Category: Medical Industry

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GEMS Hosts its 14th Annual Symposium, Bringing Together Key Healthcare Industry Stakeholders and Policymakers

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The Government Employees Medical Scheme (GEMS) will, on November 2nd, 2023, host its 14th annual GEMS Symposium under the theme: “Advancing Health Equity by Addressing the Social Determinants of Health”. Experts, thought leaders and specialists in healthcare will engage in discussions towards a better understanding of the societal determinants of health in South Africa. 

For this hybrid event, delegates will attend both in person at Sandton and virtually.

Dr Moloabi states that the “Symposium is an important event on the GEMS calendar, providing a platform for academic, clinical, government and business minds to discuss what social issues are at play in determining the nation’s health status and how to improvements in health equity can be realized”. Moreover, he also highlights the need to remove practical obstacles that make us an unequal society if we are to achieve collaborative and cohesive solutions to our healthcare challenges.”

Speakers will include: 

  • Dr Ingrid Pooe – Chief Operations Officer, Government Employees Medical Scheme (GEMS),
  • Dr Sebayitseng Millicent Hlatshwayo – Chairperson, Government Employees Medical Scheme (GEMS),
  • Dr Chana Pilane-Majake – Deputy Minister of Public Service and Administration (DPSA),
  • Professor Mcebisi Ndletyana – Professor of Political Science, Department of Politics and International Relations, University of Johannesburg,
  • Dr Selaelo Mametja – Chief Research Officer, Government Employees Medical Scheme (GEMS),
  • Mr Barry Childs – Joint Chief Executive Officer Insight Actuaries & Consultants,
  • Dr Vuyo Gqola – Chief Healthcare Officer, Government Employees Medical Scheme (GEMS),
  • Mr Louis Botha – Chief Executive Officer, Health Quality Assessment (HQA),
  • Ms Yoliswa Makhasi – Director General, Department of Public Service and Administration (DPSA),
  • Mr Frikkie de Bruin- General Secretary, Public Service Coordinating Bargaining Council (PSCBC),
  • Dr Pali Lehohla – Director of Economic Modelling Academy (EMA), 
  • and
  • GEMS Principal Officer Dr Stanley Moloabi.

Dr Pilane-Majake, the Deputy Minister for the Department of Public Service and Administration (DPSA) will deliver the keynote address, elucidating, amongst other insights, the crucial relationship between the DPSA as employer and GEMS as an implementor of a mandate to ensure access to health and wellness by government employees and thus contributing towards the attainment of the ideals of Universal Healthcare Coverage.

Media personality Ms. Faith Mangope will facilitate conversations as the panel covers key discussion points, including:

  • Achieving the Sustainable Development Agenda 2030.
  • Beyond Healthcare: Addressing health equity and social determinants of health.
  • Policy Interventions for Addressing Social Determinants of Health: Lessons and best practices.
  • Value-Based Care and Social Determinants of Health: Integrating social context into healthcare delivery.
  • Advancing health equity by addressing social determinants of health; and
  • Exploring the interplay between healthcare quality and social determinants.

At GEMS, we are dedicated to fulfilling our responsibilities towards our members and the people of South Africa. The Symposium is a testament to our commitment to Universal Healthcare Coverage, and we are eagerly anticipating a productive outcome that will be memorable and provide an insightful experience for all involved, Dr. Moloabi” concludes. 

To learn more about the GEMS Symposium, visit www.symposium.gems.gov.za. 

Categories : Healthcare Politics and Regulations Medical IndustryTags :

Life-saving TB Drug is Now Cheaper in South Africa – But Not as Cheap as It can be

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Diagram by the United States-based National Institute of Allergy and Infectious Diseases showing the medicine options for drug-resistant tuberculosis. (Via Flickr, CC BY 2.0 Deed)

By Daniel Steyn for GroundUp

The South African government and pharmaceutical company Johnson & Johnson (J&J) have agreed to a lower price for bedaquiline, a medicine used to treat drug-resistant tuberculosis (DR-TB) in South Africa.

This comes off the back of mounting pressure from activists and amid an ongoing investigation by the Competition Commission, looking into J&J’s pricing of the drug.

An estimated 14 000 people in South Africa fell ill with DR-TB in 2019. Bedaquiline is one of the main drugs used to treat DR-TB. Before bedaquiline became available, treatment for DR-TB would consist of up to two years of injections with serious side effects. The bedaquiline-containing regimen has no injectables, far fewer side effects and is typically six months. 

