployed in Senegal, Kenya, Mali, and South Africa, mobilises the Group’s longstanding expertise in medical gases to provide reliable, affordable and sustainable access to oxygen for populations in low- and middle-income countries. This initiative fully aligns with Air Liquide’s societal commitment.

In Madagascar, the initiative is being inaugurated in eight primary healthcare centres in the Antsirabe region, south of Antananarivo. These small, community-based facilities (2 to 6 beds), serving a population of 215 000, are particularly isolated and far from hospital infrastructure. They often represent the first point of access to healthcare for patients living in rural areas.

Until now, these centres lacked access to oxygen, despite its vital role in combating maternal and infant mortality. The introduction of this solution will allow for the care and stabilisation of patients experiencing respiratory distress in premature infants, complications related to childbirth, and conditions requiring temporary respiratory support, such as pneumonia or acute and chronic respiratory crises. Once stabilised, patients could be transferred to hospitals for long-term treatment.

Access Oxygen provides a comprehensive, frugal, and autonomous oxygen therapy solution. It includes the supply of equipment (in this case, high-flow oxygen concentrators, pulse oximeters, and consumables necessary for care), as well as training for healthcare staff and technicians. For the first time, the project integrates photovoltaic panels and batteries, ensuring continuity of care even in the absence of a stable power supply. In addition, training for healthcare professionals is delivered by an Air Liquide expert. In Madagascar, Hospiteq will handle the distribution, technical maintenance, and monitoring of the medical devices. The healthcare centres are part of the Ekar Santé network.

Diana Schillag, Executive Committee Member, overseeing Sustainability, stated: ”Making oxygen more accessible where it is most needed is essential to help build sustainable healthcare systems. This is why I am particularly proud of the roll-out of Access Oxygen in Madagascar. Since its launch in 2017, this social impact program has already covered areas with a total population of more than 3.4 million people in low- and middle-income countries. This initiative perfectly illustrates Air Liquide’s societal commitment and gives it its full meaning: leveraging our historical expertise in healthcare to make a real difference for local communities.”

1 Lancet Global Health Commission on medical oxygen security Graham H, King C, Rahman A et al. “Reducing global inequities in medical oxygen access: the Lancet Global Health Commission on medical oxygen security”. The Lancet Global Health, 2025; 13, e528-e584

Categories : Hospitals Medical IndustryTags :

SAMED Calls for Urgent Action as Gauteng Health Supplier Debt Crisis Reaches Critical Point

On By ModernMedia

The South African Medical Technology Industry Association (SAMED) has called for urgent and measurable action to resolve the escalating supplier debt crisis within Gauteng’s public health system, warning that continued delays in payments and procurement failures are placing both healthcare delivery and supplier sustainability at serious risk.

The call comes ahead of the Gauteng Department of Health’s hospital-level engagements with suppliers on 27 May, following MEC for Health and Wellness Faith Mazibuko’s recent acknowledgement that approximately R8 billion is owed to suppliers.

SAMED’s latest member data shows that R245 517 666.12 is owed to 27 medical technology suppliers, with a significant portion overdue well beyond the public sector’s 30-day payment requirement. Many affected suppliers are South African SMEs now operating under severe financial strain, forced to absorb the consequences of systemic procurement and payment failures while continuing to supply essential medical devices, diagnostics, consumables, and other critical technologies needed for patient care.

While SAMED welcomes the Department’s willingness to engage directly with suppliers, the association stresses that these discussions must lead to concrete commitments and operational action.

For SAMED and its members, this crisis is not new.

The association has spent more than a decade raising concerns about systemic procurement dysfunction, delayed payments, weak supply chain controls, and administrative failures that continue to undermine the effective functioning of the public healthcare system.

Today, those longstanding failures have evolved into a critical risk for both the healthcare sector and the businesses that support it.

In some cases, suppliers are delivering urgently needed products to hospitals while administrative bottlenecks make timely payment structurally impossible. This is particularly acute where delayed purchase orders, including for consignment stock arrangements, create a mismatch between supply delivery and budget allocation.

Monica Lucas, SAMED Board Member said, “SAMED members have continued supporting public healthcare under extraordinary financial strain because patient care cannot simply pause. But suppliers cannot indefinitely act as the financiers of a dysfunctional system. This is no longer just a debt issue; it is a structural operational failure that requires urgent executive intervention.”

Following the Department’s engagement with service providers on 23 May, SAMED has formally written to MEC Mazibuko requesting greater transparency on the Department’s debt reduction plans, and stronger accountability across finance, supply chain management, and hospital leadership.

SAMED will participate constructively in the upcoming hospital engagements and remains committed to finding practical solutions in partnership with government.

However, the association cautions that engagement without accountability will not restore supplier confidence.

