CO-CREATION
How collaboration created clarity for the path ahead
A mutual effort
SafeCare’s contribution
Developed in 2011, SafeCare’s standards are internationally accredited. They cover the full range of medical and non-medical aspects of care that have a direct impact on patients.
The standards are intended for all types of healthcare facilities, from small clinics to large district hospitals in resource-restricted settings. They address the challenges relevant to these facilities, while securing quality-of-care delivery in line with international expectations.
In addition, SafeCare’s model uses a stepwise approach to enable healthcare facilities to work at their own pace and gradually improve systems and services. Digital tools and resources support the facilities as they embark on a continuous quality improvement journey. Each step enables facilities to take ownership of their improvement, with the security of internationally accredited advice.
The stepwise approach
Making quality improvement sustainable & approachable
Level 1 Facility has identified quality gaps in its services. It is taking steps to improve them, but the risk of unsafe situations is still high.
Level 2 Facility is starting to create consistency in processes and procedures. There are still risks of unsafe situations, but quality is improving.
Level 3 Facility operates well, with structured processes and procedures. But it still has some work to do on the more high-risk procedures.
Level 4 Facility staff is growing accustomed to working with structured processes and procedures, and they are monitoring quality regularly. Quality of care is stable and standardized.
Level 5 Facility staff can now guarantee a consistent quality standard of care. They regularly monitor and improve processes and procedures for even higher quality
Standards as starting point
Making quality improvement sustainable & approachable
Zanzibar officials used the SafeCare standards as a starting point and:
- thoroughly compared it with the best practices and guidelines already in use,
- created further alignment and buy-in by organizing workshops for subject experts and quality officers at district levels, representatives of vertical programs, and lab and diagnostic experts,
- eliminated uncertainties through SafeCare’s comprehensive assessment guidelines, and
- aimed to include both public and private facilities to ensure consistency of care throughout the entire healthcare ecosystem.
In 2020, the Zanzibar Ministry of Health officially approved the Zanzibar Performance Rating Standards and Performance Rating Tool, based on the SafeCare standards.
First baseline assessment
Training the first assessors & initial learnings
Zanzibar started by training eight quality assessors. Participants reported that the two-week field training, coupled with intense mentoring, was challenging. But everyone completed the course.
The most competent assessors were put to work immediately to evaluate 44 facilities and provide early support.
Assessors initially worked in their own locations to limit travel costs. However, for the follow-up assessment, the assessors were sent to a different facility to ensure they weren’t re-evaluating a facility for which they had been providing technical support during improvements. This increased objectivity.
Six quality gaps identified*
Zanzibar initial assessments results
* 44 facilities
Facilities with available triage systems
Required to immediately identify severely ill patients.
Facilities with proper labelling of laboratory specimens
Ensures correct lab testing.
Facilities with waste management compliance
Prevents injuries among medical staff.
Facilities with available resuscitation training and equipment
Required to resuscitate in acute respiratory and cardiac conditions.
Facilities with compliance with protocols and guidelines
Prevents mistakes in the health care process and actions.
Staff performance review
Helps with staff development and capability-building.