BeyHealth Quarterly Journal (BHQJ) BHQJ 2018: 001:1 (May 2018) - Page 31

A POINT OF VIEW 1. Adoption of nationally agreed definitions of quality in the Nigerian health care context and state inspectorate infrastructure will professional standards and innovative care become increasingly accompanied by the need practices throughout the sector. Such an to empower such quangos to make necessary awards system is likely to have the desired While recommendations and changes on ground. effect unsatisfactory definitions exist for health such Setting-up clinical networks and case registers standards with attendant consequences for that a universally acceptable definition of health are essential building blocks for agreeing quality patient outcomes. quality is problematic, other health systems standards and providing mutual support for around the world have grappled with the same practicing healthcare professionals. Finally, a or similar issues and managed at the end of a clear approach to promoting improved patient formative process of development, to come up safety and mechanism for sharing the learning with workable definitions of ‘quality’ in health. from adverse and untoward clinical (and Lord Ara Darzi came up with a definition that administrative) it is true that various relatively incidents is essential to works for the National Health Service (NHS) in preventing a re-occurrence of similar incidents the UK and which could perhaps be adapted in the future. In his reckoning, quality in health has 3 central components, namely – patient safety, clinical effectiveness and patient experience. In 3. Public health education programmes from cradle to grave aimed at increasing the health llteracy level of the average Nigerian essence, patients and their relatives can judge Owing to a prevailing culture of entrenched the level of healthcare they receive based on socio-economic inequality, there is a compelling these (measurable) parameters. In the interest case for majoring on prevention strategies in of brevity, I will not go into much detail on this, order to reduce the financial burden of health but will attempt instead to link these 3 care for the least able to pay. Achieving a components to essence of the 2nd desirable state of increased population literacy provocation. and health awareness will also have the effect 2. Government has to provide an enabling legal and policy environment for delivery of high quality care systems of paternalism and power distance, of undermining deep-rooted, dysfunctional This will of championing necessity high involve quality largely dependent on preservation of hierarchy and false economies of knowledge inherent in the doctor-patient relationship. through legislative enactments that mandate minimum standards of governance and safety controls at all levels of care provision whether private and 4. Strengthening of the legal basis for seeking redress when detriment is experienced by patients as a consequence of medical negligence public healthcare. Indeed, the possibility of losing professional Furthermore, borrowing coinage from yet licenses and the closing down of sub-standard another US politician, the present list of medical facilities must be kept under review in to prevent ‘known-unknowns’ in terms of numbers of order health care providers, patient safety incidents, practitioners from taking advantage of lapses in unscrupulous medical professional malpractice litigation, costs of regulation and governance standards to set-up common shop within the system. health interventions and their outcomes will need to become ‘known- bulk up the academic disciplines of public 5. Recognition and reward of quality healthcare standards health and epidemiology, health economics, Recognising and rewarding clinicians and care knowns’. This will require concerted effort to medical statistics, etc. delivery providers for delivery of high quality The possibility of establishing national, regional care will incentivise and promote higher Issue 1 | MAY 2018 | up clinical practice In Conclusion Quality in health care delivery is an enduring and difficult issue to master, especially in the context of developing countries such as Nigeria, with multiple and intersecting challenges and problems. Having said this, few things should be assigned more strategic people of any nation. There is a very important saying – “our people are our destiny”. It stands to reason therefore, that the challenge confronting society regarding the quality of healthcare offered to its citizens is indeed a pertinent and existential one. Returning to my introduction regarding the remarks made by the late Hubert H. Humphrey at the dedication of the building commemorating his achievements as the 38th vice president of the united states in 1977, it is interesting (or perhaps simply apt) that this edifice was soon afterwards to become the headquarters of the United States Department of Health and Human Services (HHS). His oft- quoted comments at an interesting time in the history of his country serve to remind us of the explicitly care driving importance than the health and wellbeing of the in suitable format to satisfy the precise requirements of the Nigerian context. of essence of our existence and our responsibility as care givers in society. In the next few articles, I will delve deeper into a number of issues relevant to improving quality and healthcare delivery standards at the practitioner-patient interface. HEALTHCARE QUALITY AWARD 2018 for significant and sustained contribution by organisations and individuals to Patient Safety Patient Experience Clinical Effectiveness Please see page 15 for details. 31