After years of repeated commitments and limited progress, the sector requires clear timelines, written commitments, and measurable implementation.

“Direct engagement with leadership is welcome, but suppliers need more than reassurance. We need transparency, accountability, and a credible plan to resolve both the immediate debt burden and the underlying operational failures that continue to create it. Without that, the risks to healthcare continuity will only deepen.” – Scott de Oliveira, SAMED Chairperson

SAMED is calling for immediate action, including:

  • Publication of a verified and transparent debt position
  • A time-bound repayment plan for outstanding supplier debt
  • Executive oversight of hospital procurement and payment failures
  • Improved responsiveness from finance and supply chain leadership
  • Structured follow-up engagements with measurable progress reporting

SAMED remains committed to constructive engagement but warns that the public healthcare system cannot continue relying on suppliers to absorb systemic dysfunction indefinitely.

This week’s engagements must mark the beginning of real corrective action, not another cycle of discussion.

Categories : HospitalsTags :

Netcare Appoints Melanie Da Costa as Chief Executive Officer

On By ModernMedia

Long-serving executive takes the helm at one of South Africa’s largest private healthcare groups

Netcare Christiaan Barnard Memorial Hospital

Johannesburg, 19 May 2026: Netcare Limited, one of South Africa’s largest private healthcare groups, has appointed long-serving executive Melanie Da Costa as its next Chief Executive Officer (CEO), succeeding Dr Richard Friedland who steps down at the end of 2026 after three decades at the helm.

Da Costa, currently Executive Director: Strategy and Health Policy, will assume the role of CEO Designate on 1 June 2026, working alongside Dr Friedland through a six-month transition. She formally takes over as CEO on 1 January 2027, with Dr Friedland retiring from the Board on 31 December 2026. On the Board’s request, Dr Friedland has agreed to fulfil the role of strategic advisor to the Board and CEO for six months thereafter on a consultancy basis from 1 January until 30 June 2027.

The appointment comes at a pivotal moment for South African healthcare. The sector is navigating the implementation of the National Health Insurance Act, evolving regulatory and funding dynamics, and the rapid acceleration of digital health, data and AI. With more than two decades of experience spanning funder negotiations, health policy, capital markets, and operational leadership, Da Costa is widely seen within the industry as among the most experienced candidates to take on the role.

“Ms Da Costa is a respected industry leader with the capacity to deliver operational excellence, disciplined capital allocation and continued execution of Netcare’s strategy in service of our patients, partners, employees, medical aid schemes and suppliers,” said Alex Maditsi, Chairman of the Netcare Board. “She brings strategic acumen, commercial discipline, a growth mindset and a deep appreciation of the role that health technology and innovation play in driving differentiation and sustainable growth. Over more than 20 years at Netcare, she has made an extraordinary contribution to the Group, earning broad based  respect across the organisation and among its stakeholders. She is, without question, the right person to lead Netcare into the future.”

Da Costa, a Chartered Financial Analyst (CFA) who holds a Master of Commerce from the University of South Africa and a BCom Honours from the University of the Witwatersrand, says it is a privilege to take on the role at such a consequential moment for the sector.

“It is the honour of my career to be entrusted with leading Netcare,” she said. “Our sector is being reshaped by policy reform, by the expectations of the people we serve and by the extraordinary possibilities that digital and data-driven care now open up. Netcare’s strategy is clear, our people are exceptional and our commitment to person centred health and care is unwavering.

“I have had the privilege of working alongside Richard for two decades. The Netcare he leaves is not the Netcare he found – he and the team have built it into one of the most respected healthcare organisations on the continent. I am profoundly grateful for his mentorship and committed to building on the extraordinary foundation he and the team have laid.”

Da Costa joined Netcare in 2006 to establish its Health Policy Unit and has since played a key role in shaping national health policy through evidence-based engagement with policymakers, regulators and funders. She subsequently led the Group’s acquisition of mental health provider Akeso and served as its Managing Director. She is a member of Netcare’s Finance Committee, serves on the National Renal Care Board and is a former Chairperson of the Hospital Association of South Africa (HASA).

Dr Friedland’s retirement closes one of the most consequential chapters in South African private healthcare. A co-founder of Netcare, he has led the Group for more than three decades, building it into a leading and respected healthcare provider employing more than 18 000 people. Under his stewardship, Netcare founded several new divisions, including Netcare 911, Netcare Diagnostics and Netcare Plus, and established itself as an internationally recognised leader in environmental sustainability and digital innovation in healthcare.

“Dr Friedland pioneered and led the development of the Group’s long-term person centred health and care strategy, underpinned by digitisation, data and AI-driven innovation, which has positioned Netcare at the forefront of healthcare transformation,” Maditsi said.

