1 January 2013

Nigeria: Managing Quality in Nigeria's Healthcare

In this age, hospital services--especially the private ones-- have gone beyond the conventional way of doctors sitting in their clinics, reading newspapers or engaging in other vain discussions hoping that patients would patronise their healthcare services.

Various private hospitals have carved out a niche for themselves using relationship management, customer relations and hospital marketing techniques to expand their business. Although the prime aim of healthcare establishments in the first instance is to save lives, the truth is that private healthcare services are profit-driven as owners have to cater for various expenses and overheads to keep the business moving.

Those who run healthcare business grapple with regular payment of staff salary, procurement of new medical equipment, maintenance of computers and buildings, payment of electricity bills, procurement and fuelling of power generators, maintenance of official vehicles, communication expenses, staff seminars and printing of receipts, appointment cards and medical report sheets.

Although medical sororities such as Nigeria Medical Association (NMA) strictly prohibits hospital advertising, the dynamic nature of medical business, not only in Nigeria but globally, has made it expedient for Health Maintenance Organisations (HMOs) to place their advertisements on the pages of newspapers, over the radio/television and on the Internet under the guise of health insurance, since insurance does not forbid advertising its services to various target groups.

In these days of sophisticated and well educated customers, patients look beyond coming to the hospital and being attended to in the usual manner. Reason? They want to experience an informal contact (tactile communication); they expect the doctor to tell them what they don't know in medicine because many of them have already reseached their internet to know about their ailments before consultation; they want to feel like they are in their homes; they want to feel that they are in safe hands and get healed by the utterances of the doctors in charge, nurses on duty as well as all other contact points i.e. other health workers.

Simply put, healthcare refers to the service of providing medical care to different categories of people. By classification, there are primary and secondary healthcare systems. Primary healthcare refers to the patient's first contact for health care. It deals with general health problems which are mostly handled by General Practitioners (GPs). They are hospitals dealing with health problems such as malaria and other basic illnesses and accidents while secondary healthcare system is a branch of healthcare that deals with specialised and more technical areas such as paediatrics, surgery, gynaecology, ophthalmology and many more.

A healthcare provider can therefore be described as a hospital where medical care is provided in various forms: laboratory investigation/diagnosis, clinical analysis, medical check-up, medical advice, surgery, blood transfusion, admission and so forth. Quality management in healthcare should be seen as a problem-solving process. Then, how qualitative are the processes in our hospitals today? Are they of high standard or otherwise?

The problem-solving process in any hospital environment cuts across all the contact points of the system--right from the gatemen through the administrative/support staff, the nurses, the laboratory scientists, the pharmacists to the consulting room. This chain does not exclude the maintenance officers, the cleaners, the kitchen executives, the security men and all others that have one role or the other to play in the process of caring and live-saving.

Information management in healthcare bothers on how organisational messages are communicated in our hospitals, vertically or horizontally? Are messages well relayed to their proper destinations? How do heads of departments in the healthcare system manage hospital information at their disposal? Do we maintain the professional secrecy in the job? Professional health-workers are aware of doctor-patient confidentiality for instance, although many patients are ignorant of this. Any patient for that matter has a right of his secrecy with his doctor as any information regarding his health history cannot be divulged by the healthcare without his consent.

Katib wrote from Crescent University, Abeokuta

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