the 20th Annual CPSI Public Sector Innovation Awards 

The 2022 edition of the Annual Public Sector Innovation Awards, the 20th to date, was hosted by the acting Minister for the Public Service and Administration on  on 25 November 2022.  Category C winning innovation, HECTIS, was also awarded the coveted 2022 Innovator of the Year Award.

Congratulations to all the winners and finalists!

CATEGORY A: Replication and Adaptation of an Innovative Solution

Winner: BOMIS (Bophelong Management Information System), Free State
The project repurposed existing platforms to manage COVID-19 data. End-point devices (smartphones, tablets, laptops) were provided to various staff to ensure electronic data capturing at the point of care which enabled near real-time access to critical data. The urgency brought by Covid-19 allowed for the adoption of digital health technologies, which under normal circumstances are very difficult to implement.
The outbreak management system can in future be used for any outbreak, to improve data collection in communities, making evidence based decision making a reality.

First Runner-up: Year Beyond Home Learning Programme, Western Cape

The Programme seeks to leverage the intersection between unemployed youth and the education needs of our learners.
It comprises of 5 key elements, namely homework support, gateway language and numeracy skills support, home visits, parent/caregiver workshops and community education activations. Secondly, it uses unemployed youth to do the work whist the youth are also provided with opportunities to find their passions, improve their CVs, build their economic networks and become economically active. Each young person in this programme is further supported by a mentor.
The programme is currently servicing over 300 unemployed youth, about 2800 at-risk learners, 53 schools and 20 000 plus learners across these schools in 18 communities.

Second Runner-up: Global Green and Healthy Hospitals at Bongani Regional Hospital 
Climate change, chemical contamination, water, waste and air pollution are all exacerbating diseases the world over. These environmental health problems are increasing the pressure on and eroding the capacity of already thinly-stretched healthcare systems. The Global Green and Healthy Hospitals (GGHH) is a worldwide network which aims to create an international community of hospitals, health systems and organisations dedicated to reducing their ecological footprint and promoting public and environmental health. GGHH is the largest sustainable network in the world, focused on the interests and needs of healthcare sustainability practitioners. The network represents interests of hospitals, health systems and health organisations committed to reducing the health sector’s environmental footprint and advocating for policies that promote environmental and public health. The GGHH is addressing healthcare challenges by using innovation, ingenuity, and investment to transform the health sector and create a healthy future for people and the planet.
GGHH membership is growing (over 1,650 members in 81 countries who represent the interests of more than 60,000 hospitals and health centers) and this tells us that health care institutions the world over are finding the network as an important resource in their sustainability journey. It is also a key indicator that this journey and engagement in sustainable, climate-smart health care is expanding and entering the mainstream on every continent.

The health sector leaders have evolved the Hippocratic Oath of “First Do No Harm” beyond the immediacy of the doctor-patient relationship to incorporate a more global vision of health and sustainability. Whether working to substitute hazardous chemicals with safer alternatives, reduce a hospital’s climate footprint, or eliminate a community’s exposure to health care waste, these trailblazers recognise that we cannot have healthy people on a sick planet, and are putting hospitals and the health sector at the forefront of a global movement for environmental health.
Nurses, doctors, hospitals, health systems and ministries of health are increasingly at the centre of the solutions — playing leadership roles in transforming their own institutions and becoming advocates for policies and practices that promote public environmental health, while often saving scarce financial resources. A green and healthy hospital is one that promotes public health by continuously reducing its environmental impact and ultimately eliminating its contribution to the burden of disease. A green and healthy hospital recognises the connection between human health and the environment and demonstrates that understanding through its governance, strategy and operations. It connects local needs with environmental action and practices primary prevention by actively engaging in efforts to foster community environmental health, health equity and a green economy.

Third Runner-up: Hearing Aid Repairs Clinic- A walk-in service
The Hearing Aid Repairs Clinic was implemented as part of the Audiology services at CHBAH, approximately 14 years ago. The clinic is a walk-in service which occurs once a week; on a Monday. The primary goal is to assist patients with hearing device challenges.
To date, the project operates on the basis of the original framework. However, provision of this service has been adapted to be in line with the advances in hearing device technology, ongoing evidenced based audiological research, and patient centred care models.
The public health care system faces challenges that have a great impact on quality service delivery. Patients are sometimes placed on extended waiting lists in order to receive essential assistive devices that will help improve their quality of life. This challenge has also been observed in the audiology sectors across numerous healthcare institutions.
Patients previously had to endure a waiting period of 4-6 weeks before they could access audiological services. However, by making this walk-in service, it is now possible for patients to surpass these long waiting times, by allowing them to be able to freely walk-in to access audiological services without an appointment. These patients are immediately assessed and managed,thus increasing access,decreasing waiting times and improving patient outcomes.  

CHBAH is currently one of the few institutes that recognise the need to implement a walk-in service for patients with hearing device challenges. At the beginning of the global coronavirus pandemic, the South African government implemented regulated lockdown periods. Due to the restrictions, it was inevitable that patients would have limited access to services such as health care (WHO, 2020). This ignited the CHBAH audiologists to start thinking divergently, and start creating systems that would benefit patients and allow them to still access essential. Some of the adaptations made were in the field of queue management, whereby patients were given numbers in order to manage the queue. PPE & infection control policies were adhered to through the use of gloves, aprons and appropriate masks. Tele-health was implemented through remote monitoring and videos. Stock control of hearing aid devices was conducted through a newly developed spread-sheet.

