|Role||Consultant General Surgeon|
"It’s no good preaching hand hygiene if there is no water to wash hands with."
Mukhtar Ahmad is a consultant general surgeon at Poole Hospital, Dorset.
"I volunteered on a THET project titled “Strengthening systems necessary for improving patient’s safety and quality of health care in tertiary hospitals in northern Nigeria” and spent four weeks in two tertiary institutions in Northern Nigeria. Our broad remit was to look for ways to strengthen systems necessary to improve quality of care. I was particularly interested in improving teamwork in theatre and adherence to WHO safety checklist. I was part of a team of three NHS consultants and a systems expert from the University of Sheffield. Being Nigerian and having all studied and worked in Nigeria before relocating to the UK was an undeniable advantage for our work in the country.
I chose medicine as a career because from a young age I have enjoyed interacting with people and listening to their stories. By the time I enrolled in medical school it was clear to me I wanted to be a surgeon. I like to be able to make clear treatment decisions that lead to reproducible results. I chose to specialise in general and colorectal surgery because it gave me a broad remit with diverse, challenging conditions.
I have worked on health outreach projects in Northern Nigeria with another UK charity providing free consultations, prescriptions and minor operations. I soon realised that this was not sustainable and what was actually needed was a fundamental change in the way things were done. At the start of the THET project, Northern Nigeria was a challenging place to visit because of an ongoing insurgency. As a result our partners in the University of Sheffield reached out to the Nigeria Muslim Forum UK which has a proven track record of working in Northern Nigeria.
The project was unique in terms of its approach: rather than dive into interventions, we started with assessments of the existing patient safety culture in the two hospitals. These assessments were eye openers particularly in terms of the human factors that impeded patient safety. Our visit revealed 'silo working' in theatre where the various actors such as nurses, anaesthetists and surgeons seemed to work in parallel. This is similar to the NHS of a few decades ago.
I was subsequently involved in planning and delivering seminars addressing key themes in the WHO patient safety curriculum. I led on the infection control and ‘learning from error’ workshops. These were interactive with exercises for the participants and feedback at the end. There were also interventions at the coal face where I helped introduce the concept of the ‘team hug’ at the start of theatre lists where the entire team was briefed about the cases at hand and potential problems identified.
I had a tremendous time particularly in Gombe where the workforce was well-motivated by an inspiring leadership team. I enjoyed my interaction with colleagues ranging from the laundry to theatre. The main challenges from my perspective were the hierarchical structure that pervades the workplace and limited resources. It’s no good preaching hand hygiene if there is no water to wash hands with.
I helped organise a National Conference on Patient Safety in Nigeria. This meeting brought together leaders in the health sector from across Nigeria, the project team and an international faculty with expertise in patient safety.
I learnt a lot from the partnership - my communication skills were clearly enhanced by my participation in so many focus groups and workshops. I have also become more aware of the waste in the NHS and have strived since my return to reduce waste in my own practice. I hope to maintain my involvement with the partner hospitals to help them further entrench patient safety building on the excellent achievements in such a short time."