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Boosting healthcare with inter-professional collaboration

By Stanley Akpunonu   |   15 May 2017   |   3:57 am  

Chairman of the Occasion and Past President Nigerian Academy of Engineering (NAE), Vincent Maduka; President, Nigeria Academy of Pharmacy (NAP), and former Minister of Health, Prince Julius Adelusi-Adeluyi; President, Pharmaceutical Society of Nigeria (PSN), Ahmed Yakasai; Former Minister of Health and consultant economist, Prof. Eyitayo Lambo; Chairman, Planning Committee of NAP symposium, Sir Ifeanyi Atueyi; General Secretary NAP, Prof. Fola Tayo; former Governorship aspirant Lagos State and Chairman JayKay Pharmacy Limited, Jimi Agbaje; former Chairman Association of Medical Laboratory Scientists Council of Nigeria (AMLSCN), Vice Chancellor Ambrose Ali University Ekpoma, and Managing Director (MD)/ Chief Executive Officer (CEO), Lahor Research Laboratory and Medical Centre, Prof. Denis Agbonlahor; Assistant Editor, The Guardian Newspapers, Chukwuma Muanya; and other participants at a symposium on “Health of the Nation: The Imperative of Interprofessional Collaboration” organized by NAP and PSN in Lagos


Inter Professional Collaboration (IPC) is defined as “when multiple health workers from different professional backgrounds work together with patients, families, careers (caregivers), and communities to deliver the highest quality of care.” It is based on the concept that when providers consider each other’s perspective, including that of the patient, they can deliver better care.

Teams can also work together to develop health promotion for diverse communities and instill disease prevention behaviours amongst patients.Recent studies show that higher inter-professional team functioning is associated with better patient outcomes and cost savings.

Available evidence however suggests that unlike in the developed world, healthcare professionals do not collaborate well in Nigeria because of the claim of superiority of a particular health professional over others. This has often resulted in inter-professional conflict, which is threatening to tear the health sector apart at the detriment of the patients.

 
A vivid example is the lingering conflict between physicians (medical doctors) and the health workers under the aegis of the Joint Sector Health Unions (JOHESU).
 
To address this issue the Federal Government had set up a Presidential Committee on Industrial Harmony in the Health Sector; and the Ministerial Committee on the Review of the Residency Programme in Nigeria.

Despite efforts of successive governments to address the menace of inter-professional disharmony in the country, the situation is not getting any better.
However, there appears to be light at the end of the tunnel with a renewed concept by the Nigeria Academy of Pharmacy (NAP) in partnership with the Pharmaceutical Society of Nigeria (PSN). The pharmacists have called for IPC in the area of health where professionals work together, sharing responsibility for problem solving and decision making to formulate and carry out plans for patients’ care.

The NAP and PSN at a symposium on “Health of the Nation: The Imperative of Interprofessional Collaboration” said that the Nigeria health system should be based on teamwork.

They said that health professionals from a variety of disciplines should work together to deliver the best possible healthcare services to all Nigerians and all members of the team are equally valuable and essential to the smooth running of hospitals.

Former Minister of Health, Prof. Eyitayo Lambo said that the nation’s health system is very poor as a result of scanty provision for health in the constitution and lack of legislative definition of the role and responsibility of various health actors.

Lambo in his keynote address lamented that even the National Health Act has failed to resolve the problem as constant change in leadership leading to policy somersault, endemic nature of corruption, low accountability, and weak public private partnership in health, poor financing and poor quality services hinder development in the healthcare system.

Also, the economist explained that a possible strategy to strengthen the national healthcare is by inter-professional healthcare team as members of multiple profession share responsibility with thorough coordination among team members in generating treatment plans and achieving better result.

Lambo added that the benefit of working together is to improve efficacy of health system, to elevate responsive health outcomes and increase in capacity building.