“He also initiated and led the Group’s environmental sustainability strategy, which has positioned Netcare as a global leader in this field. We also acknowledge his inspirational leadership from the frontline of Netcare and the broader healthcare sector during the COVID-19 pandemic. The Board thanks him for a lifetime of service to Netcare, to our patients and to our country.”

Dr Friedland said he is confident he is leaving Netcare in the strongest possible hands.

“Melanie is an exceptional leader and a person of deep integrity. I have watched her grow from establishing our Health Policy Unit to becoming one of the most respected voices in South African healthcare,” he said.

“She understands Netcare – our people, our purpose, our strategy and the contribution we make to the country. Netcare is more than a company; it is a community of more than 18 000 people who turn up every day to care for others. I will hand over the leadership of that community with pride and with absolute confidence in Melanie’s ability to take it forward.”

Netcare is at present in a Closed Period until 10:00 on Monday, 25th May 2026 and is therefore regrettably unable to grant interviews.

Categories : HospitalsTags :

Net Zero Waste Hospital Certification a First for SA

On By ModernMedia

Netcare Blaauwberg Hospital leads the way in reducing landfill waste

Friday, 15 May 2026: The Green Building Council South Africa (GBCSA) has recognised Netcare Blaauwberg Hospital as the first hospital in the country to achieve Net Zero Waste certification with general waste to landfill reduced by more than 90%.

Valid until 2029, this latest certification marks a new departure for healthcare in the country and a notable step in the Netcare Group’s environmental sustainability strategy, first implemented in 2013.

Chief executive officer of GBCSA, Lisa Reynolds, commended the Netcare Group’s initiative in achieving this significant milestone of Net Zero Waste certification.

“As the first hospital in South Africa to achieve the rating, it will serve as the template for other Netcare Group facility certifications, and provides a case study for all medical facilities looking to execute their sustainability goals,” she says.

“The certification process was characterised by solid teamwork, across the Netcare Group teams, the Zero Waste sustainability consultants, and the technical team at GBCSA, and it is this teamwork that is taking projects beyond the boardroom and into action.” 

Alan Abrahams, Netcare’s Cape regional manager and general manager of Netcare Blaauwberg Hospital, congratulated staff and doctors on their enthusiasm for pioneering the Net Zero Waste initiative in the hospital setting.

“Caring for people and caring for the environment should be indivisible, yet progress towards sustainability requires commitment to measurable steps towards the goal of Net Zero Waste within the broader aims of the global Race to Zero,” Abrahams says.

“We appreciate Netcare leadership’s commitment and the support from the Group’s environmental sustainability team who have guided our Net Zero Waste certification journey. This would not be possible without each person in the hospital doing their part to reduce the amount of landfill waste by incorporating small changes into daily practices.”

The GBCSA’s Net Zero Waste Level 2 certification process analyses an existing building’s operational waste generated during day-to-day use and assesses how much of this waste is diverted from landfill, whereas Level 1 is a separate category measuring construction waste reduction in new buildings.

Netcare Blaauwberg Hospital successfully achieved the required diversion rate in line with global best practices through its own waste management processes, without any purchased offsets.

Dimakatso Nhlapo, Netcare’s national lead on integrated waste management, explains that a multidimensional approach is required to achieve Net Zero Waste Level 2 requirements in the healthcare setting.

“Healthcare risk waste, such as blood-contaminated items and pharmaceutical products, is managed in line with regulatory requirements and is not part of this process. Our efforts focused on the hospital’s general waste, which would otherwise be disposed of in landfill,” she explains.

“We looked at where we could minimise waste from every angle and improved the separation of general waste at source through practical measures, such as providing different bins for different types of materials.” 

“The shift towards reducing the hospital’s landfill waste to less than a tenth required continuous staff training and education on waste diversion. Onsite general waste sorting systems and improved processes for the recycling of paper, cardboard boxes, plastics, textile waste, and e-waste were established to further reduce the need for landfill,” Nhlapo says.

“We identified items commonly used in the hospital that can be safely reused and set up the necessary systems to ensure they are properly cleaned and disinfected. For organic waste, such as food scraps, we also established a composting system at Netcare Blaauwberg Hospital.”

André Nortje, Netcare’s environmental sustainability manager, adds that when Netcare joined the United Nations Race to Zero 2050 global campaign in 2021, it became the first healthcare institution in Africa to do so.

“Only by setting ambitious environmental objectives can these goals be achieved. Alongside Netcare’s strategic efforts to improve energy and water efficiency and reduce reliance on non-renewable resources across our operations, minimising waste to landfill is a fundamental component of minimising our operations’ footprint on the planet,” he says.

“We anticipate that many of the learnings from this first hospital’s Net Zero Waste certification will be replicable across other Netcare hospitals and will inspire other healthcare providers and corporates to seek ways to reduce landfill waste through similar initiatives,” Nortje concludes.