Award of the SERVICOM Index · Award of the SERVICOM Index Report of SERVICOM Compliance Evaluation...
Transcript of Award of the SERVICOM Index · Award of the SERVICOM Index Report of SERVICOM Compliance Evaluation...
February 24, 2009
The People’s Right to Be Served Right
Award of the SERVICOM Index
Report of
SERVICOM Compliance Evaluation of
National Hospital, Abuja
(General Out-Patient Department)
Office of the Secretary to the Government
of the Federation
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EXECUTIVE
SUMMARY
SERVICOM Index compliance Evaluation Report
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SUMMARY OF SERVICOM COMPLIANCE EVALUATION NATIONAL HOSPITAL,
ABUJA
Date of Evaluation: February 24, 2009
Score: 1.6 out of 4 (40%)
Ranking: Two Star (**) Service
Description: Fair
Findings
Strengths:
Customers confirmed that there are no hidden costs on charges
The use of Public Address Systems to disseminate information on service delivery
and other hospital activities
The hospital carries out customer satisfaction survey to determine customers’
satisfaction level
There are designated waiting areas with seats throughout the hospital where
customers seat while waiting to receive service
Weaknesses:
There are no clearly defined processes involved in monitoring performance against
set Standards, to show that the hospital adheres to its set standards in rendering
service to its customers For instance, the set standard on customer care in the
areas of promptness, speed of response and staff treatment of customers have no
process of monitoring as customers wait endlessly before services are accessed
The directional signs provided to direct customers to different service points in the
hospital are not enough e.g. there is no clear directional signs to the GOPD. This
makes access to service difficult for customers and visitors
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Customers and stakeholders of the hospital confirmed that costs and charges are
not set within the reach of the poor and the very poor especially with regards to
laboratory tests and costs of drugs. As a result poor citizens find it difficult to
access the services of the National hospital
Frontline staff are not trained on complaints handling, this affects the level of their
professionalism in the resolution and investigation of all complaints
Customers are not aware of how long it takes to receive service at the GOPD and
other service outlets of the hospital as they wait endlessly to be attended to from
one service point to another e.g. customers confirmed that it takes an average of
3- 4 hours before one receives service at the hospital
Customers complained that staff do not offer explanations for delays in service
delivery nor do they explain interruptions to services e.g. Doctors resume duties
between 10.00 am – 11.00 am while the patients are kept waiting without
explanations
Appointment procedures are not clearly detailed at all service outlets for the benefit
of both new and old customers. This gives room for preferential treatment as was
observed during our mystery shopping as also confirmed by customers
There is no evidence to show that the hospital has implemented the result of
consultation with all customer groups and adapted service accordingly e.g
costs/charges of service and issue of staff punctuality to work as contained in the
Report on Quality of Care Survey carried out by the hospital between September
– November, 2008
There exists the issue of some departments not duly represented at management
meeting. This excludes some staff from participation in the consultation process in
the service delivery system of the hospital
Frontline staff do not wear name tags, offices and desks are not clearly marked to
indicate names and functions of officers for easy identification by Customers
Performance targets are not set for individuals (staff) and departments, therefore
where there are variances in the overall targets of the hospital, it cannot be fully
explained
Frontline staff are not trained on Customer care, this affects the level of sensitivity
in the treatment of customers e.g. The majority of the customers interviewed
complained that most staff of the hospital at different service points are rude and
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arrogant; and are not friendly to customers. This was also confirmed in the Report
on Survey on Quality Care carried out by the hospital between September –
November, 2008
The Chief Legal Officer who is also the nominated Complaint Desk Officer is not
clearly identifiable to customers to ensure that customers have someone to talk to
when services fail
Recommendations:
There should be clearly defined processes involved in monitoring performance
against all set Standards. For example, a system should be put in place to check
how long patients take to access the services of the hospital. Such monitoring
system should take into account the movement from one service point to another.
