SERVICOM FMC

YENAGOA
PRESENTATION
IN
HEALTHCARE PROVIDERS
CAPACITY BUILDING
SEMINAR
BAYELSA MEDICAL UNIVERSITY (BMU) EVENT HALL
9TH NOV. 2021

BY
MARGARET DIGITEMIE
(SERVICE IMPROVEMENT DESK OFFICER)
TOPIC 1: Improving the ease of
service provision.
 OUTLINE
• Introduction: SERVICOM, FMC Yenagoa
• Healthcare services in FMC Yenagoa
• Categories of service providers in FMC Yenagoa
• Quality of care
• Patient-centred care
• Challenges in service provision
• Improving service provision
 INTRODUCTION
• SERVICOM means a service compact (agreement) with all Nigerians for
service excellence.

• Established by President Obasanjo in 2004 having identified

inefficiency and corruption as the biggest problems of our public
offices, being impediments to effective implementation of government
policies.

• Established on the imperative to change the poor service delivery

system in Nigeria.

• Driven by Government’s commitment to deliver service, and the

citizens’ expectations of service delivery (SERVICOM, 2017).
 SERVICOM VISION AND MISSION

• VISION: To be the foremost change agent for service

excellence.

• MISSION: To improve citizen satisfaction by promoting service

excellence in public services.
 FMC YENAGOA IN BRIEF
• A healthcare provider.

• Established in 1999 by the Federal Government on taking over the then

State Specialist Hospital.

• Offering mainly tertiary health care (referrals), but also primary and
secondary health care to the immediate community.

• Services are available on payment of prescribed fees, as well as under

insurance cover for NHIS and BHIS enrollees.

• It has made tremendous progress in personnel, infrastructure, and

systems over the past 22 years.
 FMC YENAGOA VISION AND MISSION
• In line with the vision and mission of SERVICOM;

• VISION: To become an excellent and foremost reference

tertiary healthcare service provider by 2011 and beyond.

• MISSION: To provide quality tertiary healthcare

services through the use of highly skilled manpower
sustained by research and training in a friendly
atmosphere in the Niger Delta.
 HEALTHCARE SERVICES IN FMC YENAGOA
• Outpatient care (adult & paed. • Dental care
clinics) • Preventative care (immunization,
• Emerg. care (adult & paed.) H2H counselling, F/P, etc)
• In-patient care (med. & surg.) • Physical & occupational therapy
• Perinatal care (O&G, assisted (physiotherapy)
fertility) • Nutritional support
• Mental health care • Pharmaceutical care
• Lab & diagnostic care (lab, • Blood bank services
radiology, histopath., molecular • Ambulance services
lab)
• Mortuary services
 CATEGORIES OF SERVICE PROVIDERS IN FMC
YENAGOA
1. CLINICAL STAFF
• Social workers
• Medical doctors • Dieticians
• Nurses and midwives • Clinical social workers
• Pharmacists • Anaesthesia technicians
• Med. lab. scientists • Laboratory technicians
• Physiotherapists • Medical records officers
• Dental therapists • Ambulance drivers
• Optometrists • Health assistants
• Radiographers • Health attendants
• Medical psychologists • Morticians
 CATEGORIES OF SERVICE PROVIDERS IN FMC
YENAGOA contd.

• 2. NON-CLINICAL STAFF

• Admin. officers • Legal officers

• Accounts officers • Environ. health officers
• Auditors • Store officers
• Info. & comm. techs • Electricians
• Engineers • Plumbers
• Architects • Carpenters
• Procurement officers • Cleaners
 QUALITY OF CARE
• Quality of care is “the degree to which health services
for individuals and populations increase the likelihood
of desired health outcomes” (WHO, 2021).

• The patient is the consumer of our healthcare services,

and as such, would necessarily demand rights to the
delivery of quality services (Prakash, 2010).
 QUALITY OF CARE contd. (WHO, 2021).

Quality health care should be: To ensure quality health care, health services must be:
• Timely – reducing waiting times
and sometimes harmful delays.
• Effective – evidence-based
• Equitable – providing care that
healthcare services to those does not vary in quality on
who need them. account of gender, ethnicity,
• Safe – avoiding harm to geographic location, and socio-
economic status.
people for whom the care is
• Integrated – providing care that
intended. makes available the full range of
• Patient-centred – care that health services throughout the life
responds to individual course;
preferences, needs and • Efficient – maximizing the benefit
of available resources and
values. avoiding waste.
 PATIENT-CENTRED CARE (PCC)

• Patient-centred care is one of the elements of quality of care.

