Managing Mafraq hospital is no small task; from educating staff, bringing back customer care and raising nursing standards to international levels, Chief Nursing Officer Gail Smith has to take care of it all.

On paper, as CNO Gail exercises management responsibility over Mafraq hospital, ensuring that efficient nursing services meet world-class standards of patient care and nursing practice is in place that meet the needs of the patients, staff and physicians. In practice, Gail has to overcome a lot of challenges.

Tell us how you first got involved in nursing and Mafraq hospital?

I was trained in South Africa; my background and further education is in nursing education. I went and started an education programme for one of the hospitals in Saudi and once that once done, I moved to Qatar for six and a half years. I am now employed by Bumrungrad International who are the management company for Mafraq hospital. I’ve been at the hospital for three years now. In that time, I’ve helped oversee a whole host of changes.

And what are some of those changes?

This hospital is not the same hospital I joined three years ago - physically and also in terms of safety care. I’m not saying it’s now perfect, very few hospitals get everything perfect … but we’ve come a long way.

One example of change is the nurses uniform – the nurses had all different colours. We’ve put them in a uniform which is functional, that is culturally correct, and that actually makes them stand out and away from looking anything other than a professional nurse.

We have also changed a huge amount of how we educate and how we train the nurses, even after their education: continuous nursing education is a big thing. The medical field changes all the time – new equipment, new medicine, new research – we implement evidence based practice and train the nurses at Mafraq accordingly.

Why do you believe customer care is such an important change for the hospital?

Nurses are there 24 hours a day. So when patients are sick or need help at night it’s the nurses that are the first contact. And that’s what we try to educate our nurses about.

What’s important to remember is that most hospital staff – just under half of all hospital staff in any hospital – are nurses: it’s a big percentage. We currently employ 792 nurses. If you get them on board to move any change in the organisation they change the organisation. The nurses at Mafraq have changed this organisation.

One of the things the nursing profession has lost, all over the world, is the care factor. Technology has replaced so much of the hands on stuff that nurses used to do. We’ve been working hard to get the caring back so that it’s not just about checking vital signs, or just doing the medicine run and the dressings for the day. To get the blend between clinical skills and caring right, that’s what is very important to us. Because lets face it, patients don’t know whether it’s the latest piece of equipment that we’re using, they don’t know if it’s the right drug – they don’t even know if it’s the right dressing you’re using on them. But they know if someone cares: I think we sometimes forget that.

Alongside those changes, you must encounter some challenges?

Of course. For example, we have great difficulty in recruiting Emirati women once they have finished their education, so that is one of the big challenges for us. We want to have more Emiratis choose nursing as a career, because they are the leadership of tomorrow.

Culture is one of the reasons for Emirati’s deterring from going into nursing: it’s a big issue as they have to look after males, they work shifts – including night shifts – and they wear a uniform. I would say that only two percent of our nurses are Emiratis: they are excellent, but too little in numbers. Nursing is actually a very good career, so we’re working very hard to try and raise the profile.

Aside from internal challenges, what challenges do hospitals such as Mafraq face?

There is still a large number of Emiratis and other nationalities that prefer to go out of the country for healthcare. And as long as we have this situation, with the amount of resources that the government provides for health services, it means we are really not meeting the needs of this country.

They are a number of reasons that many choose to seek healthcare elsewhere. First of all, there are some services not yet provided at the level that it should be; some people may have had a bad experience before, and the perception is often that it is better elsewhere. Are they right? In some cases possibly, but on the whole, no. You can get equally good care here. The government provides excellent support – but it’s up to us to make the change – to change that perception.

What’s next on the list for changes and challenges?

In the next three years the focus is to continuously improve – to reach to an international health standard.

We are also building a new Mafraq hospital that will be complete in late 2013 – so the big thing now is fine-tuning our services now that the major, immediate, apparent deficits and safety measures have been made, and to get everyone on board in delivering that service to the highest, international standard. There’s a lot of research that actually shows that if they [nurses and physicians] work well as a team, the outcome of the patients improves: there are less deaths, less complications, less infections, because there’s better communication and teamwork. Teamwork is particularly important as we move to the new hospital – we need a very strong team that can adapt to the new environment.

Why a new hospital?

The current hospital is roughly 23 years old, and while that’s not old when you consider other institutions around the world, the hospital is old in design – rather than the building. It leaves no room for growth. The new hospital is modern and large, with space for 790 beds. A lot of Abu Dhabi is moving off the island and out into our area so it fits nicely: as Abu Dhabi grows, so do we.

The new building is the next stage for Mafraq – and the first of SEHA’s new facilities to open. It’s actually built on the Bumrungrad model: a lot of Gulf patients still go to Bumrungrad so we need to offer the same here – offering the best healthcare available. The new facility is the next step in helping us deliver that.

Charlie Kennedy