Doctor job description

Roles of the DSCT team members Review of documents available

Who is this new kid on the block?

Reason for the DSCT existence: “ To ensure equitable access to appropriate and improved quality of care for mothers, newborn babies and children. Responsible for clinical governance and skills development. “

Primary role and focus of the DSCT specialist “The primary role of the District Clinical Specialist is supportive supervision and clinical governance and not the direct delivery of clinical services.” “The specific focus of the DSCT is maternal and child health.” DSCT’ s in South Africa : Ministerial Task Team Report 2012

Clinical governance:  To provide the means of developing the organisational capability to deliver sustainable, accountable, patient focused, quality assured healthcare.  '... a framework through which organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.' (Donaldson and Gray, 1998).  It's about everything we do to improve the quality of care that people received from us', '...It's everyone business

Authority of the DSCT: “ The

authority of persons occupying DSCT posts will arise partially from the posts themselves , but more so from their individual credibility based on their knowledge and experience.” DSCT’ s in South Africa : Ministerial Task Team Report 2012

Management style  Old – functional management with beaurocratic structures  New – Matrix management

“In matrix management, leaders suddenly find themselves having to master the challenges of managing crossdivisional teams over whom they have little formal authority.” “.organizational management in which people with similar skills are pooled for work assignments.”

Matrix management

Advert for DSCTposts – 1. Knowledge  Own clinical discipline, legislation , regulations and policy  QA , programme planning, implementation and evaluation  Information management  HR and financial management

2. Skills:  Leadership  Communication  Problem solving  Computer literacy

and the following attributes - self confidence objective, ethical and empathetic

3. Key performance areas (KPAs)of DCST:  Deliver quality health care for mothers, new born and children at district level  Promote equitable access to the appropriate levels of care  Up to 10% of time in clinical care and 10% in research – to maintain competency. (80% in district)  Support service delivery a/c discipline at district facilities  Promote clinical effectiveness at facilities – outreach, protocols etc

KPAs continued:  Logistics: work with DMT to establish and maintain systems, surveillance, health information, communication, referral guidelines. Ensure appropriate infrastructure and resources  Monitoring and evaluation: Critical event analysis, morbidity and mortality meetings/audits  Reporting effectively : to DSCT, community, NGOs, to management structures.

JOB DESCRIPTION SPECIALIST DYADS Ministerial Task Team Report: 2011 Regional hospital (1.2m population)

OBGYN- Paediatrician Facility based

District hospital Family physicians Facility based

MOU

PHC

CHC

Provincial specialist

OBGYN/Midwife Paediatrician/Paediatric nurse Anaesthetist

Family Physician/PHC Nurse

PHC outreach teams

Primary focus Families at home

Secondary focus

Medical and nurse specialists Presentation to National Health Council 8/2011 on DSCT roles

Doctor job description:

Nurse job description:

 General –

 General

 Promote equitable access and appropriate care

 Promote the provision of appropriate primary prevention, promotive and curative health care services

 Assist with strategic & operational planning  Co-ordinate, monitor , support discipline related services  Maintain competency in the discipline

 Assist with strategic & operational planning  Clinical leadership & support in the functional areas of expertise

Medical and nurse specialists Doctor job description:

Nurse job description:

 Facility support -

 Facility support -

- Clinical focus - packages, outreach & participation

- Clinical focus - packages, outreach & participation - Policies & protocols

 Organisational support –

 Organisational support

- Infrastructure , equipment & resources

- Infrastructure , equipment & resources

- Staff development, support

- Staff development, support - Unit systems & management

Medical and nurse specialists Doctor job description:

Nurse job description:

 Systems and logical support

 Systems and logical support

- Information, referral and surveillance

- Information, referral and surveillance

 M&E

 M& E

- Quality improvement programmes and reporting systems

- Quality improvement programmes and reporting systems

- Mortality audits

- Appropriate mortality audits

Group activity:  What is the role of the DCST in the district - go beyond objectives and to state practical priority functions  How is the role of the DCST different from other stakeholders on the district management team eg the district managers, MCH and PHC programme managers, operations managers, coordinators and information officers?  How do you give the DSCT posts authority?  How have you managed these roles thus far? What factors have helped hindered this?

Do we know who we are? Accepted

Making a difference together