Bedaquiline has been provided by the South African government since 2018.

In July, J&J agreed to sell bedaquiline to lower and middle-income countries through the Stop TB Partnership’s Global Drug Facility for $130 (R2470) per six-month regime, but South Africa does not make use of this facility due to national procurement policies.

Instead, about the same time that J&J made this announcement, the National Health Department agreed to pay J&J R5500 for the drug.

The Competition Commission announced in September that it will be investigating Johnson & Johnson’s pricing of the drug. The commission assisted the Department of Health in renegotiating the price, says department spokesperson Foster Mohale.

This week the department sent out a circular indicating that it will be paying R3,148 for bedaquiline.

Bedaquiline is prescribed to 7000 to 8000 people a year, Mohale told GroundUp. Mohale says the new price amounts to a 40% saving on bedaquiline for the next two years.

Candice Sehoma, Access Campaign Advocacy Advisor for Medicines Sans Frontiere (MSF), told GroundUp that the “momentous” cost saving is a “big achievement”. Sehoma says it is a sign that the global campaign to ensure accessible and affordable treatment for TB is yielding results.

MSF has estimated that bedaquiline could be manufactured and sold for profit for as little as $102 (R1940).

Fatima Hassan, director of the Health Justice Initiative, says that while the price drop is a victory, it is important to ensure that this does not happen again.

“The significant price reduction emphasises why price scrutiny is significant,” Hassan told GroundUp.

Alleged “evergreening”

J&J’s patent for bedaquiline expired in July 2023, but J&J had already applied for a new patent for a slightly different version of bedaquiline, which was granted. This meant their patent protection continued in South Africa after the original patent expired.

This amounts to “evergreening”, says Hassan. Evergreening, as explained in this article in The Conversation, “is achieved by seeking extra patents on variations of the original drug – new forms of release, new dosages, new combinations or variations, or new forms”.

The Competition Commission will be looking into J&J’s alleged “evergreening” as part of its investigation.

After making its agreement with the Global Drug Facility, J&J has announced it will not be enforcing the new patent – a move that will allow generic versions of the product to enter the market and further lower the price.

GroundUp sent questions to J&J but received no response.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Expert Opinion Medical IndustryTags :

Opinion Piece: The Rise of Affordable Medical Insurance

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Reaching the masses with quality healthcare services

Photo by Hush Naidoo Jade Photography on Unsplash

By Sandra Sampson, Director at Allmed Healthcare Professionals

With its two-tiered, highly unequal healthcare system, only 14.86% of South Africa’s population can currently afford private healthcare, and rising costs are making it difficult for many to keep paying their monthly medical aid premiums. There are plans to implement National Health Insurance (NHI) to fund healthcare in the public and private sectors, although this process which began in August 2011 has been slow, and the NHI Bill is still under consideration in the National Assembly.

Despite concerns about the state’s ability to implement the NHI effectively and competently, delivering quality medical care to the population must continue to be a priority for every healthcare provider. This is where a specialist Temporary Employment Services (TES) provider can assist – delivering a flexible, competent, quality workforce on demand for institutions in both the public and private sectors.

Increasing access to quality healthcare

The public healthcare sector is primarily intended to serve those who are unable to access private medical aid and is currently accessible to all, regardless of immigration status or nationality. Significant funding is a massive drawcard for specialists in the private sector, which has resulted in a widening gap between public and private healthcare facilities in much of the country. The impending NHI is intended to address this gap and enable greater access to specialist care and more free services for all, while improving the quality of public healthcare by establishing a national fund that will allow for the purchasing of healthcare services on behalf of users. Estimates for funding this national health initiative range from R165bn to R450bn, and the government has been given the go-ahead by the Gauteng High Court to continue its recruitment drive before the bill has even passed.

Access starts with affordability

In line with this move, affordable healthcare insurance is on the rise. This trend starts with partnerships between healthcare and financial services providers, and has already been seen in the likes of Dischem, Clicks and Tyme Bank’s TymeHealth, all offering medical insurance, enabling access to high-quality healthcare specialists to a market that was previously woefully under-serviced. As the demand for quality healthcare increases, there will be a proportionate increase in the need for healthcare professionals.

