HOSPITAL RATINGS: THE NIGERIAN EXPERIENCE

  

In an environment where patients are demanding and taking an active role in choosing their health care provider, and expecting quality service and value for their money, there is an urgent need for investments in the healthcare sector. As is often said “Health is Wealth”, the progress of any nation is hinged on the health of its citizenry, if it aims to leverage on its working populace.

Nigeria has no accreditation body to rate the hospitals and clinics, that operate within its borders, there is a need for government in partnership with nonprofit organizations to set up an Accreditation Commission, which will develop a framework for quality control and standards, working in concert with the World Health Organization and other international standards bodies.

A lot of Nigerians undergo surgeries and other common hospital procedures. It could be comforting for the consumer to know how well or otherwise their local hospitals stand up to close scrutiny, Nigeria has few National Specialist hospitals i.e. Children’s hospital, Oncology, Gynecology, Geriatrics, Urology, Diabetes and Endocrinology, Ear, Nose, and Throat, Neurology, Ophthalmology hospitals.

The only Women and Children Hospital that was established in Abuja, was unfortunately converted to a National Hospital thereby shortchanging the women and children, as tertiary hospitals abound around the country. There is a need for hospitals to promote patient centered healthcare environment in order to stay competitive in the ever changing health industry. Parameters need to be put in place to benchmark performance to meet rising customer expectations.

Hospital care is primarily diagnosing, treatment care, rehabilitation, teaching and research, but in a changing world, these dynamics are constantly changing to include Ambulatory care, Community outreach programmes as well as Social and employment functions.

With the proliferation of hospitals and clinics across the country, it is difficult to tell which hospital is best suited to handle any specialized treatment, as every corner plot clinic brands itself as a specialist hospital, and “Jack of all trade”.

Hospitals need incentives to participate in voluntary assessment of their facilities, Government needs to put in place incentives and other positive remunerations for hospitals to participate in accreditation, to promote a culture of transparency, professionalism and accountability.

State hospitals management boards should be mandated to commission local surveys with standardized set of questions for national performance monitoring and benchmarking. Results would then be submitted to the Federal Ministry of Health that would enable it put in place policies and performance measurement systems. This would also be published and put in the public domain to assist customers make informed choice as regards their treatment.

Principal methods of measuring hospital performance are Regulatory inspections, Public satisfaction surveys, Third party assessment and Statistical indicators.

·         Inspections of hospitals measure the minimal requirement for the safety of the patients and personnel.

·         Surveys measure domains of patients experience and satisfaction.

·         Statistical indicators measure areas of improvement in performance management.

·         Third party assessments measure standards by peer review, ISO standards, compliance to international standards for quality and accreditation systems.

·         International self assessment by multi disciplinary teams of health professionals.

In the current harsh economic climate, Government needs to put in place some policies and incentives to encourage public and private health stakeholders to buy into this scheme, most importantly if needs to

·        Provide tax holidays to hospitals and clinics which participate in the scheme.

·         Total exemption of import duties on life saving hospital equipments and drugs.

·         Legislation to ensure registration and accreditation of all hospitals and clinics, operating in the country and establishment of an electronic data bank to store all data on these centers and the medical practitioners working in these places, and annual updating of the data.

·         Establishment and proper funding of medical research institutions.

·         Establishment of specialized world class medical cities to encourage medical tourism, and discourage capital flight of Nigerians travelling abroad for treatment.

·         Establishment of specialized tertiary hospitals like Oncology hospitals, Children hospitals, cardiology hospitals, etc

·         Continuous training of healthcare  providers, Consultants, Doctors, Nurses, Pharmacists,  and  Technicians

·         Establishment of world class diagnostic laboratories, it is a shame that there are tests that cannot be handled in the country, and samples are sent to South Africa, for analysis, while patient’s lives are risked waiting for results, sometimes taking days and weeks.

·         Establishment of Ambulance and Paramedic services, encouraging private sector participation in ambulatory services and establishing 3 digit call centers nationwide. Making it mandatory for them to be first responders at all traffic accidents and other accident scenes.

·         Closure of all Open drug markets, establishment of internationally certified drug markets.

·         Strengthening of the Pharmaceutical Industry and assisting them in the research and development sector, enabling them to acquire WHO certification.

·         Establishment of International Standards Certified Laboratories around the countries.

·            Adoption of the Coroner’s law by all states in the country to eliminate superstition and suspicion on causes of untimely deaths.

·         Establishment of Rehabilitation centers and long term care facilities.

·         Establishment of Behavioral health care centers and Addiction centers.

·         Establishment of Storage facilities for safe handling of drugs from the ports to the hospitals especially vaccines.

·         Establishment of Health Banks to solely fund the health sector. 

·         Strengthening the National Health Insurance scheme to enable it capture all Nigerians from the urban to the rural area.

·         Legislating a Bill of Rights for patients in the health sector as a lot of patients have a low expectation and are too readily satisfied with poor services.

·         Establishment of a patient complaints mechanism and provision of surveys for patients at all health facilities.

·         Legislating laws to provide for speedy resolution of medical malpractice suits.

·         Establishment of a National Research institute for alternative medicine

·         Establishment of medical equipment manufacturing hubs.

These are some advantages of hospital rankings and accreditation

·         Provides high standard of care to patients

·         Strengthens patient safety

·         Creates a competitive framework

·         Creates an enabling environment for recruitment of high net worth professionals

·         Improves risk management

·         Encourages private equity participation in the sector

·         Encourages staff motivation and team building.

·         Encourage good business practice

·         Strengthens patients rights and responsibilities

·         Assist hospitals market themselves positively.

These are some parameters for ranking hospitals and clinics:-

·         Competency of the doctors and other medical personnel

·         Infrastructure available in the facility

·         Innovation in treatment

·         Patient care

·         Availability of diagnostics equipment

·         Availability of multiple specialists

·         Cleanliness of hospitals and its environs

·         Death rates

·         Re admission rates of patients.

Ultimately it is Important, we ask the government and healthcare regulators to rate our public and private hospitals to ensure patients are afforded high quality services. Medical mistakes are all too common in hospitals like objects left in patient bodies after surgeries, hospital acquired infections, drug mix ups, wrong diagnosis.

 Patients need to research health facilities via the internet, sample opinions of past patients of that facility as well as death rates of the facilities. The accreditation process should aim to improve hospital performance rather than create unnecessary wrangling.

Improvement in health process should be a never ending philosophy. In the face of increasing health care costs it is important that the consumer is given all the tools to make an informed choice, as this could be a life or death decision.