This will ensure that the hospital adheres to its set standards in rendering service
to its customers
Adequate directional signs directing customers to different service points should be
put in place within the hospital especially that of the GOPD. This will make access
to service easy for customers and visitors
The issue of high costs and charges not set within the reach of the poor and the
very poor should be looked into by the management. Appropriate downward
review of price should be carried out in order to address the issue once-and-for-all
so that poor citizens can also access the service of the hospital
Frontline staff should be trained on complaints handling, this would enhance
effective resolution and redressal of all cases of service failures
Concerted efforts should be made by the management to reduce actual waiting
time of 3-4 hours in the hospital so that an average realistic waiting time could be
developed for the benefit of the customers
Staff should endeavour to give honest and substantial explanations for delays and
interruptions to service. This should be done as part of recovery of a breakdown to
service delivery and will reduce anxiety and anger of customers at service points
Appointment procedures should be clearly detailed at all service windows for the
benefit of both new and old customers. This will prevent incidence of preferential
treatment being given to some customers by staff and will ensure equal treatment of
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all customer groups
The hospital should endeavour to implement the results of consultation and adapt
service accordingly such implementation should be made public for all to know that
the hospital considers the views of its stakeholders in the service delivery process
Management should look into the re-occurring issue of some departmental heads not
being represented at management meetings. Adequate information on this should
be given to staff particularly Heads of Units for transparency purpose and for
improved service
All staff should wear name badges. Offices and desks should clearly indicate
functions and names of officers. This will ensure easy identification of staff at the
service points
Clear performance targets should be set for individuals(staff) and Departments in
order to monitor individual and department performance against set standards and
targets in the overall achievement of the hospital’s goal
Frontline staff should be trained on Customer Care, this would give staff the
mindset and capacity to always treat customers with respect and dignity during
service provision and delivery
The position of the hospital’s Complaints Desk Officer presently located at the legal
unit should be re-assigned to the SERVICOM unit for prompt resolution of cases
of service failures as directed by the Federal Executive Council
Full details of the Complaints Officer, Name, Room number and telephone number
should be clearly stated in the Charter
Conclusion
The SERVICOM Index awarded to the National Hospital, (GOPD) Abuja is 1.6 out of 4
(40%) which represents two star (**) and indicates ‘Fair’ service delivery. Although this is
still far from praiseworthy, it is our belief that the National Hospital, Abuja could ensure
continuous improvement on the quality of service delivered to members of the public if the
recommendations contained in this report are faithfully implemented.
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MAIN
REPORT
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1.0 Introduction
This is a report on the findings of a SERVICOM Compliance Evaluation of the National
Hospital, (GOPD) Abuja. Compliance has been measured against the SERVICOM Index,
a yardstick for measuring the quality of service as delivered by Government through its
various Ministries, Departments and Agencies.
The SERVICOM Index is predicated on the facts that:
The ultimate purpose of governance is to serve citizens
Citizens have the right to be served right
Service is well delivered only when citizens are satisfied; and
The Federal Government is committed to the provisions of SERVICOM (Service
Compact with All Nigerians) as a programme to improve service delivery throughout
the country
Customer satisfaction is the overriding consideration of service delivery. Extensive
research, consultations and surveys have shown that customer satisfaction is broadly
driven by several drivers, listed below. The selected service windows of the National
Hospital, Abuja has been evaluated for each of these drivers through customer
interviews, discussions with staff, discussions with partners, review of key documents and
observations. The Index score for National Hospital, Abuja has been calculated as a
weighted average of the composite scores evaluated for each driver. The weight of
importance attached to each driver is as follows:
Service Delivery – 30%
Timeliness – 24%
Information – 18%
Professionalism – 16%
Staff Attitude – 12%
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2.0 Acknowledgement
We acknowledge the co-operation of the following for their contributions in the course of
the evaluation exercise.