Practical resourcing alternatives

It is not economically or practically feasible for healthcare institutions (whether in the private or public sector) to hire more medical professionals permanently, which means they will have to explore other resourcing options. This is becoming increasingly difficult in South Africa, as many skilled medical staff are seeking work elsewhere as a result of poor working conditions created by loadshedding, corruption, and incompetent administration. Although the Department of Home Affairs has added new skills to our country’s critical skills list (many of which include medical practitioners and individual specialisations) the healthcare industry is still severely understaffed. Hospital groups are only growing more frustrated with the government’s inability to address the decreasing number of medical practitioners, particularly nurses. The Hospital Association of South Africa (HASA) has reported that nurses in the country are reaching retirement age without the necessary inflow of younger employees. In 2020, there were more than 21,000 nurses in training, but South Africa still needs as many as 26,000 additional nurses to meet the growing demand.

Meeting the demand flexibly

TES providers in the healthcare sector have the potential to meet the demand of healthcare institutions for nurses and specialists, without these institutions having to commit to the responsibilities and costs associated with full-time employment. TES providers are on hand to supply the vetted and highly-skilled workers so desperately needed. Every healthcare institution can be supplied with the resources necessary on a shift-by-shift basis. So, if, for example, there is a deficit of five ICU nurses at a certain hospital, a TES provider can meet this with very short notice. If, on the other hand, patients are discharged or rerouted, these additional nurses can be cancelled at short notice, and the TES provider picks up the hospital’s slack and answers it with flexible resources on demand. Additionally, when it comes to meeting the fluctuating demand for speciality staff, a TES partner will become indispensable.

Equitability and affordability depend on agility

Ultimately, regardless of when the NHI comes to fruition, healthcare institutions should begin partnering with a TES provider if they haven’t already. Along with providing medical professionals on demand, this comes with cost-saving benefits for the hospital or clinic. Not having to employ full-time staff to meet fluctuating needs is a cost-saving exercise. Not only from a wage standpoint but also from an HR perspective in terms of payroll, industrial relations and skills development. The TES partner is responsible for all aspects of the employment relationship, while the healthcare institution gains access to qualified healthcare professionals as needed, at a fixed rate on flexible terms. This means that as soon as hospitals decide to invest in making their wards and spaces bigger and more efficient, they will have access to the medical resources necessary to staff them in a manner that enables equitable access to quality healthcare.

Categories : Medical IndustryTags :

Sharing Health Data Saves Lives: Showcasing the CareConnect Health Information Exchange in Action in SA

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In a nation where healthcare has been marred by disjointed systems and fragmented care, South Africa’s healthcare organisations are making strides to change this narrative.

South Africa’s health journey has faced challenges with siloed information, often paper-based systems, and a lack of information flow between health professionals, funders and health facilities. These barriers have significantly impacted the cost, quality, and access to healthcare for patients. In response, the Competition Commission’s Health Market Inquiry (HMI) panel spotlighted the urgent need for solutions that bolster transparency, coordination, and innovation.

South Africa’s first industry-wide health information exchange, CareConnect HIE, is a game-changing initiative and the brainchild of major hospital groups, including Life Healthcare, Mediclinic, and Netcare, coupled with leading medical scheme administrators like Discovery Health, Medscheme, and Momentum Health. Their shared vision? An interoperable health system that breaks historic barriers, promoting enhanced patient care, quality, and efficiency. This transformative approach to healthcare was showcased in action at an event in Sandton today, providing attendees a firsthand look at the potential of HIE in South Africa.

Since its launch in August 2022, CareConnect HIE has rapidly advanced, with over 5.2 million consented lives now integrated into the system. However, the true value – from population health benefits to progressive funding and health delivery models – exponentially increases as the amount of data on the exchange grows.  Therefore, the aim of the HIE is to be the hub of exchange and the single integration point for ALL health data – from both the public sector and the private sector. Bearing testament to this, representatives from the South African Private Practitioners Forum,  the Radiological Society of SA, Mediclinic, Discovery Health, Altron and Momentum Health will share their insights on how HIE will be used in their organisations. In addition, representatives from the Western Cape Department of Health will talk to the public-private collaboration with CareConnect.  

CareConnect has adopted a set of international standards (FHIR and HL7) to transfer and share data between various healthcare systems regardless of how it is stored in those systems.  These standards underpin interoperability because all participants are ‘speaking the same language’.  An interoperable health system will be critical in achieving Universal Health Coverage (UHC) which will require the ability for patients to move seamlessly between the public and private health sectors, facilities, clinicians or other service providers, depending on the expertise and care they require. To this end, there is engagement with the National Department of Health, who were represented at the event.

Dr Rolan Christian, CEO of CareConnect HIE

Central to the CareConnect HIE is a Unified Care Record (UCR), an electronic medical record that holds a patient’s entire medical journey. This constantly updated and ever-evolving record gives clinicians on-demand access to consolidated patient data, promoting swift, well-informed treatment decisions when and where they are needed.

