By Dr. Loveday Onyebueke
In healthcare, the term “innovation” has traditionally been reserved for the development of new therapies, drugs, or medical devices. As both private and public efforts to reform the Nigerian healthcare system gain momentum, it is clear that innovation must be explored in a broader context, one that examines previously underdeveloped opportunities in areas such as data analytics, consumer behavior, provider incentives, and process improvement in care delivery. This is at tandem with the objectives of National health policy which is essentially to strengthen the national health system such that it will able to provide effective, efficient quality, accessible and affordable health services that will improve the health status of Nigerians through the achievement of the health-related Millennium Development Goals (MDGs).
The Minister for Health Professor Isaac Adewole since his appointment by President Muhammadu Buhari has stressed at different interactive fora with healthcare providers the need to carry out a holistic health care reform to address the issue of weak health system, disharmony among health workers, inadequate physical infrastructure, materials and technology as well as lack of governance and regulation—all of which have not been properly addressed and threatening the survival of the country’s health care system.
In line with this understanding, the Federal Medical Centre, (FMC), Umuahia, Abia State (formerly known as Queen Elizabeth Specialist Hospital) is in the forefront of carrying out this innovations in health care delivery services in line with the policy direction of the Federal Government. The Medical Director Dr. Abali Chuku, who is driving the Federal Government’s change agenda in the health sector, has turned the medical facility into a Centre of Excellence and a reference point in health care services. Dr Chuku personified a leader whose vision is to create a better institution by judicious utilization of available public resources while living a lifestyle that serves as role model to others. His objectives and policies do not hide under any form of complexity and ambiguity but simple, plain and easy-to-comprehend. His leadership style enthrones confidence, accountability, and purposeful policies per problem.
In the past years the management under Dr. Chuku, ,initiated several policy reforms to make the medical centre one of the best in the country in terms effective service delivery and this has assisted in changing the public perception of the hospital which was poor in the past. The transformation has also touched other areas of the hospital administration, like personnel, patients and customer care. The changes cut across other areas.
The management has procured and installed a Computed Tomography (CT) Scan machine manufactured by General Electric, and also a Mammography Machine. The hospital never had CT scan until Dr. Chuku came on board. The Management has also acquired new MRI machine to complement the CT scan already in place in the hospital. With these machines and advanced Diagnostic Laboratory, there is no doubt that FMC Umuahia stands out as the best in healthcare delivery destination in the entire southeast geopolitical zones as the hospital is the only hospital that has a functional CT Scan in the zone. The hospital’s CT Scan is not on Public –Private Partnership (PPP), it is wholly- owed and operated by the Federal Medical Centre, Umuahia. The other health institutions in the South east that have CT Scans, are not under the operation of Federal Government, rather PPP arrangements.
In order to improve the services in the hospital, the Management has actually used or borrowed some of the trends in social media platform like a Wireless Application Service Provider (WASP) to provide preliminary results to the consultants. Since some of the consultants are within that social media user group, it is found useful to use that platform. For example, if x-xay or CT scan is taken, result is transmitted to the doctors so they can have preliminary plan while the actual hardcopy result of the x-ray or CT Scan are being transmitted. This has actually contributed to effective service delivery with respect to CT scan.
Another innovation at FMC Umuahia apart from CT scan is a functional In-Vitro Fertilisation (IVF) centre. It is on record that the hospital’s IVF laboratory is not only purpose- built but it is also one of the best IVF in the country. If one comes to FMC Umuahia, the health institution is adjudged as one of the neatest health institutions in the country. In fact, the IVF centre is the neatest units in the hospital and this gives one the feeling that such facility is in a foreign country. It has to be neat because the result depends on the environment of that area. FMC Umuahia results are higher than average results in other health institutions. In most cases it is 30 percent, but the hospital’s case it is little higher than 30 percent and has been able to have positive pregnancy test. Still new is the dialysis centret with four functional dialysis machines as efforts are been made to increase the number to six machines. Out of this two machines, one will dedicated to HIV positive patients and the other for hypertensive positive patients.
Still new in FMC Umuahia is 88 bed facility complex with 16 bed private ward which has been commissioned and fully functional with the state of the art facilities. The Management copied National Hospital Abuja and added 1% to it. National Hospital Abuja has 12 private wards but Fmc Umuahia has 16; making the hospital bigger and better equipped. The hospital has piped oxygen and suction machine in all the rooms, multi -(6)-parameter monitors that include ECG, networked to a central work station in all the rooms. The rooms are en-suite and made comfortable to give a 3-star appeal at half the cost of National Hospital charge, with a guaranteed and better individual care. There are three categories: the private rooms, 6 bed mini wards, and the 16 bed open wards; other support spaces for nurses, doctors, laboratory and pharmacy. Services have commenced in the facility.
