Abstract
BackgroundIn 2016 the Gauteng Department of Health engaged University of Pretoria Family Medicine to provide` education, training and information and communication technology support for the phased scale-up of ward-based outreach teams (WBOTs) through community-oriented primary care (ICT-enabled COPC). As in all service delivery, quality assurance is essential. In contemporary best practice, it brings together peer-to-peer learning and quality improvement (QI) in what is termed here as peer-learning reviews (PLRs).AimTo assess implementation fidelity and assure the quality of community-based healthcare services.SettingThis study was conducted in two districts of Gauteng province, South Africa.MethodsA 3-day PLR of paired WBOTs was conducted by multi-disciplinary teams of academics, partners and site-selected healthcare practitioners. Guided by a benchmark survey distilled from the seven COPC practice elements, they conducted individual interviews, accompanied WBOT members in field and facilitated solution-focused peer exchange workshops with all participants.ResultsAt all sites there was clear evidence of achievements and practical challenges with respect to mapping; support, networks and partnerships; infrastructure and functional equipment; work integrated learning; data and service activities; and performance status and management. Methodologically, PLRs supported inclusive, context-specific learning for all along the healthcare service pathway. They generated action plans derived from shared understanding and joint decision-making.ConclusionThe PLRs and the implementation results demonstrate the importance of structuring learning into service and research. Both helped develop participants’ abilities to understand what they do, do their work, grow their sense of self-worth and improve their relationship with others.
Highlights
In 2016 the Gauteng Department of Health engaged University of Pretoria Family Medicine to provideeducation, training and information and communication technology support for the phased scale-up of ward-based outreach teams (WBOTs) through community-oriented primary care (ICT-enabled COPC)
The results show that peer-learning reviews (PLRs) are able to generate a rich and multi-layered understanding of what it means to deliver healthcare services to people in their homes in the existing public primary health system
The PLR process and the implementation results demonstrate the importance of structuring learning into service and research
Summary
In 2016 the Gauteng Department of Health engaged University of Pretoria Family Medicine to provideeducation, training and information and communication technology support for the phased scale-up of ward-based outreach teams (WBOTs) through community-oriented primary care (ICT-enabled COPC). The success of healthcare reform in South Africa[1] hinges on services that can respond to the complexity of health in context.[1,2] A system that is functional, provides quality care and is universally accessible needs to integrate healthcare from the home to and from health facilities through levels of services and across public, private, non-governmental and traditional sectors.[3] Guided by community-oriented primary care (COPC), services should be rendered by multidisciplinary teams of healthcare professionals and workers informed by the best available practices and knowledge. Workplace learning is structured into the service pathway through information technology (IT) as well as organised curriculation in order to continuously develop the individual and collective capacity of healthcare providers
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