When I joined the Quality Improvement team at Alimosho General Hospital, Igando, I did not know how much the experience would change the way I see healthcare.

Our project focused on reducing prolonged Length of Stay in the Accident and Emergency Department. At baseline, patients were staying for an average of about 165.1 hours — approximately seven days. As a nurse, this was not just a number to me. I could see the overcrowding, pressure on healthcare workers, and the effect prolonged stays had on patient flow.

We decided to understand the problem before trying to solve it. Working as a multidisciplinary team of doctors, nurses, pharmacists, health records staff and management, we mapped the patient journey and identified key delays involving bed availability, EMR and documentation, discharge and referral processes, and diagnostic services.

Using the PDSA approach, we tested targeted changes, including bed monitoring, A&E laboratory tagging and EMR optimization. We monitored our progress through run charts and learned from the data.

Our baseline average was approximately 165.1 hours. Following the first intervention, the July average reduced to approximately 10.5 hours, while the September average was approximately 62 hours. Although the results varied, the improvement remained substantially below our original baseline.

The journey was not without challenges, particularly with accessing some EMR data and coordinating changes across different service points. However, these challenges taught me the importance of patience, teamwork and persistence.

My biggest lesson from this experience is that QI is not just about identifying problems; it is about understanding the system, testing solutions, measuring results and sustaining what works.

This experience has changed the way I approach problems in healthcare. I now believe that every healthcare worker can contribute to meaningful improvement.

I am proud to have been part of this journey, and I hope we continue to build systems that provide timely, safe and better care for our patients. #benedictahbecky