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Eerste Rivier Hospital Exceeding Expectations in Public Health Care

When driving to state run Eerste Rivier Hospital, one hardly expects to find a hospital on the forefront of innovation, least of all with a holistic health mindset.

For its first 18 months, the hospital was privately run, but for the past nine years has been managed by the state. As opposed to many government-run hospitals that are infamous for their long queues, for example, Eerste Rivier’s waiting area is relatively empty by 11am.

Under the guidance of Chief Executive Officer Dr Timothy Visser, Eerste Rivier Hospital now renders services that one would not expect from a district level hospital like acupuncture, which is sometimes administered by the CEO himself. Traditional services like physical therapy, social services, psychiatry, psychology and even a life skills coach are offered. In addition, a reward group or Adherence Club, encourages antiretroviral-using patients to take their medication regularly.

“We tend to look at the reason behind the ailment,” says Mr Luigi Heynes, who is responsible for revenue generation, security, telecommunications, reception and admission services. This aids medical personnel in their preventative approach even though it may seem contradictory to the way the hospital’s success is measured, namely by occupancy. The amount of beds filled determines the amount of staff employed and for the past two months this 90 bed hospital has run at a 110% occupancy.

Success is measured financially as well. Last year the departmental goal for Eerste Rivier was R1.7million, however management were able to surpass their own personal goal of R2.2million. One of the reasons for this is that this hospital is pioneering green solutions. It has managed to reduce its electricity usage by 47% through simply changing insulation on water pipes and is also looking at using solar power in the near future. Furthermore, the kitchen waste is made into fertilizer and used in the hospital’s own garden.

The biggest secret to the hospital’s success however, possibly lies in its yearly themes like “Think for a change”, “Exceeding expectations” and this year’s, “Shift happens”. Heynes says these themes have become his personal credo.

Eerste Rivier Hospital enjoys close links to the Aravind Eye Hosiptal in India, one of the largest facilities in the world for eye care. Local doctors and nursing staff are sent to Aravind for training and apply what they have learned upon their return. These teachings include streamlining operations in Eerste Rivier so that doctors operate on two cataract patients simultaneously. This is very effective, cutting costs, increasing the amount of patients that can be attended to and it also reduces waiting time for new patients. The state sets a benchmark for the amount of cataract surgeries to be administered in a given area and Eesrte Rivier has now become a large contributor.

“We don’t patch up and pass on” says Heynes.  This is very evident in the E-ward or Medical Recovery Ward, which is also used for substance abuse addicts and the mentally disturbed. It is not a psychiatric unit, but by law hospitals must observe a patient for 72 hours before referring on to a psychiatric facility. When no beds are free in the relevant hospital, patients are kept in the E-Ward until a suitable alternative becomes available. In addition, a security guard is always on duty in this ward due to the sometimes aggressive nature of a few patients.

Eerste Rivier is generally not an affluent community. It is a place where gang violence, substance abuse and poverty play a major role. Ironically Eerste Rivier Hospital treats many private patients who prefer its high quality of treatment. “People are beginning to realise that they are entitled to quality health care and service. When they see the food everything changes completely,” jokes Heynes, “so many are not aware that the hospital is no longer privately owned”.

Wellness days informing the public of services offered take place annually with stalls to educate the community on a healthy lifestyle and diet. On a rate-your-hospital website, one patient posts, “Very clean and well maintained – staff is (sic) very professional and friendly!”

With Eerste Rivier setting such a shining example of the potential for state hospitals in South Africa, perhaps the time has come to feel hopeful about our public health care system.

Aravind Eye Hospital, India: //www.aravind.org/

Image 1: Waiting room
Image 2: Healthnet transports some patients free of charge
Image 3: Entrance to Eerste Rivier Hospital

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