1. Alh. Yayale Ahmed Secretary to the Government of the Federation,
Office of the Secretary to the Government of the
Federation (OSGF)
2. Dr. Hakeem Baba-Ahmed Permanent Secretary, GSO, Office of the
Secretary to the Government of the Federation
(OSGF)
3. Dr. Z O Ajuwon, Chief Medical Director/Chief Executive Officer,
National Hospital, Abuja
4. Dr. I. L. Audu Director of Clinical Services/Chairman Medical
Advisory Committee (CMAC)
5. Barr. Judith I. Irabor Chief Legal Officer/Complaints Officer
6. Dr. J. A. Momoh HOD, Chemical Pathology
7. Alhaji Abdul Msheliza HOD, Pharmacy
8. Dr. Oche Ogbe HOD, Haematology
9. Dr. Ify Monye HOD, Family Medicine.
10. Mrs. A. Abubakar Health Records Department
11. Mallam Yahya Sadiq, Nodal Officer/Assistant Director Information
Services National Hospital, Abuja
12. Dr. K. O. Iregbu Medical Microbiology, National Hospital, Abuja
13. Mrs. Foluke Oni Nodal Officer, Office of Secretary to the
Government of the Federation (OSGF)
14. Mrs. Tola Tiamiyu MSU Staff, Office of the Secretary to the
Government of the Federation (OSGF)
3.0 Terms of Reference
National Hospital, Abuja was selected for evaluation following a Presidential directive that
all Government Ministries, Departments and Agencies (MDAs) be evaluated for
SERVICOM Compliance.
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The Mandate of the SERVICOM Compliance Evaluation team is to identify those areas of
action that can bring immediate or urgent improvement in services to citizens.
To ascertain the present state of service delivered to the Nigeria citizens
4.0 Methodology
National Hospital, Abuja is located at Central Business District in the Federal Capital
Territory (FCT) Abuja.
:
The Main Service Windows of the National Hospital are:
Accident and emergency
Intensive Care unit to cater for serious medical and surgical cases
Operating Theatre Units where a full range of minor and major operations are
performed including endoscopic procedures
Labour Ward/Theatres for deliveries and infant care facilities
Paediatric and neonatal care services for sick children
Radio Diagnostic services using ultra-modern X-Ray Machines such as
Mammography, CT Scan and Magnetic Resonance Imaging (MRI), etc
Haemodialysis services using a Linear Accelerator and other equipment
Cancer treatment services using a Linear Accelerator and other equipment
General and Private Wing Out-Patient Services
In-patient wards comprising private, semi private and open wards
Family Planning and Reproductive Health Services
Ear, Nose and Throat, Ophthalmology and Dental services
Laboratory services in microbiology, haematology, morbid anatomy/histopathology,
chemical pathology and immunology
Non-clinical services such as finance, administration, engineering, etc
Ambulance Services
Invitro-fertilization (IVF) services
Neurosurgical services
Urology services
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Psychiatry services
The General Out-Patient Department of the National Hospital, Abuja was justifiably
chosen for the following reasons:
It is the first point of call and reception (gateway) for every customer to the
Hospital.
It provides full range of services and has high volume of customers
It serves as referral clinic to the various specialist’s clinics and admissions for
patient whose illness needs further attention.
It runs 24 hours call services.
The result of the evaluation can be used to bring about improved services to all its
customers nationwide.
Therefore, the General Out-Patient Department was selected for evaluation based on
the process a customer is to follow in order to receive service. This process generally
touches on four main points of contact::
Registry: collection of cards, retrieval of existing folders/records
Consultation: medical examination/treatment
Pharmacy: drug services, drug costing and dispensary
Laboratory: conduct medical tests
The SERVICOM team for this evaluation consisted of two SERVICOM Officers, the Nodal
Officer of the Office of the Secretary to the Government of the Federation (OSGF), one
MSU Staff from the OSGF and the Nodal Officer of the National Hospital, Abuja.
Evidence was gathered at the service window through customer interviews, discussions
with staff, discussions with partners, review of key documents and general observations.
Given the particular nature of the services provided by the National Hospital, Abuja, it was
also important to evaluate further evidence by administering questionnaires, and
conducting interviews with its partners: the pharmaceutical companies and the external
surgeons. The website of SERVICOM office www.servenigeria.com and National Hospital
website www.nationalhospitalabuja.net were also used for research.
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The key documents reviewed include:
Service Charter of the National Hospital
Operational Manual for the National hospital
Staff Handbook
National Hospital Customer Care Policy
Report on Quality of Care Survey (September – November, 2008) edition
2008 Annual Statistics/Performance Report
National Hospital for Women and Children , Abuja (Establishment , etc)Act
Minutes of Stakeholders’ Forum of 17th December, 2008
National Hospital, Abuja Newsletter (January 2009) edition
5.0 Findings
The findings presented in this section comprise of an Index score, observations on the
Service Charter and on the quality of service delivery found at the service windows.