• Defined as “care that is respectful of and responsive to individual

patient preferences, needs, and values and ensuring that patient values
guide all clinical decisions (IOM, 2000).

• It is a model of healthcare which encourages providers to partner with

patients to deliver individualized care that meets the people’s
expectations and improve healthcare system efficiency and effectiveness
(Santana et al., 2018).

• Requires caregivers to be open, flexible, and respectful in the provision

of all aspects of care.
PATIENT-CENTRED CARE
 SOME FEATURES OF THE PCC MODEL
• Focus is more on patient’s problem than on the diagnosis.
• Care is not limited to the patient alone, but relations.
• Patients and their families are no longer seen as passive “order
takers”, but active “team members.”
• Strict visiting hours and visitor restrictions are a thing of the past
in PCC model. Patients are given the authority to identify who can
visit and when.
• Patient relations (defined by the patient) are invited to visit
during rounds and shift changes so they can be part of the care
team, participating in discussions and care decisions.
• When not in the room with the patient, they are kept updated of
the patient’s progress directly and timely.
 FACILITATORS OF PCC
• Healthcare provider factors: Respect, compassion,
empathy, effective communication, relevant staff
training and development.

• Structural and system factors: supportive and

accommodating environment, and policies.

• Note: PCC requires redesigning and restructuring

services and roles to be more conducive to the model
(Santana et al., 2018).
 BENEFITS OF PCC
• Some benefits of PCC are:

• More satisfaction of patients and their families with the care.

• Enhanced reputation of healthcare providers among

healthcare consumers.

• Higher morale and productivity among clinicians and

ancillary staff.
 SOME CHALLENGES IN SERVICE PROVISION
• Bad working attitude: lateness, absenteeism, malingering, poor
interpersonal relationship, etc.

• Inadequate skills.

• Shortage of personnel.

• Shortage of working equipment and materials.

• Limited available services.

• Distance/mobility between service points

 IMPROVING SERVICE PROVISION:
SERVICE IMPROVEMENT PLANNING (SIP)

• A customer service improvement plan is a set of strategic steps that

need to be taken to achieve a measurable goal.

• Based on research evidence of what needs improvement, what should

be prioritised, and how you plan to go about achieving those steps.

• A healthcare facility comprises of various departments rendering

different services towards a common goal.

• Therefore the overall service improvement of the facility depends on

the improvements in individual departments.
 STEPS IN SIP
1. Pre-planning research:
 SWOT Analysis
 Customer care survey: to help you rate the quality of your
service from the customers’ perspective.
2. Define your goals (SMART)
3. Create an action plan
4. Take action, now!
5. Measure performance at continuous intervals
 SWOT ANALYSIS (PRE-PLANNING)
STRENGTHS WEAKNESSES
• What do you do better than any other facility? • What could you improve?
• What makes you unique? • What should you avoid?
• What unique low-cost resources can you draw • What are things that customers may see as your

INTERNAL FACTORS
upon that others can’t? weaknesses?
• What do people in your facility see as your
strength?

OPPORTUNITIES THREATS
• Do people have a need? • What changes do you face?
• Do people prefer something else? • What are your current competitors doing?
• Are there any changes in technology? • Is changing technology making things difficult?
• Are there changes in government policies? • Is there an issue with finances?
EXTERNAL FACTORS
GOAL-SETTING
ACTION PLAN
 EXAMPLES OF SOME SERVICE IMPROVEMENTS
CARRIED OUT IN FMC YEN.

• Medical records decentralised,

• Paypoints decentralised,
• Pharmacy outlets decentralised,
• Appointment and tally system in GOPD,
• Shift duty in GOPD,
• Blood bank services,
• ANC separated from immunization unit,
• Outsourcing of the morgue, etc.
TOPIC 2: The unsatisfied patient:
common complaints, addressing
criticism, and exceeding
expectations.
 OUTLINE
• The healthcare customers: the patients
• Patient’s expectations
• Patient’s satisfaction
• Patient’s bill of rights
• The unsatisfied patient
• Common complaints and resolutions
• Healthcare providers criticism
• Exceeding patient expectations
• Conclusion
 THE HEALTHCARE CUSTOMERS: THE PATIENTS
• They are sick and under stress
• They are reluctant
• They relinquish privacy
• They are at risk
• They need ‘whole person’ service
• Under these circumstances, healthcare customers can be far
more emotional, demanding, sensitive, irritable, and
uncooperative.
• Therefore, healthcare providers have a duty to understand the
customer from this perspective in order to render good
 PATIENT’S EXPECTATIONS

• Expectations are based on the patient’s understanding of the

illness, cultural background, health beliefs, attitudes, and
level of understanding.

