Hayani Hospital: Overview

Presented to Matlala hospital

Date: 7th November 2023
Venue: Hayani hospital: Main Hall

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Introduction
• A family without visitors is of the witches
• We are delighted to have visitors coming for bench-marking
• We also did go for bench-marking in Gauteng in 2022
• This is about an axe sharpening another axe
• Else the axe will become blunt where it will still do the job
but the hard way.

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Purpose
• To present an overview of the hospital in terms of:
• Historical background
• Physical infrastructure
• Human resource
• Clinical Programmes
• Challenges and mitigation

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Historical background
• Hayani hospital – specialized hospital for MHCUs built in 1969 as a residential
centre for people living with leprosy from all over SA.
• With the introduction of the homeland system, Hayani was eventually
transformed into a hospital for the physically and intellectually disabled and all
patients who were at Khathutshelo (Tshilidzini hospital) were brought here.
• Venda became independent in 1979 and eventually it was further transformed
into a hospital for MHCUs to date. Most of the physically disabled were
transferred to Shiluvani Residential Centre.
• Some patients in the RSA had to be brought back resulting in an increased
number of patients whose homes were unknown appealing for social work
services.

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Main services
• Admit, care, treatment and rehabilitation of Mental Health Care Users in
terms of:
• Assisted patients (not opposed to admission and are in need for psychiatric
treatment)
• Involuntary patients (opposed to admission and could be a referral from the 7
sister hospitals or from Court of Law throughout the district)
• State patients (committed a crime and found not responsible by Court of Law
following an observation)
• Mentally ill prisoners (already in prison but happened to be suffering from
mental illness)
• Conduct forensic assessments (both single & panel assessments)
• We also do conduct outreach service to the 7 hospitals and Correctional Services.
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Profile of the hospital beds
• It is approved for 390 beds comprised of:
• Currently it has 250 usable beds accommodated
into 11 units classified into:
• 4 female units and 7 male units which are
comprised of:
• 4 intellectual units
• 3 Chronic units
• 4 Forensic units
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Acute unit
• The hospital has been operating without an Acute Unit
• Acute cases were thus far being admitted in the Maximum Security Ward.
• The challenge of establishing an Acute Unit has always been the shortage
of staff
• Having acknowledged the significance of the Acute Unit:
• Serving as a referral for difficult cases from the district hospitals
• The requirement for receiving the registrars and or other students
• A resolution has been taken to activate the Acute unit out of an existing
unit. Steps are at an advance stage. The Task team is aggressively working
on the matter.
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Acute unit: continued
• Activation measures include:
• Converting one unit into an acute unit
• All acute cases no longer to be admitted in the MSW
• Multidisciplinary team to expedite the granting of Leave
of Absence (LOA)
• Difficult cases from the regional and district hospitals to
be transferred to the identified units.
• A task team is still working on the logistics
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Staff component

Approved Filled Vacant

Core 576 241 335
Support 404 77 327
980 318 662

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Clinical Services staff
Post Designation Approved Posts Filled Posts Vacant Posts
Medical Officer 4 2 3
Speciality
Medical Officer 16 5 11

Clinical 9 2 7
Psychologists
Pharmacists 5 3 2
Medical Officer 5 1 4
Comm Serve
Allied Health 59 15 44

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 Provision of Care, Treatment and
Rehabilitation Services
• In order to strengthen the care, treatment and rehabilitation
programme of the MHCUs, a Multi-disciplinary team approach is
one of our strengths involving:
• Medical services
• Clinical psychology services
• Occupational Therapy Services
• Nursing Services
• Social Work services
• Physiotherapy services, and
• Nutrition services
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Performance in terms of efficiency
indicators
• Inpatient Bed Utilization Rate = 83% (207/250)
• Expenditure Per Patient Day Equivalent = R 2342
• Patients granted Leave of Absence = 14% (30/207)
• OPD headcount: 1224
• Forensic: 426
• Others: 798

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Clinical Psychology Services
• Only 2 clinical psychologist and 1 trauma counsellor
• MDT demands every patient being reviewed to have clinical
psychology input and or group therapies.
• Assessment tools were a challenge but new tools have just
been received.
• There is a park-home provided for the functional space but
due to unavailability of furniture, network connection and
telephone. But it is being utilized in the spirit of optimizing
available resources.
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 Occupational Therapy services
• In-door and out door activities being offered
• Functional rehabilitation services include among others:
• Pillow making
• Car wash
• Excursions alternate weeks facilitating community re-integration.
• The hospital would like to have a bus for weekly excursions. Currently
relying on a bus from the District office.
• Revival of sports activities is at an advance stage.
• Xmas party to be conducted in collaboration with the donors hosting the
event
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 Social work services
• 5 social workers seconded from DSD plus 1 contract social worker (1yr) i.e. 1
responsible for 2 – 3 wards.
• MDT demands social workers input with each and every patient
• OPD is another area in dire need for a social worker enhancing social
integration. Currently they are rotating to OPD.
• 2 dedicated vehicles would enhance the social worker services in terms of:
• Home visits
• Family re-integration – one day visits
• Collaboration with UNIVEN being looked into for strengthened contribution

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 Achievements
• Kitchen received an acceptance certificate from municipality
• Pharmacy received a compliance certificate
• Park homes for the clinical programmes: OPD, Clinical psychology, Medical
and Dental Units, Occupational Therapy and Pharmaceutical warehouse.
• Full complement of the Multi-disciplinary team
• Alternate weeks of patient excursions in collaboration with the community
stakeholders – free entrance
• 7 television sets for patients received as a donation

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Challenges:

Challenges Mitigation
• Dilapidated and not fit for • Strengthening maintenance. Soliciting
purpose physical infrastructure maintenance materials
from sister hospitals.
infrastructure
• Prioritisation of the budget. Currently
• Financial constraints like focusing on non-negotiables:
other health facilities austerity measures
• Shortage of human • Optimizing the available human
resources like other health resource. Surviving through
experiential learners and EPWP
facilities participants
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In conclusion
• The status of the hospital in terms of human resource and
physical infrastructure is gradually deteriorating heading for
a crush unless something is done.
• The hospital is faced with a challenge or retention strategy
amidst the increasing attrition rate.
• There is a need for recognition of individual performance as
well as creating opportunities for personal and professional
development.

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