TOWARDS A MORE COHESIVE HEALTHCARE DELIVERY SYSTEM IN NIGERIA

TOWARDS A MORE COHESIVE HEALTHCARE DELIVERY SYSTEM IN NIGERIA Healthcare can be defined as the provision of medical and related services aimed at maintaining good health, especially through the prevention and treatment of disease.

Collaboration can be defined as the act of working together with one or more people in order to achieve something. Some level of collaboration between healthcare providers, is necessary in any healthcare setting. In hospitals, careful coordination of services between physicians, pharmacists, nurses, laboratory scientists and other professionals must occur around the clock in other to achieve patient centred goals and objectives.

In outpatient settings, health care providers are supposed to operate at varying levels of collaboration depending upon the types of services offered. No single discipline or specialty can meet all of a patient’s needs. A hospitalized patient, for example, may need a physician to provide a diagnosis and treatment plan, a pharmacist to ensure optimal medication use, a nurse to administer medications, a nursing assistant to help with bathing and toileting, laboratory scientist to take specimen samples, a dietician to monitor food intake, and a physiotherapist to aid in muscle strengthening and flexibility. Without communication among all of these professionals, comprehensive and efficient treatment of the patient is not possible. Collaboration involves coordination of individual actions, cooperation in planning and working together, and sharing of goals, problem-solving, decision-making, and responsibility. In general, health care providers tend to strongly identify with their own discipline and its language, values, and practices. Hence Collaboration may be very difficult to negotiate effectively because of differences in disciplinary socialization. Nurses, pharmacists, and social workers face comparable issues in collaborating with physicians, including a lack of acceptance by physicians of the full breadth of other professionals’ roles, continuing status, contradictory expectations regarding the autonomy of non physicians, and a commonly expressed need for physicians’ recognition of their competence. Conflicts between professionals can undermine the collaborative efforts of the team. Each member of the team must sacrifice some degree of autonomy in order for the group to function. Team meetings are a critical aspect of health care team functioning, and effective communication between all members is needed, but often lacking Effective communication among team members is crucial to successful collaboration in patient care. The nature of the pharmacist-physician relationship makes some tension inevitable: Actions that the pharmacists must routinely perform in the practice of pharmaceutical care (interventions such as correcting, advising, reminding, recommending, and reporting) are intrinsically threatening to physicians professional identities. Pharmacists can utilize politeness and face-saving strategies to present recommendations to physicians (for example by asking leading questions rather than directly suggesting an alternative drug). Therapeutic interventions by pharmacists offering safer, more medically and/or cost effective drug alternatives to physicians are generally well-accepted and are very common in teaching hospitals and other tertiary hospitals. As pharmacists seek to expand their roles within health care organizations, some physicians generally view such expansion as an encroachment on their territory. Some researchers have found benefits to increased pharmacist involvement in geriatric patient care among others. For example, pharmacist review of prescriptions for elderly patients improved quality of patient care in regards to appropriate medication use by catching possible interactions, allergies, contraindications and over-medication. Specifically, multidisciplinary and interdisciplinary team care in a wide variety of clinical settings has been associated with the following outcomes: decrease in length of hospital stay, increased patient satisfaction, better coordination of patient care, increased use of hospital rehabilitation services, improved functioning in Activities of Daily Living, improved pain control, decreased emergency room usage, decreased mortality one year after discharge, and decreased overall health care costs In conclusion, professionals must trust and respect one another, and the work and perspectives they contribute, as well as develop a sense of caring about others, since effective collaboration leads to a synergy that improves patient care. This is the sum total of all the hustle and bustle of players in the healthcare sector. Pharm (Dr) Kingsley C. Amibor, B.Pharm, Pharm D. Mpcp Clinical Pharmacist