African Partnerships for Patient Safety: safer care through international partnerships

Kisiizi hospital, Uganda, now has its own infection control professional with the support of African Partnerships for Patient Safety, a WHO programme.

January 2013

Infection control nurses Samantha Walker, from Chester, and Moreen Ahimbisibwe, from Kisiizi, discuss ways to improve hand hygiene compliance in health workers.
APPS Chester-Kisiizi hospital partnership

The Church of Uganda Hospital, Kisiizi, is a 250-bed general hospital in the highlands of south-west Uganda, a 7-hour journey by road from the capital city of Kampala.

Just two years ago, patient safety was an obscure concept that was almost impossible for hospital staff to apply when faced with practical realities. Infection control was extremely challenging at this remote hospital without a reliable supply of alcohol-based hand rub. Dirty laundry was cleaned by hand. Incinerators were not tackling waste safely.

Now, Kisiizi hospital has its own infection control professional, the first in the country, and all staff, including laundry staff and maintenance teams, know what they can do to prevent infection and provide safer care. The Medical Superintendent of the hospital has been recognized by the Ugandan President for hospital-wide efforts in improving patient safety in health services across the country.

Serious problem, rapid action

This rapid transformation has taken place with the support of African Partnerships for Patient Safety (APPS), a WHO programme that has paired 14 African hospitals each with a hospital in England, France or Switzerland.

Infection control nurse Samantha Walker from Chester works with the pharmacy team at Kisiizi Hospital.
APPS Chester-Kisiizi hospital partnership

The programme was established in 2009 in response to a call from 46 ministers of health in WHO’s African Region for urgent action to address “the serious problem of patient safety”.

Today WHO’s Patient Safety Programme has launched a “resource package” so that any hospital, whether in Africa or other developing country setting, can set up their own partnership with another hospital to improve patient safety.

Kisiizi Hospital is paired with the Countess of Chester Hospital in England, one of the first partnerships established by the programme. The hospital now makes its own alcohol-based hand rub from the local banana supply, has built two incinerators for waste management and has a new industrial washing machine purchased with funds raised by the APPS team lead in Chester. Hospital infection rates have fallen and, perhaps most importantly, are tracked over time.

While the hospitals are using WHO’s tools to increase the safety of patients, they also have the flexibility to make adaptations necessary for their situation. For example, when the hospital adapted WHO’s Surgical Safety Checklist for use in the local context, they felt one step was missing. At this faith-based hospital, staff pray for each patient before starting surgery. Dr Tonny Tumwesigye, Medical Superintendent, says that it was important to add the question “Has the team prayed for the patient?” to WHO’s checklist to help health workers to accept the checklist as their own.

Two-way learning

Two nurses practice good hand hygiene at Kisiizi Hospital, Uganda.
APPS Chester-Kisiizi hospital partnership

Although the main aim of the programme is for staff from the European hospitals to provide knowledge and experience to support their African partner hospital in providing safer health care, the programme has proven to be mutually beneficial for staff on both sides. “Sharing and learning flows in both directions,” says Sarah Hoyle, programme lead at Chester. “We have learned a lot from working with our colleagues in Africa. In particular, this has focused competencies in team work, communication skills as well as problem solving. Further, a renewed energy for change at Chester can be seen based on the observable change in infection control systems at Kisiizi.”

In addition, in five visits to Kisiizi, infection control nurse, Samantha Walker, has vastly improved her knowledge of tropical medicine and diseases, as well as developed leadership skills, through her work with Kisiizi Hospital. “The experience at Kisiizi has been profound and has shaped who I am and the way that I work,” she says. “Pathology, problem solving and patience!”

Pioneering patient safety across Africa

The African Partnerships for Patient Safety programme is not limited to improving patient safety just in the selected hospitals but is deliberately designed to build on the momentum and lessons learned to expand the work to other health facilities and communities in that country and across the African region. Already, the programme’s success has generated political interest and has stimulated national patient safety policy dialogue in more than 10 countries.

“The way forward for patient safety in Africa will be informed by the pioneering work of these partners in strengthening patient safety,” says Dr Shams Syed, who oversees the programme at WHO.

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