President, NAP, and former Minister of Health, Prince Julius Adelusi-Adeluyi, said most of the brightest minds are in the health sector. “Over the years the efficacy suffer sudden decline and we have act accordingly. It did not start today coupled with distractions and cooperation problems. Governments are fed up with the noise from healthcare. There is this lack of trust within us. We should come together as an organised body to tackle issues,” he said.

He continued: “let us put our fate in our hands and see the effects. Let us help us and stop celebrating our differences. Let us involve in team work and see the ripple effect on our healthcare system.”

President, PSN, Ahmed Yakasai, reiterated the urgent need for as healthcare professionals and caregivers to work together as brothers and sisters in the interest of the patient and the healthcare sector of this country.

He said the three secrets to pragmatic growth of the health sector in terms of deliverables to the public include: collaboration, collaboration, and collaboration.

Yakasai said Nigeria’s health systems must therefore be charged with bridging professional disparities, as we are in a hybrid environment of peak complexity that requires and demand of us to be efficient and deliver on the promise of “wellness”.

The pharmacist said the golden bullet for us, in his humble view, is teamwork through inter-professionalism. He said, according to the World Health Organisation (WHO), 2010, “It is no longer enough for health workers to be professional. In the current global climate, health workers also need to be inter-professional.”

Yakasai further stated: “What we must have – as pharmacists, nurses, physiotherapists, medical doctors, laboratory scientists to mention a few – is the reliance on one another to reinforce our work and move our professions toward greater integration. We have all participated in teams, but the culture of health care has long emphasized solo acts.

“Inter-professional collaboration should therefore be our key mantra. Inter-professionalism happens ‘when multiple health workers from different professional backgrounds work together with patients, families, and communities to deliver the highest quality of care’. Our teamwork must be based on the notion that when we professionals consider each other’s perspective, including that of the patients, we can surely deliver better, efficient and effective care, which is our ultimate goal as healthcare providers.


“To achieve this, will require of each of us to shift our focus towards collaboration, partnerships, and sharing, working together in an environment of mutual respect, trust, accountability and communication.”

Yakasai challenged health professionals to commence the journey towards inter-professionalism. This, he said, will require of systemic change in practice, exposure to each other’s role and perspectives, effective and open communication, professional trust, and a system of coordinated care that enables patients to be part of the decision making related to their care.

A former Vice Chancellor Ambrose Ali University, Prof. Dennis Agbonlahor, said that in other to address the health problems, an unbiased minister of health who would be competent and ready to expand health professionals should be appointed.

Agbonlahor advised the government to always implement outcomes of collective bargains so as to reduce strike actions. Meanwhile, Assistant Director, Nursing Services, Lagos State University Teaching Hospital (LASUTH) in her opinion said that the healthcare organisations should access possible setups for proper communication and be diligent about offering programme and outlets to foster team collaborations which actively encourage ideas and opinions of the team members.

In his own account, Dr. Ebun Sonaiya, said healthcare is team effort, each healthcare provider is like a member of the team with special role.He added that healthcare is becoming increasingly more interconnected and that coordinating care between nurse, pharmacists, doctors, and physicians is the way out. Sonaiya said that role clarity should be properly stated and team member’s need to be comfortable with skills overlap but the key is for everyone to work for a common goal.


The PSN President added: “Since I became the President of Pharmaceutical Society of Nigeria in November 2015, I have being an ambassador of peace, harmony and inter-professionalism in our health care sector. I’ve extended my hands of fellowship to all and sundry in the health care sector because I believe that together we are stronger.

“Going forward, The PSN will keep adopting this philosophy which will be detailed in our 25 year strategic plan document to be launched soon, as we will install collaboration and inter-professionalism right at the heart of it. In my view, adopting this team-based culture of mutual respect and understanding is possible and, in fact, necessary as we all have a moral obligation to join hands for the benefit of the patients.

Together everyone achieves much. Each of us needs all of us, and all of us need each of us. Distinguished listeners, together we are stronger and better. Together, we can move the healthcare of this nation forward.”



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