It is a not for profit organisation that exists solely to further the interests of its member hospitals. To this end HASA involves itself with national and provincial forums of the Department of Health, as well as their related committees and personnel. We welcome you to our new website.
The South African Society of Anaesthetists provides the following six guidelines regarding the responsibilities of anaesthetists towards intubated patients in the recovery room:
The responsibility of the maintenance of a safe airway up to the point of full recovery rests with the anaesthesiologist.
As a general rule standards of quality care demand that the anaesthesiologist responsible for an intubation should personally extubate the patient.
There are circumstances where a patient can be held in the recovery area while still intubated.
The anaesthesiologist should not leave the institution while the patient is intubated unless a competent colleague or an intensive care unit has assumed responsibility for the airway.
The anaesthesiologist should not commit to other duties (including another anaesthetic) when the patient requires an endotracheal tube for the maintenance of a safe airway in the recovery period - unless a suitably qualified person is immediately available to deal with any complications relating to the airway.
Recovery room nursing staff are entitled to refuse to accept responsibility for the care of a patient if they are inadequately trained or experienced in the management of complications relating to an endotracheal tube.
Doctors working at private hospitals are in private practise and are
not employed by the hospital. Although private hospitals want the best
surgeons possible working at their hospitals, they cannot be held
responsible for the actions the doctors. Doctors in private practise
are legally and professionally responsible for their own actions. If
you believe that the doctor acted negligently or unethically, you can
ask the Registrar of the Health Professional Council to investigate the
action of the doctor. You could also contact a lawyer to determine
whether you could bring a civil action against the doctor.
Although most private hospitals charge according to medical aid rates,
it may be that your medical scheme does not agree to pay for certain
items. The hospital will be acting within its legal rights to bill the
balance owing directly to you. The contract for the payment of the
hospital bill exists between you and the hospital, not between the
hospital and the medical scheme. Because most hospital bills are
settled in full by the respective medical schemes, most patients never
become involved in the settlement of the bill.
It is not advisable to give clients a ‘quote’ on what the cost of the procedure will be as there are too many variables related to different surgical techniques, time in theatre, use of endoscopic equipment, complications, co-morbidity and length of stay.
It is thus important to tell the client that only an estimated average price can be provided based on an average time in theatre plus an average length of stay, with no complications or co-morbidities. In the case of fixed fees per procedure or a daily or per diem rate it is easier to provide a more accurate costing estimation.
Explain very clearly that the estimated price does not include the surgeon’s fees, the anaesthetists’ fees or laboratory, physiotherapy and radiology fees. It also does not take into account a longer time in theatre or hospital and does not include the cost of any additional procedures or medication.
HASA receives frequent complaints from patients relating to quoted amounts having been exceeded. This situation can be avoided through better communication.
Often a problem arises when the surgeon neglects to inform the patient of the full details of the procedure or that the procedure will be performed endoscopically. It is always best to obtain the ICD10 Codes from the doctors before doing a costing.
Other important cost variables are the use of expensive skeletal fixators, vascular catheters and equipment.
Much unnecessary client dissatisfaction and negative word-of-mouth can be avoided by not giving quotes and by carefully explaining the basis used to calculate estimate costs.
The responsibility for obtaining pre-authorization for admission to a hospital for a specific diagnosis or procedure rests with the medical scheme member or patient. This authorization should be granted in writing with an authorization number being provided, the name of the person granting the authorization, the procedure or diagnosis and the approved length of stay.
In the event of an emergency admission the responsibility still rests with the patient or medical scheme member. If no pre-authorization is done, the patient will be admitted as a private patient. If a request for an increase in length of stay or level of care is denied by the medical scheme, the patient will also revert to a private account.
In many instances hospital staff do become involved in obtaining authorization, as a service to their clients, but the ultimate responsibility rests with the medical scheme member. It is imperative for all patients to sign the admission contract which states that the patient or guarantor remains responsible for any amount owed to the hospital or not reimbursed by the medical scheme.
South African nurses have been sought after internationally for decades due to our high standards of theory and practice. South Africa was the first country in the world to legislate nurse training and practice, thereby setting, maintaining and controlling standards. Every nursing course was centrally examined and registered, enrolled or certificated by the S.A. Nursing Council as a quality control measure. This also served as an international “branding of the product.” - Trudy Petersen: Group Nursing Coordinator – Life Path Health Group. (R.N., R.M., D.P.N., D.C.H.N., D.N.E., D.N.A., Adv.D.P.N.)
The Hospital Association of South Africa is a non-statutory body; the Association will gladly act as a mediator and will investigate an incident on behalf of a patient, or relative.
