Dr. Muhammad Dogo-Muhammad is a highly respected medical doctor and healthcare leader with a distinguished career spanning multiple continents. Currently serving as the Chief Medical Director of Baze University Hospital, Dr. Dogo-Muhammad brings a wealth of experience and expertise to his role. A UK-trained Consultant General Surgeon and Urologist, he also holds a Master’s degree in International Health and Hospital Management from Germany. His extensive experience in healthcare leadership includes serving as commisioner for Health in Bauchi State, where he understood the importance of creating a strong health network and its impact on communities. He has led numerous public hospitals in Nigeria, leveraging his global expertise to drive positive change. Notably, he spearheaded the development and implementation of crucial policies and reforms as Executive Secretary and CEO of the National Health Insurance Scheme (NHIS), now known as the National Health Insurance Authority (NHIA). In this interview with MARY NNAH, Dogo-Muhammad shares his insights and experiences, offering a unique perspective on healthcare leadership, innovation, and policy
What motivated you to transition from clinical practice to health leadership roles, such as your time as a commissioner for health and CEO of the NHIS?
I found myself literally plunged into political space – public appointment – as an honourable commissioner of health in my state – Bauchi State – during the military era (1997-1999). I never applied or even indicated any desire to get involved with such an assignment. In fact, I resisted it, but I had to do it because it was a national assignment. I had wanted to remain in my clinical practice.
As for the post of the Executive Secretary and CEO of the NHIS, I transferred my service from the Bauchi State government to the Federal Government in 2002 to have a national platform at policy-making position.
I served as a Consultant Special Grade I in the Inspectorate Division of the Department of Clinical Services of the Ministry of Health. I was sponsored by Vamed Engineering Company to go for an MBA course in International Health and Hospital Management (IHM Option) in Frankfurt, Germany (2015-2016).
I went around the world to see different health systems in locations like Germany, Austria, Finland, the UK, the USA, Dubai, and Japan; these exposures broadened my horizons in health and hospital management.
The intention then, was to get me to handle the maintenance of equipment of all the Federal Government’s tertiary hospitals that were fully refurbished and equipped to the highest global standards. Well, that was not to be the case, as I was posted to Federal Medical Centre Gusau as an Interim Administrator in 2016 because there was a crisis in the hospital’s administration.
Barely two months later, there was another problem at the NHIS, and I was posted as a National Coordinator for NHIS, a post I served for six months. I was appointed as the substantive Executive Secretary and Chief Executive Officer of the organisation (2006-2012). I did not plan to transition from clinical practice to health administration, but rather, it was by the providence of the Almighty.
How do you approach leadership and team management in a healthcare setting?
Leadership in any situation is about aligning followership and giving a sense of direction; it’s not any different in the healthcare setting than in a hospital. However, the unique nature of the healthcare environment is such that all cadres have specific training and there must be an optimum mix of required manpower in the medical team for it to function well. Almost all cadres have regulating bodies that routinely ensure that, at least annually, all personnel get valid practicing licenses.
The corporate culture of the healthcare environment is further enhanced by human nature, which has been engraved in a person’s psyche, but it must be further developed. Delegation of responsibilities and knowing the limits of everyone in the team must be well entrenched so that efficient use of resources and confining one to his/her competence is complied with. This allows for an easy flow of referrals from the lowest level of care up to the top. The use of Standard Operating Procedures (SOP) further minimises errors of omission or commission.
What is your vision for Baze University Hospital, both in the short term and long term?
Baze University Hospital (BUH) was established to serve as the teaching hospital for the training of medical students at Baze University as a precondition to retaining the accreditation of the university for medical college. It’s instructive to note that right at the onset, the vision of BUH was to be “the trusted leader in quality medical care.” Thus, the entire staff was aligned to this vision, and all that followed was geared towards achieving it.
In the short term, my vision must comply with the conditionality of retaining the accreditation of the medical college. Of course, all teaching hospitals are centres for training, tertiary healthcare provision, and research. BUH is not any different from these functions.
In the long term, BUH will be a training ground for all categories of clinical and allied medical professionals, such as pharmacists, nurses, postgraduate training consultants, etc. Medical laboratory scientists and technicians are already being trained, as are medical radiographers.
Another area of concern for which BUH is seriously working to achieve is to reverse the current case of medical tourism with Nigerians going out of the country; they should look inwards. Also, the COVID-19 saga taught us that facilities of world-class standards must be established in the country, and I believe BUH has endeavoured to provide just that.
