, CMD, Baze University Hospital

HIGHLIGHTS

* The role of the community in public health initiatives is very fundamental

* Continuous learning in the medical field must revolve around patient care

* As a medical practitioner, I would like to be remembered as an expert in general surgery and urological surgery

*Ensuring patient safety is paramount for delivering high-quality healthcare

By Sola Ogundipe

Dr Muhammad Bello Waziri Dogo-Muhammad, the Chief Medical Director (CMD) of Baze University Hospital, is a highly experienced medical doctor of repute.

A UK-trained Consultant General Surgeon and Urologist, Dr Dogo- Muhammad also has a Master’s degree in International Health and Hospital Management from Germany.

As a former Commissioner for Health, he understands the importance of creating a strong health network and its impact in communities. He has led many public hospitals in Nigeria, offering his expertise and global experience along the way.

Dogo-Muhammad  was appointed the Executive Secretary and CEO of then National Health Insurance Scheme  (NHIS), now called the National Health Insurance Authority (NHIA), where he spearheaded the development and implementation of important policies and reforms. He retired in 2012.

He  is a member of the Nigerian National Institute for Policy and Strategic Studies, Kuru, and an ICPC Ambassador.

 In this interview he shares his views on ways to improve community health, innovation in healthcare, patient safety and other critical issues connected to the Nigerian health sector. Excerpts:

How do you view the  role of community involvement in public health initiatives?

The role of the community in public health initiatives is very fundamental. After all, it’s about their health. Advocacy visits to community leaders help achieve the general acceptability of the community. Grassroots campaigns with health education further facilitate taking ownership of programmes. In some cases, undertaking health outreach campaigns allows those at the lower rank of society to access services they cannot afford otherwise.

Can you share an experience of a significant crisis you faced in your leadership roles and how you managed it?

I was at FMC Gusau and later at the NHIS. The crisis experienced at NHIS at that time was tackled. The crisis at FMC Gusau followed the same framework of first studying the route course of the crisis, doing a rapid needs assessment to resolve the immediate critical issues, then undertaking SWOT and PEST analyses, proffering plausible solutions and mitigants, designing the roadmap for implementation and hitting the ground running.

Of course, there must be defined key performance indicators (KPI) that will guide the progress of the journey. Identification of bottlenecks and appropriate loop-back feed mechanisms help reset the journey and resolve the bottlenecks. The expected output and outcome are predictable if the plan is executed accordingly.

What role do you think innovation plays in the healthcare sector, and how can it be better harnessed in Nigeria?

Innovation has contributed immensely to the healthcare sector, especially in terms of the clinical side of patient management. Many innovative advancements have been deployed in patient care; the list is inexhaustible. However, for illustrative purposes I submit a few examples here:

a.  Diagnostic investigations in radiology have advanced from the basic analogue x-ray to digital, ultrasound scanning, computerised tomogram scanning (CT), magnetic resonance imaging (MRI), and positron emission tomogram (PET) with increased clarity and better definition of disease entities.

b. Minimally invasive procedures like transurethral resection of the prostate, pin-hole surgery for abdominal diseases like gallbladder stones, appendectomy, sleeve gastrectomy in bariatric surgery, robotic laser surgery for radical prostatectomy, urinary bladder, uterus, tumours of the large intestine, pancreatic tumors, etc.

Now, Cath lab for coronary artery blockades and clearance of cerebral embolisms have brought a lot of relief not only to the patient but even to the physician.

The advent of stem cell therapy, especially in homopoietic stem cell transplantation in neurodegenerative diseases, diabetes mellitus, and sickle cell disease, has shown great potential. However, further advancements are restricted because of ethical reasons and other controversial issues.

What resources do you recommend for continuous learning in the medical field?

Continuous learning in the medical field must revolve around patient care. What immediately comes to mind is for the medical professional to be on top of his/ her game in patient care-giving.

It’s for all members of the medical team to endeavour to be at the forefront of medical advancement and patient care.  Continuous Professional Development (CPD) enables the individual to proactively enhance skills, knowledge and expertise.

A typical example is like that of a very senior consultant with a world-renowned expertise but having to go for a training workshop (hands-on) in the latest robotic procedure. Thus, staying updated with the latest advancements, techniques/skills improve the outcome of patient care.

Continuous Medical Education (CME) through attending conferences, seminars and scientific meetings further facilitates the uptake of the frontiers of knowledge in patient care. Credit units attained for the attendance of such gatherings are used to assess the suitability of the individual professional to get renewal of annual practicing licenses of the various regulatory bodies.

Research conducted in various specialities and subspecialties further pushes the frontiers of knowledge in patient management.

Online participation in webinars, virtual attendance, reading journals, etc are other avenues that one could be abreast with the latest advancements in the medical field.

There are many search engines online and medical centres that are parked full with information for best practices in patient care.

What  legacy do you hope for in the Nigerian healthcare system?

As a medical practitioner, I would like to be remembered as an expert in general surgery and urological surgery. I would also like to be remembered as one of the best chief executives of the National Health Insurance Scheme (NHIS), now National Health Insurance Authority (NHIA).

How do you tackle challenges related to patient flow at BUH, particularly during peak times?

So far, the influx of patients is not overwhelming. However, provision has been made to handle patient flow right from the outpatient department where there are up to eight consulting rooms. In addition, there are 4 number specialty rooms and a capacious Accident and Emergency department, including an emergency operating room.

The Department of X-rays and Radiology is fully equipped with a digital X-ray machine, 12 ultrasound scanning machines, 8 mobile X-ray machines, a CT scanning machine, and an MRI scanning machine.

There are 4 number fully equipped laboratories i.e., chemical pathology, microbiology and immunology, haematology and blood transfusion, and histopathology.

There’s a dedicated operating room for obstetrics and gynaecology patients on the ground floor and 4 number operating rooms on the first floor for other subspecialties.

All these service areas are fully manned and ready to attend to any level of influx of patients.

Generally, the throughput of an outpatient case is about 30 minutes, but it could be longer if a consultant must attend to a case.

What protocols do you have in place to enhance patient safety at BUH, and how do you ensure adherence to these protocols among staff?

Ensuring patient safety is paramount for delivering high-quality healthcare. Therefore, BUH has a comprehensive protocol to enhance patients’ safety by establishing a safety culture at all levels of the organization, with leadership actively promoting safety initiatives. Also, the hospital has a reliable patient identification process to prevent errors in administration and treatment.

BUH fosters clear and open communication among all healthcare staff and between staff and patients, and uses standardized protocols to ensure that critical information is passed accurately during care transitions. Also, we implement protocols for medication reconciliation to avoid errors during patient transitions and continuously educate our staff on safe medication administration practices.

Furthermore, BUH ensures strict adherence to strict infection prevention protocols, including hand hygiene, equipment sterilization, and isolation procedures for infectious patients, monitors compliance, and provides ongoing training to staff on infection control.

Furthermore, the hospital implements a surgical safety checklist to ensure all necessary steps are taken before, during, and after surgical procedures. We also conduct time-out procedures to confirm the right patient, procedure, and site before surgery.

Also, we assess our patients for fall risks upon admission, implement individualized fall prevention plans, provide our staff with training on fall prevention measures, and ensure that environments are safe and free of hazards