5.1 Charter Evaluation
The evaluated score for the Service Charter of the National Hospital, Abuja is
Two (2) out of three (3).
Description: Suitable
5.1.1 Findings on Service Charter
Standards guiding the service provision and delivery are not stated in the Charter
The existing grievance redress mechanism stated in the Charter has no time
frame stated for complaints resolution and redressal
Details of the Chief Legal Officer, who is the Hospital’s Complaints Officer are not
clearly stated e.g. The Name, Office telephone and Room number are not stated
in the Charter
Prototype Charter of service outlets are displayed at some service points of the
hospital
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5.1.2 Recommendations for improving Service Charter
Service standards of the hospital should be reflected in the Charter
Specific time frame to resolve complaints should be stated in the Charter
The position of the hospital’s Complaints Desk Officer presently located at the
legal unit should be re-assigned to the SERVICOM unit for prompt resolution of
cases of service failures as directed by the Federal Executive Council
Full details of the Complaints Officer, Name, Room number and telephone
number should be clearly stated in the Charter
Prototype Charter of the service outlets should be displayed at the various
service points of the hospital
5.2 Index Score
The table below summarises the result of the evaluation of the service window. Based on
these, we have calculated a score for the National Hospital
The overall Index score awarded for the National Hospital (General Out-patient
Department) is 1.6 out of 4 (40%)
Description: Fair
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Score for National Hospital, Abuja (General Out-
Patient Department)
Overall Index score 1.6
Service Delivery 1.7
1 - Standards and
practices / performance 1.1
2 – Reception
experience 2.4
3 - Complaints and
grievance redress 1.6
Timeliness 1.3
1 – Standards and
practice / performance 1.3
2 – Customer
friendliness 1.3
Information 1.9
1 – Information 1.8
2 – Customer feedback 2.0
Professionalism 1.3
1 – Transparency 0.8
2 – Efficiency 1.9
Staff Attitude 1.7
* Scores are rounded to one (1) decimal place.
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5.3 Key Findings
The following observations have been made on the quality of service delivery provided by
the National Hospital, Abuja which we feel need to be addressed as a matter of urgency
5.3.1 Service Delivery
There are no clearly defined processes involved in monitoring performance against
set Standards, to show that the hospital adheres to its set standards in rendering
service to its customers For instance, the set standard on customer care in the
areas of promptness, speed of response and staff treatment of customers have no
process of monitoring as customers wait endlessly before services are accessed
The directional signs provided to direct customers to different service points within
the hospital are not enough e.g. there is no clear directional signs to the GOPD.
This makes access to service difficult for customers and visitors
Customers and stakeholders of the hospital complained that costs and charges
are not set within the reach of the poor and the very poor especially with regards to
laboratory tests and costs of drugs. As a result poor citizens find it difficult to
access the services of the National hospital
Frontline staff are not trained on complaints handling, this affects the level of their
professionalism in the resolution and investigation of all complaints
It was observed that the toilet facilities at the Emergency Unit are kept under lock
and key. Customers are therefore at a loss as to where to go for toilet purposes
5.3.2 Timeliness
Customers are not aware of how long it takes to obtain services at the GOPD and
other service outlets in the hospital as they wait endlessly to be attended to from
one service point to another e.g. customers confirmed that it takes an average of
3- 4 hours before one receives service at the hospital
Customers complained that staff do not offer explanations for delays in service
delivery nor do they explain interruptions to services e.g. Doctors resume duties
between 10.00 am – 11.00 am while the patients are kept waiting without
explanations
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5.3.1 Information
Details of the actions taken to remedy poor performance are not published for the
customers to know the possible outcomes and in turn develop confidence in the
service delivery system
There is no evidence to show that the hospital has implemented the result of
consultation with all customer groups and adapted service accordingly e.g
costs/charges of service and issue of staff punctuality to work as contained in the
Report on Quality of Care Survey carried out by the hospital between September –
November, 2008
Costs and payment procedures are not clearly displayed at all service windows, for
the benefit of the customers and to forestall hidden costs
5.3.4 Professionalism
Appointment procedures are not clearly detailed at all service outlets for the benefit of
both new and old customers. This gives room for preferential treatment as was
observed during our mystery shopping as also confirmed by customers
There exists the issue of some departments not duly represented at management
meetings. This excludes some staff from participation in the consultation process in
the service delivery system of the hospital
Staff complained of not being motivated, this is due to the fact that good work is
neither commended nor rewarded whereas staff are promptly disciplined when their
performance is unsatisfactory.
