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COMMUNIQUE FROM THE 1 CONFERENCE OF THE SOCIETY FOR QUALITY IN HEALTHCARE IN NIGERIA .............sharing healthcare best practices
PREAMBLE The Society for Quality in Healthcare in Nigeria held its maiden conference at the Agip Hall, MUSON centre, Lagos on the 7th of July, 2009. This conference was an avenue to introduce the society and its activities to the general public. It also served to promote the concepts of quality improvement, patient safety and accreditation which are fundamental to quality in healthcare. The conference was declared open by the Honourable Minister of Health, Prof. Babatunde Osotimehin ably represented by Prof. Akin Osibogun, the Chief Medical Director of the Lagos University Teaching Hospital who emphasized that the Minister considered social and technical quality as imperative to his vision of improving the Nigerian healthcare delivery system. Welcome remarks were also given by Dr Ngozi Onyia, the Chairperson of the conference organizing committee and Prof. E. A Elebute, the President of the society. In his speech, the President reiterated that real change in the Nigerian healthcare delivery system could only be achieved if healthcare practitioners and other stakeholders “see the deficiencies, feel the pains and develop a passion for change”. Mrs Njide Ndili, the Secretary of the society also introduced the society to the conference participants. She spoke about the society’s mission statement and objectives, promoters, identity /logo and scheduled activities. Facilitators at the conference included Prof. Stuart Whittaker, CEO COHSASA, Prof. Emmanuel Otolorin, Country Director JHPIEGO Corporation, Dr Christoph Hammelman, Country Director of Family Health International, Dr. Ajibike Oyewumi, Quality Improvement Manager Lagoon Hospitals, and Dr Dudley Wang; Regional Health Manager, Shell E&P Africa. The conference was well attended by representatives from the Federal Ministry of Health and National Health Insurance Scheme, several Chief Medical Directors of Teaching Hospitals, , public and private sector hospitals, organized private sector, HMOs, medical students, student nurses and members of the public, all with a common interest to see improvement in the quality of healthcare in Nigeria. CONFERENCE OBJECTIVES 1. To create awareness about the activities of the society and drive membership 2. To promote principles and practice of quality improvement and risk management in healthcare. 3. To introduce the concept of accreditation as a tool for quality improvement in healthcare 4. To create awareness around the importance of patient safety and measurement of clinical outcomes 5. To exchange ideas and knowledge on ways of improving healthcare quality
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KEY OBSERVATIONS 1. The Society for Quality in Healthcare in Nigeria (SQHN) is a non partisan, non governmental and not for profit organization established to lead, advocate and facilitate the continuous improvement of quality and safety in healthcare in Nigeria through education, collaboration, training and accreditation. 2. Healthcare service provision in Nigeria lacks a coordinated quality assurance and improvement programme. 3. Quality assurance in healthcare in Nigeria has been mostly driven by developmental partners and the private sector 4. Quality improvement programmes in private and public sector facilities are feasible, pilot programmes have been successful in improving the quality of patient care, clinical outcomes and programme targets/objectives in selected areas 5. Patient safety is a fundamental crux of quality improvement in healthcare, it requires building systems that identify what works - effective practice, ensure that the patient gets it -appropriate use and delivering care flawlessly - no errors. 6. Quality improvement involves deliberate and concerted efforts to improve the quality of medical care and it requires a holistic focus on structural, process and outcomes elements involved in the provision of medical care 7. There are a plethora of quality improvement methodologies however they all involve designation of standards, evaluation of performance with respect to the standards and the continuing implementation or maintenance of corrective or appropriate actions to ensure compliance with designated standards 8. Accreditation is a process and not an end in itself. It must be implemented to institutionalize quality improvement initiatives. 9. Accreditation programmes must include standards - a statement of expectation defining the capacity of governance, managerial, clinical, or support system to deliver value to perform as expected, performance Measures /indicators - points of reference for evaluating the organization's actual performance compared to a targeted objective and a performance database with standardized data elements definitions with data accuracy and completeness validated. 10. Reporting of errors by staff who make errors, or unknowingly engage in at-risk behaviour, should be encouraged to promote learning which is critical to quality improvement 11. Information technology is critical to quality improvement and accreditation initiatives 12. Attaining accreditation involves commitment, ownership of the quality initiatives and hard work  Â
RECOMMENDATIONS 1. The FMOH should institutionalize quality improvement and accreditation as part of it public sector health facility upgrade initiatives as well as advocate for the adoption by private sector health facilities 2. The FMOH should coordinate the development of a national policy for patient safety 3. The FMOH should raise awareness of all stakeholders on the importance of patient safety 4. Quality improvement should be included in the curriculum of medical, nursing and paramedical students 5. Quality improvement activities should be prioritized to focus on high priority conditions 6. The health care professional bodies should be involved in quality improvement initiatives 7. FMOH should coordinate the developing and implementing of regulatory frameworks for preventing, monitoring and reporting adverse events; and facilitating information exchange and data sharing;