Vol. 8 April 2020 - CLINICAL GOVERNANCE PROPERLY IMPLEMENTED CAN GALVANISE THE DRIVE TO HEALTHCARE EXCELLENCE IN NIGERIA

Clinical Governance properly implemented can galvanise the drive to Healthcare excellence in Nigeria

The diagnosis of dysfunction in the Nigerian Healthcare system is self-evident. The magnitude of the problem and the multitude of underlying factors have been discussed ad nauseam by several commentators. Government actions to improve healthcare delivery have proved ineffective and amount to mere rhetoric for political gains. Collective action by all stakeholders is required. More so by doctors and all healthcare professionals. Change for the better will only happen if there is true commitment to working towards well defined quality standards.

In the course of my research into health quality improvement in Nigeria, I came across a paper which resonated well with my own thoughts. The paper is titled “Guidelines for Performance Management in Hospitals” by Mobola Olatawura and Chukwuka Monye, both of Ciuci Consulting.  The link to the paper is below:

 http://www.ciuci.us/wp-content/uploads/2013/11/Guidelines-for-Performance-Management-in-Hospital.pdf

The paper makes a compelling case for Clinical governance as an essential tool for quality healthcare improvement in Nigeria. It gives a step-by-step guide on the implementation of effective clinical governance structure in Nigeria and other developing countries. By the way, clinical governance is well entrenched in U.K. National Health Service (NHS).

Clinical Governance is a framework of activities for maintaining and improving the quality of care within a healthcare system. The components of clinical governance include:

a)     Risk Management

b)    Clinical audit

c)     Education, Training and Continuous Professional Development

d)    Evidence-based care and effectiveness

e)     Clients’ experience and involvement

f)      Staffing and staff development

These components should work together in an integrated manner to provide the basis for a sustained quality service delivery. The paper cited above is not the first or the only one to emphasise the importance of clinical governance. Many others have presented well written papers on clinical governance but it has never been adopted on a national basis and has never been taken seriously enough.

The paper commented that in the banking and finance industry, corporate governance is stressed and violation of it can attract jail sentences. They go on to ask “Is it not disturbing that banking and finance sector is given more attention than the health sector?” They make the point that health institutions in Nigeria lack effective clinical governance structures and that accountability, transparency and a focus on quality assurance are somewhat lacking. According to the authors, an investigation carried out in a Nigerian government owned hospital, showed that the number of deaths and errors that occur in the hospital are unknown and there are no policies to encourage transparency, perform regular audits, detect, log and prevent repeat of errors.    

We must stop the rot. Covid-19 crisis is ongoing and should serve as an eye opener!.

There should be a national strategy for healthcare quality improvement. Clinical governance has to be at core of that strategy. If clinical governance structures are properly implemented, the benefits will flow to every hospital, every health clinic and every citizen needing medical care in Nigeria.