Most frontline staff do not wear name tags and offices / desks are not clearly
marked to indicate names and functions of officers for easy identification of staff
by Customers
Organisational charts are not displayed at all service points so that the hierarchy of
the organisation is known to customers to enable them know where to go when
services fail
Performance targets are not set for individuals (staff) and departments, therefore
where there are variances in the overall targets of the hospital, these cannot be
fully explained
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5.3.5 Staff Attitude
Customers complained that the presence of Interns Doctors in the consultation
rooms without explanation or prior information to the patient does not give room for
privacy
Customers complained that services are rendered on preferential treatment basis
and not on first come first served
Frontline staff are not trained on treatment of customers, this affects the level of
sensitivity in the treatment of customers e.g. it was observed that some frontline
staff in the Medical Records Unit and at various service points of the hospital are
arrogant and not friendly to customers
The hospital’s Chief Legal Officer who is also the nominated Complaint Desk
Officer is not clearly identifiable to customers to enable them channel their
complaints when services fail
5.4 Additional Findings
5.4.1 Service Delivery
The existing system of dispensing drugs based on product needs without adequate
pharmaceutical care makes the hospital not to be patient oriented in its treatment
of customers
Customers waiting to be bled for the Oral Glucose Tolerance Test (OGTT) in the
lab have no adequate place for privacy and to rest after the test
5.4.2 Professionalism
Customers complained that essential drugs are not available on a regular basis for
the prompt treatment of customers
The majority of the customers interviewed complained that continuous payment of
consultation fee at every instance at the hospital when seeing a doctor is
unaffordable and should be looked into by the management
Staff and customers of the hospital complained that there are not enough
professionals to attend to the teeming patients (doctors, consultants, pharmacists)
who visit the hospital. This results in delay at service points
The retrieval of folders and cards allocation systems causes delay in the Records
unit
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5.4.3 Staff Attitude
Customers complained that frontline staff at GOPD devote much time discussing
private matters rather than being committed to their duties and at the expense of
giving timely service to customers
6.0 Recommendations
The following recommendations are provided in order to suggest actions that can be
taken which could directly lead to improvements in service delivery. In this report, we are
unable to comment on general constraints relating to physical or human resources, or
structural and systemic issues, which may impinge on effective service delivery of
services to the public
6.1 Key Recommendations
6.1.1 Service Delivery
There should be clearly defined processes involved in monitoring performance
against all set Standards. For example, a system should be put in place to check
how long patients take to access the services of the hospital. Such monitoring
system should take into account the movement from one service point to another
This will ensure that the hospital adheres to its set standards in rendering service
to its customers.