In spinal and nerve surgeries, a lot of advances in minimally invasive procedures are in use, and the frontiers are limitless. When one talks about innovation in the healthcare space, the horizon is almost limitless.
How do you envision technology transforming healthcare delivery in the coming years?
Information technology, Artificial Intelligence (AI), and cyber-knife technology in the treatment of cancers are among the cutting-edge technologies for the future. The deployment of technology into the healthcare space is imperative and inelastic. It will transform healthcare as we know it today.
What advice would you give to young health professionals aspiring to leadership roles in healthcare?
Young health professionals aspiring to leadership roles in healthcare should in addition to going for further studies to improve on their professional callings, must have administrative exposure either in public or private settings. I will advise them to undergo a training that exposes them to managing human resources, administration, and business i.e. an MBA of some sort. More courses on strategy and policy formulation and execution will be very handy.
How do you measure patient satisfaction, and what steps do you take based on feedback from patients?
At Baze University Hospital, we take a dual approach to handling customer feedback manually and electronically to ensure comprehensive insights into patient satisfaction. Manually, we utilize in-person feedback forms, suggestion boxes, and face-to-face interactions with patients during consultations or at discharge. For example, patients can provide feedback on their experience through forms we collect and analyze weekly, which allows us to capture real-time concerns and address them quickly. Electronically, we leverage our hospital’s website and patient portal for online surveys and feedback forms. After discharge or following specific treatments, we invite our patients to rate our performance and tell us their experiences. Additionally, we have integrated wall-easy display screens in every corner of the hospital where patients can leave feedback instantly on their experiences. For instance, after a procedure, patients may rate their care and provide comments, which our teams reviewed electronically to track common trends and prioritize improvements.
Both methods work hand-in-hand to ensure that feedback is effectively captured, evaluated, and acted upon, helping us refine services, enhance patient care, and improve the overall hospital experience.
What methods do you use to foster effective communication and collaboration among different healthcare professionals in the hospital?
Effective communication among hospital staff ensures patient safety, improves teamwork, and enhances overall care quality. At BUH, we promote effective communication through regular team meetings to discuss updates, share concerns, and collaborate on problem-solving. Also, we encourage interdisciplinary ward rounds where different healthcare professionals (nurses, doctors, pharmacists, etc.) discuss patient care collaboratively to promote understanding and respect among team members. We develop and disseminate clear communication protocols for different scenarios (e.g., emergencies, handoffs), ensure staff training on these protocols, and ensure role clarifications to prevent overlapping duties and responsibilities.
Furthermore, we ensure attendance at training sessions on effective communication, conflict resolution, and teamwork to enhance staff skills and encourage using technology, like secure messaging apps, electronic health records (EHRs), and collaborative platforms to facilitate quick and efficient information sharing.
As an organisation that promotes a Just culture, BUH encourages open dialogue where staff feel comfortable sharing their thoughts and concerns without fear of criticism. Also, we involve patients in discussions about their care, enabling staff to communicate openly with them and improving staff communication skills. We have channels for staff to provide feedback on communication practices, and we recognize and appreciate effective communication practices and teamwork among staff to reinforce positive behaviors.
How do you approach training and professional development for hospital staff to ensure they are equipped with the latest knowledge and skills?
Training and professional development are essential for hospital workers to remain competent in the latest technologies and skills. At BUH, we prioritize training and development through regular continuing education courses focusing on new technologies, medical procedures, and best practices. These trainings can be in-person, online, or hybrid formats. Also, we organise workshops and seminars led by experts in various fields covering new technologies, software, and treatment protocols and providing hands-on experience when possible. We also use simulation-based training to allow staff to practice new skills in a safe environment. Simulation is particularly effective for high-stakes procedures where proficiency is critical, like Basic Life support (BLS) and advanced cardiac life support (ACLS) training.
Similarly, BUH encourages mentoring because medical science is an apprentice-like training requiring pairing experienced staff with newer employees. Mentoring fosters knowledge transfer and helps develop skills in a supportive environment. With free accessible internet, BUH provides access to online learning resources, including webinars, courses, and medical journals. Online learning allows staff to learn at their own pace and stay current with industry developments. BUH promotes cross-training among different departments to enhance staff versatility and understanding of various roles within the hospital. It also conducts performance evaluations that identify areas for improvement and create personalised development plans for staff, aligning training with individual career goals.
