The need for quality in healthcare services in the country was last week re-echoed at the just concluded fifth West African Health Exhibition (WAH) as over 500 experts who brain-stormed identified poor hospital services and management as a major factor that has plagued the development of the health sector in Nigeria.
In a chat, the Chairman National Consultative Committee on Cancer Control in Nigeria, Prof. Francis Abayomi Durosinmi – Etti who was also the chairman of the occasion said “Although the necessity of introducing quality and health care risk management procedures in health care institutions is no longer contested, it must be recognised that total quality control is coming to hospitals very slowly”
Speaking during the opening ceremony of 2010 WAH in Lagos, Durosinmi – Etii who applauded the theme “Delivering Quality Healthcare Services in West Africa” noted quality of healthcare services determines the desired health outcomes and are consistent with current professional knowledge.
His words, “Indeed, quality management is a profound change in the hospital that leads to transformation of its organisation. This transformation concerns every actor within the organisation; implying a change in culture, habits and behaviour and disrupting the sociological hierarchy and power systems”
While noting that hospitals across the country are searching for ways to improve quality of care and promote effective quality improvement strategies, he pointed out that in more developed countries, essential elements of a successful strategy must include developing the right culture, attracting and retaining the right people, devising and updating the right in – house processes and giving staff the right tools to do the job.
He further added that external influences, such as local market competition and public or private health quality initiatives and standards also have an impact in quality health care service delivery. To ensure quality, the Chairman told the participants that first, is the need for healthcare institutions to attract and retain the right people.
“High- quality physicians, nurses, administrators, and ancillary staff are critical to producing high – quality outcomes and effective quality improvement. Successful recruitment and retention of nursing staff is tied to an absolute respect for and empowerment of nurses who must be treated as full partners in patient care and given opportunities for advancement. All are expected to be good team players, able to participate in multi- disciplinary teams for both quality improvement and patient care management.”
He further stressed the need for health care institutions to equip and give their staff the right tools to do the job. “ Our hospitals must give their physicians, nurses and other staff the tools and support they need to practice high – quality medicine on a daily basis and to identify and investigate quality problems when they do surface. This, he said, must include; investments in information technology as well as quality improvement/performance improvement departments with qualified staff who abstract medical records, analyse data, and facilitate the quality improvement process.”
Durosinmi – Etii however, regretted that hospital environment in Nigeria is not a favourable terrain for such changes as they are institutional organisations charactered by a high level of involvement on the part of health care professionals, particularly doctors in the decision making process.
He noted that professional bureaucracy has limited power, contrary to the mechanical bureaucracies found in the industry. The Chairman enjoined stakeholders that in setting up quality management, they should take into account these obstacles adding that no matter what quality management model retained, great importance must be placed on implementation strategies necessary to achieve the goals of quality management.
In his welcome address, the Executive Director, Global Resources, Dr. Wale Alabi said the theme of the conference was chosen to highlight one of the biggest issues still hampering the ability to deliver 21st century medicine and quality healthcare in the country’s healthcare service delivery, processes and systems.
Alabi stressed that before we can experience any meaningful development in the health sector, the country must adequately put in place protocols and processes that would support quality assurance and raise the standard of care in healthcare institutions across the country.
A comprehensive approach, supported by strong national leadership, governance and information systems, is needed to ensure skilled, motivated and supported health workers in the right place at the right time. For example, national authorities may focus on rapidly increasing the outputs of education and training programmes, along with measures to improve recruitment, performance and retention of workers - especially in rural and underserved areas - and actions to address imbalances in the mix and use of skills within a primary health care framework.
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