Privacy and security of data is critical to the success of HIE. The CareConnect HIE conforms to both local and international data privacy regulations to ensure that sensitive health information remains protected at all times and will only be accessible to healthcare providers when medically necessary and only with the patient’s consent. User-based access permissions are automatically regulated by the HIE, further safeguard­ing sensitive patient information.

Sharing health data saves lives. The more data the industry shares, the more value and benefit to the patient that will be extracted from the HIE.

Dr Rolan Christian, CEO of CareConnect HIE

CareConnect’s innovative new use cases, ranging from tracking acute and chronic patient conditions, listing allergies and adverse reactions, to standardising doctor clinical (discharge) summaries, were demonstrated at the event. These features will enable better coordination of care, minimise medical errors and pave the way to a more cohesive health system. 

HIE in various forms has become common across many health systems in the world and has become a priority on many a government health policy agenda as a solution to achieving greater cohesion within health systems  and as a mechanism to address cost and quality issues in health. Reflecting global best practices, the CareConnect HIE aligns with the world’s most mature HIEs and breathes life into the National Department of Health’s National Health Digital Strategy for South Africa.  This important document outlines the country’s goals towards the development of electronic health records and building interoperability and linkages between existing patient-based information systems.

A strict code of ethics relating the use of information is governed by an internationally recognised and best practice multi-party trust agreement, called DURSA. The DURSA provides a framework that deals with sharing of data among HIE participants and defines the permitted purpose for which the data can only be used.

Dr Rolan Christian, CEO of CareConnect HIE shared: “Sharing health data saves lives. The more data the industry shares, the more value and benefit to the patient that will be extracted from the HIE. We envision that CareConnect HIE will become a ‘utility’ for the entire health sector – to enable improved quality of care, better health outcomes and a more responsive health system.”

The event today boasted a stellar lineup of speakers. Notably, Dr Stavros Nicolaou from B4SA and Aspen Pharmacare and Dominick Bizzarro, offering international perspectives from MVP Health Care, joined other industry luminaries. Their combined insights painted a promising future for healthcare – one that’s harmonised, transparent, and unequivocally cantered on the patient.

Categories : Medical IndustryTags :

Physicians and Nurse Practitioners have Similar Prescribing Error Rates

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Photo by Towfiqu Barbhuiya on Unsplash

A study of more than 73 000 primary care physicians (PCPs) and nurse practitioners (NPs) in the US suggest that  both are similarly likely to inappropriately prescribe medications to older patients. According to the authors, this study adds to growing evidence indicating that when prescriptive authority is expanded to include NPs, these new prescribers do not perform worse than physicians. The study is published in Annals of Internal Medicine.

NPs, registered nurses with advanced degrees and more experience, are helping to solve the ongoing PCP shortage problem in the United States. Currently, state laws determine what type of medical care NPs can provide, such as practicing independently and prescribing medications without physician supervision.

Researchers from University of California, Los Angeles, Yale Law School, and Stanford University calculated inappropriate prescribing rates for 23 669 NPs and 50 060 PCPs prescribing medications to patients aged 65 years and older across 29 states in the US where NPs are authorised to prescribe. Inappropriate prescribing was defined using the American Geriatrics Society’s Beers Criteria. The researchers found that both PCPs and NPs averaged approximately 1.7 inappropriate prescriptions for every 100 prescriptions written. However, NPs were overrepresented among clinicians with the highest and the lowest rates of inappropriate prescribing. According to the authors, these findings provide useful lessons for policymakers, lawmakers, and regulators. Use of clinician-level performance measures, coupled with efforts to improve prescribing at the organisational and individual levels, could help to address deficient performance among all clinicians who prescribe. The authors say that technologic interventions, such as prescription drug monitoring, have a role to play, as do initiatives aimed at ensuring better adherence to trusted guidelines like the Beers Criteria.

An accompanying editorial from authors at University of California, Los Angeles suggests that rates of inappropriate prescribing are too high among clinicians of all stripes. The authors note that NPs are providing a greater proportion of care to older adults outside of large metropolitan areas, many of whom would likely have no other source of primary care. They also emphasise that NPs will continue to serve critical roles in ensuring that older adults in areas with inadequate numbers of health care providers receive primary care. The goal of clinicians should be to reduce variation and improve prescribing quality among all clinicians who care for older adults.

