The Hospice Palliative Care Standards have been with us for a number of years now.
I have been privileged to have been connected to these standards in some way since they were first rolled out to the various Hospices in South Africa in 1998 (when they were known as ‘Standards for the Provision of Palliative Care in Hospices).
I have witnessed the evolution and development of these standards over time and how they have to a greater or lessor extent had an impact on various Hospices. There has been the outright rejection of the need for these standards all the way through to the passionate embracing of them as key for the future development of Palliative care as well as it delivery. I find myself in the passionate embracing camp.
Currently, as CEO of Msunduzi Hospice, I am fortunate to be part of a wonderful governance and leadership team who also embrace the need for the Palliative Care Standards and can see their value. I have always been transparent in my enthusiasm for these standards. Msunduzi Hospice has been continually accredited by Cohsasa since August 2009 (at least as far as I can go back), and we are currently at the mid-point of our first 4 year accreditation cycle. Being able to use and proudly display our external accreditation status has been immensely helpful in maintaining relationships with a number of funders as well as developing lasting networks with others. Having an external accreditation status is something that not many (if any) other NPO’s can boast about and we should be boasting about it.
As a requirement of our current accreditation we were subject to an interim survey in early February. This was conducted by Cohsasa and went very well. As I had never participated in an interim survey before, I did not have much feel for what would be happening and how the assessment would take place. My thanks to Cohsasa for all the assistance they provided and for the surveyor who was very approachable and open to comment and suggestion. On the whole the interim survey was a wonderful experience for our organisation, our leadership team and for me personally. The focus of the interim survey was on processes and systems. In particular Risk and Quality systems. About tracing issues through the entire organisation and not dealing with issues in silos. About the marriage of care and administrative systems and the need for both. Quality Improvement activities, audits and assessments and the impact of these activities and their measurement and recording. I find it difficult to put this into words, but the interim survey focuses on the wholistic bigger picture and we, as a site and we as Hospices in South Africa, need to move away from navel gazing to see this bigger picture. How care links to management, how networking links to care and sustainability. How Quality systems are a means to sustaining the entire system of care. I trust we can get there? There is a phrase from Galileo Galilei – ‘Measure what is measurable, and make measurable what is not so.’ The Palliative Care standards give expression to this. We measure what we do and we make measurable those aspects of our programme that seem to be beyond measure.
Currently the 3rd edition of the Palliative Care standards is begin reviewed. I am part of the team involved in the review of our standards and it is exciting to see how the themes spoken of above are finding their way into the next edition of the standards.
The often repeated challenge levelled at the Palliative Care Standards is that the time and effort that needs to go into them does not translate into funding for the individual Hospices. I beg to differ on this matter. The time and effort that goes into developing and implementing policy and procedures that give expression to the Palliative Care Standards has a direct relationship with the sustainability of Msunduzi Hospice. It is these standards that guide the policies that guide the care that we provide. It is these standards that ensure that we provide Quality Palliative Care for all our patients and their families. It is this care that we market to our community and to our potential funders. It is this care that directly results in the income from numerous private and corporate funders. It is this care that speaks so highly to the Department of Health and ensures that we are reliable partners in efforts to increase the footprint of Palliative Care in South Africa. It is the standards that set the goal post for all our systems and processes. It is the standards that enable us to be measured (externally by Cohsasa) and to proudly say that we are accredited. Without them, there would be no measurable Quality Palliative Care. We proudly measure what we do and boast about it as well. The standards are about our care and our sustainability.
For all Hospices in South Africa, time and resources spent on compliance with the standards and using the Self Assessment Tool (make enquiries with HPCA) are not wasted. The fruit will be harvested.
To learn more about Msunduzi Hospice and the work they do, click here