The benefit of some of these adaptations resulted in patients still being able to access face to face sessions at the hospital, while using the correct PPE and infection control measures. Alternative forms of intervention were made accessible to patients through tele-health, this included videos which to aid patients to resolve minor issues with their devices when they were unable to get to the hospital due to the national restrictions. Lastly, surveys conducted with the patients who attended the clinic during this time, resulted in fruitful information and engagement that has allowed the clinicians to now extend services to include support groups and succession planning related to the future of this clinic, as well as research as this is a unique service that appears to be available currently only at CHBAH.

Category B: Citizen-Focused Innovation Harnessing non-ICT Solutions

Winner: Greenstick, Western Cape

This improvised femoral traction splint is advantageous in low-and middle-income countries as it is a suitable alternative to unavailable commercial traction splints. This is the first improvised femoral traction splint made from readily available, recyclable materials.
The improvised femoral traction splint is made from reusable and easy to build from recyclable materials. The materials needed include a discarded axillary crutch, and collar and cuff padded sling material and skin traction. Most of these materials are found at district level hospitals ensuring that the improvised traction splint can be built at any institution.

First Runner-up: Early Prostate Cancer Treatment
Prostate brachytherapy is a newer approach to treating early prostate cancer relative to the traditional methods – external beam radiotherapy or a radical prostatectomy. The procedure itself has been done in parts of the world since the early 2000s but has not been available in the public sector in South Africa particular in Gauteng. This was due to a lack of skills to do such procedures and the perceived cost of the radioactive sources or “seeds”, but with new team members joining radiation oncology, the skills to do these procedures in the public sector now exist. The procedure has been available for patients at Chris Hani Baragwanath and Charlotte Maxeke Johannesburg Academic Hospitals.
The use of Prostate Brachytherapy has considerably improved prostate cancer treatment in the Public Sector and has resulted in the following benefits:
· Reduced waiting times for treatment from up to 5 years to 2 weeks
· Procedure takes 1 hour compered to the 4 to 5 hours radical prostatectomy operation
· Savings on theatre time, hospital stay, and reduction in medical personal care time
· Reduction in costs for expensive hormonal treatment
· Patience discharged the next day after this procedure
· Success rate is at 90% of all patients treated.

Category C: Innovations harnessing Technology

Winner: HECTIS (Hospital and Emergency Centre Tracking Information System), Western Cape
The initial proposed solution was to assess the current manual paper-based registers and how it relates to the business process flow of an emergency centre patient, map it to an electronic application with additional value-based functionality for both patients and users, and lastly to iterate with Subject Matter Experts and Clinical Specialists working within the Emergency Centre environment. The HECTIS application has managed to achieve this initial brief and more.
It is currently the only e-innovation in the public sector to assist in managing an Emergency Centre and has been iteratively built with direct feedback from end-users. It, therefore, is not an adaptation or replication of an existing tool, but instead a true ground-up development with collaboration across both clinical and technical domains.
It follows the flow of a patient from the time of entry into the Emergency Care Unit until the patient leaves the unit with further capability to extend into in-patient care. It has active daily users that range from Admin Clerks, Nurses, Clinicians as well as Hospital Managers. For each user base the application provides value-based functionality for management of patients in the Emergency Care unit. This ranges from clinical decision support to automated algorithms for triage. Over and above the direct management within the emergency care unit it also provides a one-of-a-kind global view of EC pressures across the platform at a sub-district, district, or provincial level. This allows for real-time adjustment and equitable support across the acute emergency care environment.
First Runner-up: 3D Foot Scan
3D Foot Scan, Western Cape
The Innovation
Medical Orthotists and Prosthetists (MOPs) are a scarce resource with only 157 MOPs in the entire Public Service and 9 in the Western Cape. To alleviate this, consulting, diagnosis and treating patients with foot pain, health staff are now making use of a motion sensor pressure plate, 3D foot-scanner and online software when designing custom-foot orthotics helps correct and control a diversity of foot conditions. These foot conditions and foot deformities include diabetic feet and leg length discrepancies.
By using the 3D foot-scan and milling machine, the service has been extended to 92 annual Outreach Clinics. Rural patients can be reach by making use of a mobile foot pressure plate and laptop where a MOP can scan patients in a challenging rehabilitation environment, design the innersole and digitally send the file to our main centre where the manufacturing can begin whilst the clinician is on the road travelling back from the clinic.
The digitized workflow platform frees up resources of an orthotist’s time to manage more patients. Previously it took Orthotists up to 4 hours to consult, cast and manufacture custom-innersoles. Now it only takes an hour from consultation to fitting custom-made innersoles.
Implementation of this has saved the Western Cape Department of Health R200 per pair of custom-made innersoles, costing only R195,00 per pair. Since implementing this digital platform 3220 pairs of innersoles were manufactured within
14 months with a total saving of R644 000.00 for the department.