Source: EurekAlert!

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Uniting in a Shared Vision for Improved Patient Safety

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Talk to your patients about safe, effective use of medicines

Photo by Cottonbro on Pexels

Approximately one in ten patients experience an adverse drug reaction during their care1. This can lead to serious harm or even death. Sanofi is committed to reducing these numbers by working with healthcare practitioners to create a culture of patient safety.

“Patient safety is a top priority for Sanofi,” says Yusuf Dawood, Multi-Country Safety Head for Sanofi Southern Africa. “We believe that patients should be essential partners in their healthcare journeys, and we are committed to working with healthcare professionals alongside their patients to ensure optimal therapeutic outcomes. We call on all healthcare practitioners to join us in raising awareness of patient safety. By working together, we can advocate for improved communication and reduce patient harm.”

Here are some key tips for healthcare practitioners on how to improve patient safety:

  • Ask patients about their concerns and listen to their feedback. They can provide valuable insights into their own health and well-being and by engaging them, healthcare practitioners can ensure that potential issues are detected as soon as possible and handled appropriately.
  • Provide patients with clear and concise information about their care. Patients need to understand what their diagnosis is, what treatment options are available, and what the benefits and risks of each option are. They also need to know what to expect during and after their treatment, and how to manage any side effects or complications. By giving patients accurate and easy-to-understand information, healthcare practitioners can empower them to make informed choices about their care.
  • Communicate with patients and other members of the healthcare team. Use simple and unambiguous language, avoid jargon and acronyms, and confirm that the patient has understood the information they have been given. Use tools such as checklists, handovers, and feedback loops to ensure that the information they share is complete and accurate.
  • Follow safety protocols and procedures. Healthcare practitioners need to adhere to guidelines, policies, protocols, best practices and standards of care established by professional bodies and regulatory authorities, which have been designed to prevent or minimise harm to patients.
  • Report issues immediately. Report any patient safety issues to the appropriate authorities in the interest of public safety. Report any medication-related patient safety issues to the relevant pharmaceutical companies. This enables companies to continuously monitor the benefit-risk profile of their products and ensure the safe use of medicines.

“Patient safety should be a top priority for healthcare professionals and pharmaceutical companies because the goal of both sectors is to improve and protect the well-being of individuals,” says Dawood. “When safety is compromised, it not only jeopardises the health and trust of patients but also undermines the credibility and integrity of the entire healthcare system. By working with pharmaceutical companies like Sanofi, healthcare professionals can provide real-world feedback on drug efficacy and side effects. This collaborative approach ensures that treatments are both safe and effective.

Join Sanofi in championing patient care. Let’s collaborate, communicate, and make every patient’s journey safer.

Reference
1. Ribeiro, M. et al. (2018) ‘Increase of 10% in the rate of adverse drug reactions for each drug administered in hospitalized patients’, Clinics, 73, pp. 1–6. doi:10.6061/clinics/2018/e185.

Categories : Healthcare Politics and Regulations Medical IndustryTags :

Only with Both the Private and Public Sectors Working Together Will NHI Succeed

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Photo by Hush Naidoo Jade Photography on Unsplash

For National Health Insurance to succeed in South Africa, a meaningful collaboration needs to take place between private and public health care so as to speed up the implementation of the initiative and overcome major obstacles.

This was the opinion of the five panellists who on the first day of the Hospital Association of South Africa conference in Cape Town spoke of how best the NHI could be rolled out by calling on private health care for assistance.

“’It’s fundamental to the economic growth that we so desperately need in South Africa, and a productive nation needs access to health care. So we do need to address the inequalities, we need to address the gap and do not need to preserve the status quo,” said Professor Roseanne Harris, of Discovery Health.

But a concern she raised is the risk of the introduction of a single funding model reliant on taxes, and the introduction of a monopoly market.

“And one of the implications of the bill is centralisation (of health care). There is a need for planning to ensure that it won’t have an unintended consequence of impacting service delivery and impacting on the rights of the healthcare personnel,” she added.

Harris said that both the private sector and public sector needed to go through a consultative process and that sustainable critical milestones needed to be put in place to hold the process to account.

Another panellist at the event Dr Simon Strachan of the South African Private Practitioners Forum (SAPPF), pointed out that the COVID pandemic showed how public and private health care could collaborate successfully.  Here service agreements between the two entities were met and were focused solely on fighting the pandemic.

“So to create the way forward, what we need to be able to do is to have a very clear understanding of what it is we’re trying to achieve, that there is robust trust, and that there is a groundwork for sustainable collaboration,” he explained.