• There may be realistic and unrealistic patient expectations

(Lateef, 2011).
 PATIENT’S EXPECTATIONS contd.
GENERAL EXPECTATIONS UNREALISTIC EXPECTATIONS

• to be listened to. • to discuss several major problems,

• to receive clear explanation and all in one standard consultation.
instructions about their • prescription to be given without a
condition. consultation.
• to be treated with care, concern, • to call the physician 24 hr/day for
and compassion. any problems.
• to be treated by staff who are • thinking that the physician will
professional in their work. always know the exact diagnosis at
(Lateef, 2011). consultation and start treatment
immediately.
 DEALING WITH UNREALISTIC EXPECTATIONS
• do not allow patients to • patient's request for a second
manipulate you with opinion from another physician
unreasonable demands. is acceptable.

• assess deeper why such requests • as a last resort, the patient can
are made. This exploration can be referred to another physician
also enhance communication for care, if both parties cannot
skills. come to an agreement (Lateef, 2011).
• explain clearly in simple terms,
avoiding medical jargon, why
further tests and consults are
needed.
 PATIENT’S SATISFACTION
• Patient’s satisfaction is the extent to which patients are happy with
their healthcare, both inside and outside of the doctor’s office.

• Patient’s satisfaction is a measure of quality of care, that gives

providers insights into the effectiveness of their care and their level
of empathy.

• It is a very effective indicator to measure the success of caregivers

and hospitals.

• Care that meets patient’s expectations results in satisfaction (Lee, 2010).

 FACILITATING PATIENT’S SATISFACTION
• Break the ice: eye contact, smile, call by name, express with words of concern.
• Show courtesy: kind gestures and polite words.
• Listen and understand: encourage patients to tell their problem. Invite and answer their
questions.
• Inform and explain: promotes compliance. People are less anxious when they know what's
happening.
• See the whole person: see beyond illness.
• Share responsibility: risks and uncertainty abound in medical practice. Acknowledging risks
builds trust.
• Pay undivided attention: reduces distractions and interruptions.
• Secure confidentiality and privacy: watch what, where, and to whom you talk about the patient.
• Preserve dignity: treat with respect and modesty.
• Remember the patient's family: families feel protective, anxious, frightened, and insecure.
Extend yourself, reassure, and inform.
• Respond quickly: Keep appointments, and apologize for delays.
 BENEFITS OF PATIENT’S SATISFACTION
• Patient loyalty. • Increased staff morale leading to
increased productivity.
• Improved patient retention. If we annoy
one customer, we will have to satisfy three
other patients just to stay even. • Reduced risk of malpractice suits.

• Reduced vulnerability to price wars. Most • Accreditation. Accrediting bodies

patients will have no problems paying focus on quality service issues.
more money if they have to consult a
quality physician of their choice.
• Increased personal and professional
• Consistent profitability. More patients,
satisfaction: satisfied patients make
more profit. us happier, and the happier we are,
the happier will be the patients.
 PATIENT’S BILL OF RIGHTS (PBoR) IN NIGERIA
• A patient’s bill of rights is a list of guarantees for those receiving medical care.
• Launched in 2018 by VP Osibanjo
• Outilnes 12 rights patients are entitled to:
1. Right to relevant information in a language and manner the patient
understands including diagnosis, treatment, other procedures and possible
outcomes.
2. Right to timely access to detail and accurate medical and available services.
3. Right to transparent billing and full disclosure of any costs, including
recommended treatment plans.
4. Right to privacy, and confidentiality of medical records.
5. Right to clean, safe, and secure healthcare environments.
6. Right to be treated with respect, regardless of gender, race, religion, ethnicity,
allegations of crime, disability or economic circumstances.
 PATIENT’S BILL OF RIGHTS (PBoR) contd.
7. Right to receive urgent, immediate and sufficient intervention and care, in
the event of an emergency.
8. Right to reasonable visitation in accordance with prevailing rules and
regulations.
9. Right to decline care, subject to prevailing laws and upon full disclosure of
the consequences of such a decision.
10. Right to decline or consent to participation in medical research,
experimental procedures or clinical trials.
11. Right to quality care in accordance to prevailing standards.
12. Right to complain and express dissatisfaction regarding services received
(Idhiarhi, 2019).
• N/B: there is minimal enforcement of this PBoR in most facilities, but
currently, SERVICOM is providing some mechanisms and opportunities for
redress for violations of health care rights.
 THE UNSATISFIED PATIENT

• unmet patient’s expectations lead to dissatisfaction.