Training and retraining of medical personnel has been given topmost priority under Seek an Area for Excellence (SAFE) Project. The SAFE project is a local initiative whereby consultants are encouraged to identify their area of competence and are provided with training opportunities to excel in such area of choice. Over 27 persons comprising doctors , nurses and other personnel have been trained under the programme. The e-hospital project has gone far. There has been a lot of improvement in the computerization of Medical Records. The NHIS computerization/e-hospital is now running and our focus is to reduce waiting time to 20 minutes for outpatients and 1 minute for emergencies.
The hospital’s residency training is reported to one of the best in the country. The hospital’s pass rate is very high. Performance is also reported to be very impressive in Internal Medicine, Community Medicine, Obstetrics and Gynecology, Radiography, Family Medicine, Pediatrics and Anesthesiology. However, the hospital is still having challenges in funding residency training. The hospital uses its internally generated revenue to train higher manpower. FMC Umuahia also have the challenge of sub-specialization in Pediatrics and Internal Medicine and our focus is to sub-specialize in Pediatrics so as to get accredited for Part II.
According to Dr Chuku in recent chat with the media said , “My vision for the hospital in 2016 is to devote effort on improving the quality of our services, improve patient- doctor relationship and give more attention to patients’ right to information. I want to encourage staff to give information to patients. I will also improve on the working environment, and make it more conducive and improve on the aesthetics of our hospital which I believe, will boost the centre’s mission: to provide specialized and comprehensive healthcare, using modem equipment, research and training through highly motivated work force operating in a conducive environment to capture our antecedent as a mission hospital”.
In spirited effort to reposition the hospital as it veers into medical tourism and also to improve on its customer care services, the management has brought in what they call AIDET, which is actually the protocol that is operated in the United States (U.S.) This protocol which has been used by the Star Buck Chain in the United States from where it is borrowed stands for Acknowledge, Introduce, Duration, Explain and Thank (AIDET). AIDET is an acronym for these stages of customer care areas. The entire 1600-member of staff of FMC, Umuahia are being trained so as to comply with the AIDET Protocol. In fact at FMC, Umuahia, it is mandatory for newly employed staff to undergo training on AIDET Protocol before the recruitment processes is finalized. The objective is to make staff, patient friendly and customer oriented so as to change the perception of patients positively so that they can regard hospitals as a hospitality industry.
To complement the public power supply from , the management in addition to the public power from the national grid, the hospital has a 500 and 400 KVA power generating machines to augment power supply and these generators provide light to the whole hospital. The hospital equally has a standby 150 KVA generator that powers our CT-Scan and a 50 KVA for the dialysis machine. Also, there is a 30 KVA generator for the Accident and Emergency unit and all are fully loaded to serve the wards. The laboratory department has one 2.5 KVA for the machines there and another 9 KVA is dedicated to O & G Main Theatre.
The hospital has its own challenges which include amongst others the need for increased funding for the hospital in order to drive the change agenda of the present Administration. The road network in the hospital is a very deplorable state and needs to be rehabilitated. The management has approached the State Government for assistance. They equally need philanthropists and well meaning Abians and indeed Nigerians to contribute to the development of the hospital. The Hospital Management is said to be contemplating on the need to create a Public Private Partnership (PPP)/ Diaspora office which function will be to liaise with the office of the Medical Director and other partners to assist us. Dr Chuku believes that the hospital is prepared to cater for Nigerians and foreigners like who may wish to patronize the hospital instead of going abroad for medical treatment. In his words, “Well, we are not saying that we have arrived. What we are saying is that the level of care in FMC Umuahia as of date, is far better than the level of care in 2010. There are quite a few things we are doing now which we were not doing then. I can tell you that the care of diabetics in FMC Umuahia is one of the best in the country. I can also tell you that the ICU (Intensive Care Unit) of FMC Umuahia is one of the best in the country.’’
“The Wes t African College of Surgeons and the Ohio Medical College testified that we have one of the best. In a recent accreditation exercise here in FMC for the Department of Pediatrics we scored 4.3 over 5 and 4.3 over 5 is really very high. In Family Medicine we have also done very well. We have been accorded one of the highest ratings in our Family Medicine Department. We have one of the best equipped endocrinology and metabolic team in this country. We also believe in team care. We believe that no patient should be left at the mercy of a single consultant, so operate in teams”
With innovative exploits recorded at FMC Umuahia, there is no doubt that a foundation for a new beginning has been laid in the hospital. It goes to show the visionary and transformative leadership in place at this foremost health institution. A transformative leader is a person who can guide, control, motivate, direct, and lead the people in a way that influences them to convey a fundamental change concerning the issues they are dealing with.
Dr. Onyebueke , Public Health Consultant lives in Arochukwu, Abia State