An urgent need for this collaboration he said was the recent introduction of Section 33 of the NHI bill, which in its present form would have health care professionals working for the state at a fee the state sets, with benefits not included.

A second issue he said was the need for a successful funding model that will be acceptable to all South Africans.

Economist Nicola Theron of FTI consulting told the audience that structures already in place and used in the private sector could make for a smoother transition for the NHI. In particular when it comes to issues like the pricing of medicines.

“We are now at a point with the current NHI that there are talks about the lowest possible price at a reasonable return for healthcare providers. There is no indication of what return means,” she said.

“But what we have is an existing system of pricing which has been developed over time, and which should form the basis of pricing going forward,” said Theron.

By not getting the pricing right could lead to investment leaving South Africa, she warned.  She suggested in turn that it would be a better model to have multiple buyers that will stimulate competition.

Dr Ali Hamdulay, CEO, Metropolitan Health, said that a way forward would be to implement the suggestions that came out of the Health Marketing Inquiry that took a hard look at both the public and private health care systems, outlining the problems with both.

“So effectively by addressing the recommendations of the Health Market Inquiry  you’re actually foster an environment of culture and direction to work towards universal health care,” said Hamdulay.

Barry Childs, of Insight Actuaries, said that while fundraising mechanisms in the public sector needed to be improved, the introduction of the NHI offers a great opportunity to reform the healthcare system.

“As much as we talk about the need for reform of the private sector side, there’s been no meaningful reform of the public sector for many decades. And the NHI is a wonderful opportunity for them to introduce some better, more responsive financing mechanisms.” he said.

But for NHI to ultimately provide the services it promises, Childs said South Africa’s economy needed to improve, and more jobs to be created.

Source: Hospitals Association of South Africa

Categories : Medical Industry Mental HealthTags :

Rollout of Coaching Programme Reduces Burnout in Medical Residents

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Photo by SJ Objio on Unsplash

Researchers found that a national level programme to reduce burnout levels, which disproportionately affects women, was even more successful than its pilot programme two years prior. They published their findings in the journal JAMA Network Open.

“We did a pilot programme in 2021 to see if it would work and it did,” said study co-author Tyra Fainstad, MD, associate professor at the University of Colorado School of Medicine. “Then we expanded it to 26 graduate medical institutions in 19 states. There were 1017 participants. We saw significant improvement in every wellbeing outcome we assessed including all three subscales involved in burnout.”

Burnout within the health care community is a national epidemic disproportionally affecting women. Last year, the US Surgeon General declared it a `crisis’ deserving ‘bold, fundamental change’ though little was known about scalable, effective solutions to the problem.

Women are hit harder by burnout for reasons that include bias and sexism at work, pay disparities as well as a disproportionate burden of home management and child/elder care, the researchers said.

Fainstad and co-author Adrienne Mann, MD, both faculty in the CU Department of Medicine, created the web-based Better Together Physician Coaching Program at CU Anschutz with the goal of reducing that burnout. Then they replicated it to a national level and published their findings.

While the pilot programme saw improvements in `imposter syndrome’ (feeling as if you ‘don’t really belong in the job’) and self-compassion, the expanded national study also showed significant improvements in outcomes across the board including moral injury and flourishing, offering actual evidence that the program works.

“Physician trainees who received online group coaching over four months had substantial reductions in multiple dimensions of professional distress (burnout, moral injury and imposter syndrome) and improvements in well-being (self-compassion and flourishing),” said Mann.

Mann and Fainstad are both certified life coaches. Better Together is owned and operated by the University of Colorado. It’s not a business, they said, and they don’t personally profit financially from it. The program is available to any heath care institution, school of medicine, department, or residency program wishing to meaningfully support the wellbeing of their clinicians and trainees.

Better Together is web-based. Participants take part in two videoconferencing coaching calls per week where up to five people can be coached live on any topic with an unlimited audience. Calls are recorded for later listening on a private podcast.

Participants can also access unlimited, anonymous written coaching in a forum by submitting a narrative reflection and receive a coach’s response published to Better Together’s secure, members-only website. There are also weekly self-study sessions using videos and worksheets. They focus on topics pertinent to the physician lifestyle such as goal setting, cultivating a growth mindset, receiving critical feedback, imposter syndrome and perfectionism.

The researchers use the Maslach Burnout Inventory (MBI) to measure their work. The MBI has three subscales: emotional exhaustion (EE) or feeling emotionally exhausted from work; Depersonalisation (DP), detached and impersonal treatment of patients; Professional accomplishment (PA), beliefs around competence and success at work.

