Amid the limitless demand for tertiary care from public facilities constrained by lean resources and the inadequacy of skilled workers, interventions targeted at expanding access to higher layers of healthcare are sprawling out of academic hubs like the Lagos State University Teaching Hospital (LASUTH).
The hospital is pooling ideas to see that many, who would otherwise have been excluded from quality healthcare due to poor capacity, are now provided with an array of services that cater to them.
From building capacity for an additional list of surgical procedures to expanding its facilities to accommodate more bed spaces and recruiting more hands to handle steady pressure, the management spearheaded by Adetokunbo Fabamwo, the chief medical director and professor of obstetrics and gynaecology is rejigging its operations with support from the state government.
Its scorecard in the last year shows that in addition to being known for hosting a broad range of specialists, government-run tertiary hospitals are gradually emulating the efficiency common to top private facilities in the delivery of health services.
Official documents obtained by BusinessDay indicate that patient-centred care, infrastructural development, capacity building, training, and recruitment of a total of 634 personnel topped its performance chart for the year.
Patient Care
A key feature of the rejigging that took place is the disaggregation of the nursing services department into four new units comprising clinical services, training and research, monitoring crew and administration as part of the efforts to keep upgrading the hospital’s services in terms of functionality, and excellent service delivery.
The hospital began microvascular surgery for tissue in the head and neck, making it the first teaching hospital to perform the surgery successfully.
In filling the gap for the acute shortage of nurses and to ensure that patient care is optimized, ward assistants have been employed and carer services partnerships have been secured.
In terms of the bed management system, the hospital has now employed a crop of bed managers who ensure the availability of beds in the emergency units.
LASUTH now performs interventions including ICD insertion, neurosurgical intervention and microvascular breast surgery (Breast Reconstruction).
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Infrastructure
Three new 500 KVA generator were installed to augment the power supply by mainland PPP. The hospital has established a Special Services Centre where services including endoscopy, bronchoscopy, dialysis and cardiac catheterization are offered.
Also, to expand accommodation for both patients and workers on site, the contract for the resident doctors’ quarters has been awarded to the contractor now on site, while the SDG building designed to contain 120 beds with offices is nearing completion.
The Diabetes Clinic has been renovated, upgraded and commissioned. The hospital has a PPP arrangement to provide two mini ambulances to transport patients from wards to theatres and other activities.
The renovation and extension of the psychiatry ward have commenced along with the renovation and upgrading of the burns and trauma ward.
LASUTH has acquired a C-ARM Machine to replace the old one that has been inoperative and hampering efficient theatre utilization. The redesign of the ENT Clinic has commenced, a new suite of 16 fully furnished consultant offices was constructed, a parking bay has been constructed for ambulances, and new office suites are now available for the monitoring crew.
Other projects executed include a new PPP model 100 bottles per day oxygen plant that has been commissioned; a 10-bed intensive care unit was set up in Ayinke House, 12 private wards were refurbished and upgraded; the Trauma Annex in Gbagada was completely renovated and a facility manager was appointed.
Capacity Building
In line with one of the state pillars of the development agenda, education and technology, budgetary allocation and support have been provided for training and capacity development of healthcare staff in LASUTH. Staff was sponsored to attend a number of programs locally and outside the hospital.
The first in the series of attitudinal training programs were held and anchored by Prof. Ireti Akinola. Onboarding training of some newly recruited staff was held but has not been regular. A number of staff were sponsored for seminars, conferences, and training. Two Board retreats were held in Dubai and in Abeokuta and a management retreat at Dover Hotel, Ikeja.
LASUTH also embarked on a strategic staffing that brought in five neurosurgeons, three cardiothoracic surgeons, 15 consultant anaesthetists, and 16 consultant pediatricians.
In the aspect of research, the teaching hospital currently has three grant awards under purview. They include Agro Global cancer Disparities Pilot Grants ($5,000); Rheumatoid Arthritis Knowledge gap and Intervention in Nigeria, RAKGIN STUDY ($62,000); and Rapid: Evolutionary Nutritional Adaptations and COVID-19 Risk among Health Workers, US National Science Foundation ($104, 174).
Additional accreditation was acquired in dental surgery, radiology, emergency medicine, internal medicine, orthopaedic, paediatrics, ophthalmology and pathology.
Administrative reshuffle
The administration and human resource department has been reorganised into five units according to the universal standards. It now comprises a planning and recruitment unit; human resource measures and accountability unit; employee and industrial relations unit; learning and development unit; administration unit
Clinical Training
About 345 clinical staff recently concluded training and certification in Basic Life Support (BLS) skills and 200 more are soon to be trained in Basic Life Support (BLS) Advanced Cardiac Life Support (ACLS)
Some members of the clinical staff were trained on antimicrobial surveillance and antimicrobial sensitivity.
LASUTH also collaborated with Duchess and Evercare hospital as part of efforts to interchange training, and gain service improvement for clinical staff with prominent private healthcare institutions.
It also successfully established the school of Anaesthetic Technology for the training of Anaesthetic Technicians.
It is however still challenged by power supply issues, attrition of health workers, security issues, unwholesome practices among staff, and unavailability of bed space.
