Dr. Zainab Yunusa-Kaltungo, is a plastic surgeon and the Chairman of the medical advisory committee (CMAC).
As part of the University of Sheffield, Bayero University Kano and Aminu Kano Teaching Hospital partnership, which began in 2015, Dr Zainab has been the Clinical Governance lead of the project at the Federal Teaching Hospital (FTH), Gombe in north-east Nigeria. The project aims at improving patients’ safety and quality of health care in tertiary hospitals in northern Nigeria. So far the partnership has trained over 214 health workers from community health workers to theatre technicians.
The THET project is the first health partnership I have been a part of and it’s been an exciting journey that has continued even after the project officially closed in February 2017.
Prior to the project my admin work was characterised by maintaining the existing standard in running the hospital and responding to incidents as they arose. I felt a need to do more and knew there must be a better way of doing things, but didn't know how. I then reached out to a friend and classmate in the NHS, who after working briefly in Nigeria moved to the UK, asking for ways to improve the quality of healthcare delivery. He was the key link with the UK. lead from the University of Sheffield and the THET grant, and as they say ‘the rest is history’.
The project was a real breath of fresh air.
Four volunteers from the NHS visited to do a needs assessment and training on patient safety, and during the course of the project a long-term volunteer spent three months between the two partner hospitals.
The project initially aimed to train 35 health workers, but the team decided to expand to 70 to efficiently cover all aspects of the hospital. I attended all sessions not just because of my administrative position and role in attracting the project to the hospital, but because I thoroughly enjoyed the whole new world of patient safety that promises to be the answer to improving the quality of healthcare delivery.
The hospital now has a robust Multidisciplinary Patient Safety Team (MPST), conducting surveys of the patient safety culture in the hospital, and there is hospital wide awareness of what constitutes patient safety and incident reporting.
We now have an infection control team, a subset of the MPST with a more manageable and efficient number. The team regularly produces and notifies the entire hospital of the antibiogram, health care associated infection rates in addition to active surveillance and containment of outbreaks of infectious diseases.
I am reminded of how crucial the policy change has been when remembering the case of a patient with sickle cell disease. He was admitted into a side room for complications of deep venous thrombosis following bilateral hip replacement, and had overdosed on self-administered pentazocine. It was found that there was easy access to pentazocine over the counter even within the hospital pharmacy because there was no national policy restrictions as there are for other narcotics. Since the incident the hospital has included pentazocine in the same class as other opiates and is no longer sold over the counter. The consumption of pentazocine in has dropped by about 50%. This is just one of the many impacts the project has had on our hospital.
The project though very successful, had a few challenges including the raging Boko haram insurgency during most of the life span of the project. The volunteer trainers had to make several last minute change to their travel plans to avoid newly identified terrorist hotspots.
On the National level, the UK partners worked together with the two partner hospitals in Nigeria to hold a National Patient Safety Conference on 14th March 2017 in Ikeja Lagos. Following the conference, we all resolved that there's a need bring together all stakeholders within the ‘Nigeria Patient Safety Forum’ to spread the patient safety message nationwide.
It is our hope and dream that FTH Gombe will be the national hub of patient safety and be the hospital with the best patient safety indices.