• to avoid dissatisfying patients, we must listen and respond

promptly.

• consequences of patient’s dissatisfaction include care

providers’ criticism, suboptimal compliance, abandonment of
the facility, negative public reputation of the facility, and
ultimately, reduced profitability (Lee, 2010).
 COMMON COMPLAINTS AND RESOLUTIONS
S/No.
Domain of Dissatisfaction Implicit
Expectations
1.
Perceived ineptitude (adverse events, near misses,
uncleanliness, and a perceived lack of knowledge Safety
or skill)

2.
Disrespect (poor work ethic, lack of warmth, Treatment with
rudeness, and a lack of attention to privacy and
respect and dignity
confidentiality)

3.
Prolonged waits (including waiting for discharge) Prompt and
efficient care
 COMMON COMPLAINTS AND RESOLUTIONS contd.

S/No.
Domain of Dissatisfaction Implicit Expectations
4.
Ineffective communication (transfer of medical Successful exchange of
information to patients) information
5.
Lack of environmental control (inability to
control noise levels, roommate behavior, Environmental autonomy
temperature, smells, pain, lighting, staff and control
interruptions, food service, and even humidity)

6.
Substandard amenities High‐quality amenities (Lee,
2010)
 HEALTHCARE PROVIDERS CRITICISM

• Criticism of healthcare providers arises from dissatisfied

patients.

• Compromised job satisfaction contributes to poor quality care

that attracts criticism.
HEALTHCARE PROVIDERS CRITICISM contd.
• Some major issues that compromise healthcare providers’ job
satisfaction include:

1. Manpower shortage/work overload

2. Perceived poor salary
3. Lack of mentoring
4. Limited access/skills in technology
5. Lack of regular update training
6. Inter- and intra-professional crises
7. Too many administrative tasks (Health eCareers, 2012)
 EXCEEDING PATIENTS’ EXPECTATIONS
• Sustaining a culture of providing quality healthcare and ensuring
patient satisfaction is the way forward.

• To enhance provision of quality health care for a greater reputation

and profitability, healthcare facilities sincerely should invest in:

• Regular human capacity building,

• Adequate provision of working materials
• Enhancing the work environment
• Technological advancements, and
• Policy development and implementation.
 CONCLUSION
• Healthcare facilities must provide enabling conditions
for quality care provision, and constantly evaluate their
services and customer satisfaction.

• Healthcare providers must consciously work on our

skills and work ethics to ensure provision of quality care.

• Note: SATISFIED PATIENTS GO HOME HAPPY AND

TURN OUT TO BE OUR ‘BRAND AMBASSADORS’.
• FMC Yenagoa must get better in our service delivery!
 REFERENCES
• Health eCareers (2012). Top 10 Challenges Facing Healthcare Workers. Retrieved on 6/11/21 from
https://www.healthecareers.com/article/career/top-10-challenges-facing-healthcare-workers.
• Idhiarhi, S. (2019). Bill of rights for patients in Nigeria: an exploratory essay. Retrieved on 6/11/21
from https://www.researchgate.net/publication/349086576
• INSTITUTE OF MEDICINE (IOM, 2001). Crossing the Quality Chasm: A New Health System for the
21st Century. NATIONAL ACADEMY PRESS; Washington, D.C. Retrieved on 2/11/21 from
https://pubmed.ncbi.nlm.nih.gov/25057539/
• Lateef , F (2011). Patient expectations and the paradigm shift of care in emergency medicine. J
Emerg Trauma Shock. 4(2): 163–167.
• Lee, A. V.; Moriarty J. P.; Borgstrom C.; Horwitz L. I. (2010). What can we learn from patient
dissatisfaction? An analysis of dissatisfying events at an academic medical center. J. Hosp. Med.
5(9):514-520.
• Prakash, B. (2010). Patient satisfaction. J Cutan Aesthet Surg. 3(3): 151-155.
• SERVICOM (2017). About SERVICOM. Retrieved on 27/10/21 from
https://servicom.gov.ng/our-clinic/about/.
• Santana, M. J.; Manalili, K.; Jolley, R. J.; Zelinsky S.; Quan H.; and Lu, M. (2018). How to practice
person-centred care: a conceptual framework. Health Expect. 21(2): 429-440.
• World Health Organization (WHO, 2021). Quality of care. Retrieved on 2/11/21 from
https://www.who.int/health-topics/quality-of-care#tab=tab_1.
THANKS FOR LISTENING!