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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 cross-divisional 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
Regional hospital (1.2m population)
OBGYN- PaediatricianFacility based
District hospitalFamily physicians
Facility based
MOU PHC CHC
PHC outreach teams
Families at home
Provincial specialist
OBGYN/MidwifePaediatrician/Paediatric nurse
Anaesthetist
Family Physician/PHC Nurse
Primary focus
Secondary focus
Ministerial Task Team Report: 2011
Medical and nurse specialistsPresentation to National Health Council 8/2011 on DSCT roles
Doctor job description:
General –
Promote equitable access and appropriate care
Assist with strategic & operational planning
Co-ordinate, monitor , support discipline related services
Maintain competency in the discipline
Nurse job description:
General
Promote the provision of appropriate primary prevention, promotive and curative health care services
Assist with strategic & operational planning
Clinical leadership & support in the functional areas of expertise
Medical and nurse specialistsDoctor job description:
Facility support -
- Clinical focus - packages, outreach & participation
Organisational support –
- Infrastructure , equipment & resources
- Staff development, support
Nurse job description:
Facility support -
- Clinical focus - packages, outreach & participation
- Policies & protocols
Organisational support
- Infrastructure , equipment & resources
- Staff development, support
- Unit systems & management
Medical and nurse specialistsDoctor job description:
Systems and logical support
- Information, referral and surveillance
M & E
- Quality improvement programmes and reporting systems
- Mortality audits
Nurse job description:
Systems and logical support
- Information, referral and surveillance
M& E
- Quality improvement programmes and reporting systems
- 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?
Accepted
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