Adequate directional signs directing customers to different service points should be
put in place within the hospital especially that of the GOPD. This will make access
to service easy for customers and visitors
The issue of high costs and charges not set within the reach of the poor and the
very poor should be looked into by the management. Appropriate downward
review of price should be carried out in order to address the issue once-and-for-all
so that poor citizens can also access the service of the hospital
Frontline staff should be trained on complaints handling, this would enhance
effective resolution and redressal of all cases of service failures
Toilet facilities should be well kept maintained and opened for use by the
customers. This will show that the hospital is sensitive in the treatment of
customers and for improved reception experience of all customers
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6.1.2 Timeliness
Concerted efforts should be made by the management to reduce actual waiting
time of 3-4 hours in the hospital so that an average realistic waiting time could be
developed for the benefit of the customers
Staff should endeavour to give honest and substantial explanations for delays and
interruptions to service. This should be done as part of recovery of a breakdown to
service delivery and will reduce anxiety and anger of customers at service points
6.1.3 Information
Details of the actions taken to remedy poor performance not only in terms of
structural defect but in service failure should be published for the customers to
know the possible outcomes and build confidence in the service delivery system of
the hospital
The hospital management should endeavour to implement the results of
consultation and adapt service accordingly such implementation should be made
public for all to know that the hospital considers the views of its stakeholders in the
service delivery process
Costs and payment procedures should be clearly displayed at all service points for
the benefit of the customers and to forestall hidden costs
6.1.4 Professionalism
Appointment procedures should be clearly detailed at all service windows for the
benefit of both new and old customers. This will prevent incidence of preferential
treatment being given to some customers by staff and will ensure equal treatment of
all customer groups
Management should look into the re-occurring issue of some departmental heads not
being represented at management meetings. Adequate information on this should
be given to staff particularly Heads of Units for transparency purpose and for
improved service
Staff who are performing well should be motivated to continue to put in their best.
This could be done by way of commendation or reward. Staff could also be motivated
in terms of welfare packages in order to get their optimal input in service delivery at
the hospital
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All staff should be made to wear name badges, and offices/desks should clearly
indicate functions and names of officers. This will ensure easy identification of staff
by customers at the service points
Organisational charts should be displayed at all service points so that the hierarchy
of the hospital is known at a glance and all customers would know where to go for
service as the need arises
Clear performance targets should be set for individuals(staff) and Departments in
order to monitor individual and department performance in the overall achievement
of the hospital’s goal
6.1.5 Staff Attitude
The need for respect and privacy should be not be overlooked by the hospital
management. In as much as the hospital employs interns doctors, room for privacy
should be created for patient who might not feel comfortable with the presence of
two or more doctors
An appointment procedure in order to serve customers on first come first served
should be worked out by the hospital
Frontline staff especially Nurses and Records staff should be trained on Customer
care. This would give staff the mindset and capacity to always treat customers with
respect and dignity during service provision and delivery
The position of Complaints Desk Officer should be re-assigned to the Complaints
Desk Officer in the SERVICOM unit, whom the customers can easily reach to
lodge complaints when services fail
6.2 Additional Recommendations
6.2.1 Service Delivery
Drugs dispensary should be done with adequate pharmaceutical care based on
the patient needs rather than the product for improved customer sensitivity in the
service delivery of the hospital e.g. there should be interaction with the pharmacist
and patients to determine their response to the prescribed drugs
Provision of private /separate areas should be made for patients waiting to be bled
for the Oral Glucose Tolerance Test (OGTT) for improved service delivery
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Professionalism
Essential drugs should be made available at all times in the hospital on a regular
basis to enable those on emergency be attended to promptly and in case of an
outburst of disease at any given time
The issue of continuous payment of consultation fee at every instance at the
hospital when seeing a doctor should be looked into or such a fee reviewed
downwards
Management should look into divert ways of bringing in more professionals and
experienced staff to assist the existing staff in the hospital for better performance
and for service improvement e.g. experienced doctors, pharmacist, consultants
should be used rather than interns doctors
The Health Records system of retrieval of folders and cards allocation should be
well managed and computerised in order to reduce delay at the Records unit of the
hospital
Staff Attitude
Staff should devote more time to service delivery rather than chatting away at
service points. Training of staff on work ethics should be carried out in order to
eliminate attitude of rudeness and arrogance
1.2 Service Improvement Planning
Although the question of how these recommendations might best be implemented is a
management issue for the National Hospital, Abuja the SERVICOM Office, through the
SERVICOM Institute will work with the management of National Hospital, Abuja and its
SERVICOM Unit to develop and guide the implementation of appropriate Service
Improvement Plans.
Conclusion
The SERVICOM Index awarded to the National Hospital, (GOPD) Abuja is 1.6 out of 4
(40%) which represents two star (**) and indicates ‘Fair’ service delivery. Although this is
still far from praiseworthy, it is our belief that the National Hospital, Abuja could ensure
continuous improvement on the quality of service delivered to members of the public if the
recommendations contained in this report are faithfully implemented.