The EE score is a key construct in health care related burnout. A one point increase in the EE scale has been associated with a 7% increase in suicidal ideation and a 5-6% increase in major medical errors.

The researchers said a reduced mean EE score among those that took part in the training and an increased EE score in those that did not.

“From what we see in this study, coaching helps in every aspect of burnout,” Fainstad said. “The multi-modal nature of our program is unique. You can interact in many ways. That partially explains the powerful impact -that and the group nature of our coaching.”

Mann said the majority are watching others being coached and share in the experience.

“That is deeply connecting. They try to see themselves in someone else’s story,” she said. “When someone is on a view screen you have compassion and empathy for them and, by extension, learn to practice compassion and empathy for yourself.”

While few strategies to address burnout have shown much overall effect, Fainstad said this study demonstrates that group coaching works.

“We’re now showing that we have an actual evidence-based answer to burnout,” she said.

Fainstad and Mann said burnout is a product of the current, often toxic, medical culture pervading every aspect of the profession.

“Culture is a belief system,” Fainstad said. “And while structural changes are absolutely necessary to fix our medical system, working with individuals who have been harmed along the way will be imperative to healing.”

Mann suggested a step towards healing the culture would be making coaching programs like Better Together accessible to everyone – not necessarily mandatory but at least made available by institutions.

“There are other coaching programs in this space but this one is rigorously evidence-based. We studied it,” Mann said. “There are no downsides. It helps in all aspects of burnout.”

Source: University of Colorado Anschutz Medical Campus

Categories : Expert Opinion Medical IndustryTags :

Opinion Piece: Commemorating Carers Week: Putting the Spotlight on South Africa’s Unsung Heroes

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By Donald McMillan, Managing Director at Allmed Healthcare Professionals

Donald McMillan

The caregiving workforce plays a crucial role in our society, but their efforts often go unnoticed. These individuals, known as carers, selflessly care for those in need due to factors such as illness, age, or frailty. Unfortunately, they face numerous challenges that can take a toll on their well-being. It’s important to raise awareness of their struggles and provide them with the necessary support. To bring these issues to the fore, communities are coming together between the 2nd – 6th of October 2023 to commemorate Carers Week.

Caregivers have an enormous responsibility that often goes unnoticed by society. The emotional strain that comes with caregiving can have a direct impact on their mental health and often leads to depression. They often devote their time and interests to the role of voluntary caregivers and face many challenges due to the lack of recognition and support from their professional peers and society in general.

Initiatives in place

In response to these issues, governmental efforts have been put forth to assist both caregivers and non-governmental organisations with the aim of alleviating some of the financial burdens associated with their work. A noteworthy instance of this support is exemplified in the community home-based care program run by The Association for the Aged (TAFTA), which secures government funding to informal caregivers. This initiative and others like it, combined with the Carer’s Grant are part of positive strides being made within this space. However, further support is still needed to ensure that caregivers receive adequate support as they strive to provide high-quality care to their patients.

The government alone cannot be the only one providing support to carers as society and the private sector each have to role to play in alleviating the burden that sits on the shoulders of carers, particularly within impoverished and rural communities. The logical progression is for the government and all stakeholders to channel their resources into a comprehensive framework that encompasses financial aid, training, and support services for carers. Additionally, the pursuit of affordable and inventive caregiving solutions cannot be neglected.

Rising to meet growing demands

As South Africa’s population ages and chronic illnesses surge, the demand for caregiving services has swelled to unprecedented levels. To adequately address these escalating requirements, several measures must be adopted. Establishing community-based networks of support can furnish practical assistance and emotional solace. Carers must also receive enhanced training and upskilling to hone their capabilities, all the while being granted the acknowledgement and admiration they rightfully deserve.

It is imperative for entities that offer caregiving employment to invest in training to equip carers with the tools required for high-quality care provision. The integration of emotional counselling facilitated by clinical experts constitutes another crucial component of the caregivers’ support structure.

Strengthening the system

The symbiotic relationship between government bodies, stakeholders, and relevant associations is pivotal in reshaping the caregiving landscape. The collaboration between the Department of Social Development (DSD) and the South African Association of Homes for the aged- (SAAHA), exemplified by their joint registration of care workers both formal and informal, signifies a significant step toward accountability and much-needed assistance. The synergy of corporate involvement and government funding has the potential to revolutionise the lives of caregivers in both formal and informal capacities.

