Browsing by Author "Bresick, Graham"

Now showing 1 - 5 of 5
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    Alignment between chronic disease policy and practice : case study at a primary care facility
    (2013) Draper, Claire Anne; Draper, Catherine; Bresick, Graham
    Current literature supports the need to make the prevention and management of chronic diseases an international health priority. In South Africa, our Health Minister has committed the government to tackling the burden of chronic diseases alongside communicable diseases. The Western Cape has developed an excellent policy and framework to guide and improve the prevention and management of chronic diseases at a primary care level, however limited literature exists around the alignment of the policy with current practice and around any challenges to its implementation. Should the policy be well implemented, it has the potential to make a significant difference to the health of the population served. For this reason, the overall purpose of this study is to improve the care and management of patients with chronic diseases within primary health care facilities. The aim of this study is to assess the alignment of current primary care practices with the PGWC Adult Chronic Disease Management policy (which includes an audit tool), using one primary health care facility in the Cape Town metropolis as a case study.
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    Baseline measures of Primary Health Care Team functioning and overall Primary Health Care performance at Du Noon Community Health Centre
    (2017) Mukiapini, Shapi; Bresick, Graham
    Background: The importance of effective team work for improving quality of care has been demonstrated consistently in research. We conducted a baseline measure of team effectiveness and a baseline measure of primary health care performance. Aim: To improve Primary health care team effectiveness and ultimately the quality and user experience of primary care at Du Noon Community Health Centre. (CHC) Setting: Du Noon CHC in the southern/western substructure of the Cape Town Metro district services. Methods: A cross sectional study using a combination of Nominal Group Technique (NGT) method and a questionnaire survey to assess PHC team effectiveness and to obtain baseline measure for Primary Health Care (PHC) organization and performance. Results: Data from 20 providers from the primary health care team, showed that the PHC team members perceived their team as a well functioning team (70% agreement on the 7 items of the PHC team assessment tool, incorporated in the ZA PCAT. The NGT method reveals that communication and leadership are the main challenges to effective team functioning, The NGT also provides ideas on how to deal with these challenges. Data from 110 users and 12 providers using the ZA PCAT: 18.2% of users rated first contact-access as acceptable to good; 47,3% rated ongoing care as acceptable to good. The remaining subdomains of the ZA PCAT were rated as acceptable to good by at least 65% of the users. 33% of the providers (doctors and clinical nurse practitioners) rated first contact-access as acceptable to good; 25% rated ongoing care as acceptable to good, the remaining subdomains of the ZA PCAT were rated as acceptable to good by at least 50% of providers. First contact-access received the lowest acceptable to good score (18.2%) and comprehensiveness (service available) received the highest score (88.2%) from the users. For the providers the lowest acceptable to good score was for ongoing care (25%) and the highest acceptable to good score was for primary health care team (100%). The total primary scores are good (above 60%) for both users and providers but moderately higher for the providers. Conclusions: How teams perceive their effectiveness can motivate them to generate ideas for improvement. There were discrepancies between ZA PCAT (PHC team functioning) results and the NGT method results. The ZA PCAT (8 pre-existing domains) baseline results show a contrast between providers' and users' perceptions of the PHC system at Du Noon consistent with the finding of the Western Cape ZA PCAT study. We encourage Du Noon CHC to use these results to improve the user experience of primary health care services there.
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    Is it just the prayer? : Determining and exploring patients' reasons for choosing a faith-based primary health clinic over their local public sector primary health clinic
    (2016) Porter, James Dudley; Bresick, Graham
    Background: Person-centred, re-engineered primary health care (PHC) is a national and global priority. Faith-based health care is a significant provider of PHC in Sub- Saharan Africa but there is very limited published data on the reasons for patient choice of faith-based health care, particularly in South Africa. Aim: The objective of this study was to determine and explore the reasons for patients' choice of a faith-based primary care clinic over their local public sector primary care clinic. The secondary objective was to determine to what extent demography influences reasons for patient choice. Setting: The study was conducted at Jubilee Health Centre (JHC) a faith-based primary care clinic attached to Jubilee Community Church in Observatory, Cape Town, South Africa.
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    Preparedness for Paediatric CPR amongst Doctors in Cape Town
    (2022) Amien, Nabeela; Bresick, Graham; Evans, Katya
    Background: CPR is the principal medical intervention used to reduce the high mortality associated with cardiorespiratory arrest. There is a paucity of literature on the preparedness for paediatric CPR (pCPR) amongst doctors in Cape Town. The study aimed to assess the preparedness for pCPR of doctors working in Western Cape Provincial Government primary healthcare facilities (PHCFs) in Cape Town with regard to knowledge, confidence and doctors' knowledge of equipment availability. Methods: A cross-sectional descriptive-analytic study using a self-developed questionnaire to collect quantitative data from a sample of 206 doctors working in Cape Town PHCFs. Results: 173 doctors (84% response rate) completed the questionnaire. The majority (81.8%) had not done a pCPR course (Paediatric Advanced Life Support or Advanced Paediatric Life Support). 88.3% had done Basic Life Support; 28% >2 years ago. The average pCPR knowledge score was 61% (SD=20.3, range 8.3-100%). Doctors doing their community service and internship had significantly higher knowledge scores compared to Grade 3 medical officers (p = .001 and .010 respectively). 11% had performed pCPR >10 times in the past year; 20% had never performed pCPR, and 35% did not feel confident performing pCPR. More than 35% of doctors were uncertain about the availability of equipment in their facility. Conclusion: Doctors working in Cape Town PHCFs are poorly prepared to perform pCPR. Doctors' knowledge of pCPR and availability of equipment is inadequate and confidence in their ability to perform pCPR is low. Formal pCPR training and education on equipment location and availability is recommended.
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    A study of continuity in Cape Town community health centres
    (2005) Bresick, Graham; Ehrlich, Rodney
    This study sought to determine: i) the extent of continuity in Cape Town public sector clinics; ii) patients' views of continuity; iii) senior managers ideas of how continuity can be improved; iv) clinical managers' views of a proposed practice team model to improve continuity. Continuity, defined as present if patients saw the same doctor for at least 80% of visits in a 2 year period, was present for less than 9% of patients.