Moreover, as a training ground for medical students, BUH encourages staff to participate in research projects or committees focused on new technologies and practices, fostering a culture of innovation. Also, we partner with universities and professional organizations to provide advanced training and certification programs that keep staff updated on industry standards. Indeed, we foster a culture of lifelong learning by recognising and rewarding staff who pursue additional training, certifications, or education. Additionally, we have a feedback loop where staff can express their training needs and assess the effectiveness of training programs. Utilize this feedback to improve offerings continually.
How does BUH approach the reporting and management of medical errors, and what steps are taken to prevent future occurrences?
BUH approaches reporting medical errors through several strategies aiming to prevent future occurrences, including incident reporting systems, where staff can report errors or near misses anonymously. This step encourages openness and helps identify patterns or systemic issues. After that, we conduct a root cause analysis (RCA) to determine the underlying causes of the error. The hospital provides feedback to staff about reported incidents, and the actions taken can reinforce the importance of reporting and promote continuous improvement. This process helps to understand what happened and why it happened. Also, at BUH, we want to foster a safety culture; therefore, staff members are encouraged to report errors without fear of punishment. This process creates an environment where learning from mistakes is prioritised over assigning blame. Insights from reported errors help the hospital revise its policies and procedures to enhance safety protocols and prevent similar errors in the future.
Also, we conduct regular training sessions on safety protocols and error prevention strategies to help staff stay informed about best practices and the importance of error reporting. Additionally, the hospital conducts regular audits and reviews of incident reports and safety practices to identify trends and areas for improvement. Similarly, BUH collaborates with external organisations, including NAFDAC, and participates in national databases for reporting and analyzing medical errors. Such collaboration provides insights into broader trends and global best practices.
How do you assess and implement new technologies in the hospital while considering the budget and training needs of staff?
Accessing and implementing new technologies in a hospital within a resource-poor environment can be challenging but achievable with careful planning and strategic approaches. At BUH, we initiate such acquisitions by conducting a thorough assessment of the current needs and challenges faced by the hospital. We prioritise such investments if we identify specific areas where technology can make the most significant impact, such as improving patient care, streamlining operations, or enhancing communication. Also, we focus on technologies that provide the greatest return on investment and are implementable with available resources, thus prioritising low-cost, high-impact solutions that address immediate needs. Due to the substantial capital requirement for the latest technology, we sometimes seek partnerships with other organisations with access to funding, resources, or expertise in implementing health technologies to reduce the burden of such acquisitions. Also, we may explore grants, donations, and funding from various organisations that support health technology initiatives like the CBN, Bank of Industry, and commercial banks. However, where there are local alternatives, we explore locally developed technologies or adaptations that are cost-effective and culturally appropriate.
What are the hospital’s long-term goals for growth or improvement in the coming years?
At BUH, our long-term growth and improvement plans focus on enhancing patient care and operational efficiency by maintaining the highest standard of care through continuous quality improvement initiatives, including implementing evidence-based practices and regular evaluation of patient outcomes and satisfaction surveys to identify areas for improvement. Also, we will continue to invest in advanced medical technologies, electronic health records (EHR), and telemedicine to improve service delivery and accessibility and explore data analytics for better decision-making and predictive modeling in patient care. Furthermore, the management will focus on recruitment, retention, and continuous training of healthcare professionals to ensure a skilled workforce and foster a culture of collaboration and professional development among staff. For financial sustainability, we will implement strategies for revenue diversification, including partnerships, grants, and community programs, and optimize operational efficiency to reduce costs while maintaining quality care. As part of our corporate social responsibility, the hospital will partner with local organizations to address public health issues and improve community health outcomes. In collaboration with the community health department of Baze University, the hospital will conduct regular community health assessments to understand and respond to local health needs.
As an ongoing concern, BUH will prioritise expansion and upgrades to ensure facilities meet current healthcare standards and patient comfort needs. Also, we will incorporate environmentally sustainable practices in operations, such as waste reduction and energy efficiency, and promote health and wellness initiatives to encourage a healthier community. As a teaching Hospital, BUH will support clinical research and trials to advance medical knowledge and treatments and foster a culture of innovation to explore new care delivery models. Lastly, we will stay updated with healthcare regulations and ensure compliance to maintain accreditation standards by regularly reviewing policies and procedures to align with best practices and legal requirements to comply with regulatory provisions and accreditation.