Upskilling the informal carer workforce stands as a cornerstone for improving the quality of caregiving. Creating and running specialised courses tailored for caregivers is essential, as it not only enriches their knowledge and competencies but also bolsters their confidence, employability, and job satisfaction. These comprehensive courses should span various aspects, from personal care to dementia management, empowering caregivers to confront their daily challenges head-on.

Galvanising society

As mentioned, support for carers should transcend the boundaries of governmental programs and corporate ventures. The broader society has a pivotal role in elevating the status of carers. Displaying empathy, extending practical aid, advocating for improved resources, and propagating awareness about the struggles of caregivers all fall within our capability as members of the public. Initiatives rooted in communities, campaigns, and programs can collectively reshape perceptions and extend tangible support.

Carers are one of the important pillars on which our society relies, and more need for recognition of their contributions and tribulations must be given. By advocating for increased support, enhanced financial backing, and inventive solutions, we can uplift carers and ensure their endeavours do not remain obscured. With the collective resolve of government bodies, stakeholders, businesses, and the populace, we can pave the path to a brighter, more nurturing future for carers and their cherished ones.

Categories : Hospitals Medical IndustryTags :

Hospice Palliative Care Association Rebrands as the Association of Palliative Care Centres

On By ModernMedia

As of the 1st of September 2023, the Hospice Palliative Care Association (HPCA) is known as the Association of Palliative Care Centres (APCC).

“This rebranding is not just a visual change,” says Ewa Skowronska, CEO of the APCC. “It is an important message to all medical professionals and the public that our members (many of whom still refer to themselves as hospices) offer quality, specialised and expert palliative care services. Too many people equate hospice with end-of-life only and many medical professionals refer very late. This leads to thousands of patients, and their loved ones, missing out on the holistic support that palliative care provides – support that, ideally, should be from diagnosis of a life-threatening illness and not solely in the last few days of life.”

The rebrand includes a new logo element that reflects that palliative care can be provided alongside curative treatments and into end-of-life care, including bereavement support (if needed). 

“Our members adhere to the Standards for Palliative Healthcare Services, 4th edition, 2020 approved by the Council for Health Service Accreditation of South Africa (COHSASA) and the International Society for Quality in Health Care (ISQua),” says Leigh Meinert, Advocacy and Operations Manager of APCC. “This is important as sometimes there is a perception that our members are only servicing patients who do not have private healthcare support and might not be at the same level as private organisations. In reality, they have decades of palliative care experience, and compliance with these Standards ensures an ongoing level of excellence.”

As much as 90% of APCC member’s services are provided to the patient in the comfort of their own home. The patient’s loved ones are also supported by way of an interdisciplinary team. Such a team typically consists of a medical doctor, nurse, social worker, and home-based carers who can work alongside the patient’s healthcare professional and support quality of life.

Palliative care covers conditions such as HIV/AIDS, drug-resistant TB, chronic respiratory diseases, cardiovascular and neuromuscular diseases, MND and more. “Both adults and children are catered for,” says Meinert. “While patients can move in and out of a palliative care service, they may remain beneficiaries of the services for as long as they (or their loved ones) need or wish to.  Patients may be discharged from the service if they are doing well and able to function independently.  This is always negotiated between the patient, family, and members of the care team. We encourage patients to engage with an APCC member from the point of diagnosis as this helps to dispel fears and provides insight into the holistic services that can be offered. We believe that all patients have benefitted from an improved quality of life through the supportive care received from APCC members.”

“APCC has a cloud-based patient care monitoring, evaluation and reporting system able to report in detail on interventions given to any patient,” says Skowronska. “Our members are comfortable working alongside the primary clinician or specialist.  They can provide a supportive extension of care to the patient and their loved ones and, in most cases, the APCC members inter-disciplinary teams collaborate and work alongside the referring doctors who are treating the patient. They also provide supportive care to the patient’s loved ones. This may include advanced healthcare planning, as well as psychosocial and spiritual support.” 

“Our palliative care definition says it all,” concludes Meinert. “Palliative care is the physical, psychological, social and spiritual care provided by an interdisciplinary team of experts to anyone with a life-threatening illness and their loved ones. Care is offered from the point of diagnosis and extends to bereavement support if needed. Over 90% of the care that APCC members provide is home-based with a focus on promoting quality of life.

We sincerely hope that this rebranding results in more people receiving the support that they so desperately need during some of the most difficult times in a person’s life.”

For more info, visit www.apcc.org.za