 My name is Dr. O'Coyne Ibikapa-Eb. I am a primary health and public health physician with the Biasur State Ministry of Health. I work as a program manager for a maternal and child health program currently with the Biasur State Ministry of Health and my interest is on quality improvement, health system strengthening and patient safety. I got into the interests of quality improvement and patient safety when I became a program manager consigned with improving the quality and quantity of care for maternal and child health and this made me to first have an encounter with the International Society for Quality in Healthcare where I had my first quality improvement journey and then subsequently I've been able to apply the knowledge that I've achieved from the International Society for Quality in Healthcare in improving healthcare services with the Biasur State Ministry of Health. My inspiration that led to my applying for the fellowship with the Patient Safety Movement Foundation was the fact that having gone through the fellowship program with International Society for Quality in Healthcare, I know that one of the key pillars of quality is patient safety and we have a high record of medical harm and there was a need to attain the knowledge and the skills and competence required to address the issues of medical error and harm to our patients. So I was inspired when I found out that Patient Safety Movement Foundation was offering fellowship for interested healthcare practitioners to apply. So I made use of that opportunity so that I can improve on my skills, attain the competence and acquired knowledge and then also be an advocate to carry this message and spread this message of how we can reduce harm in healthcare settings and especially being someone who had in the course of practice observed harm being done to our patients and what most times assumed that as a doctor, you have the ought to say do no harm to your patient. We had assumed that we can prevent harm but it happens in healthcare settings. So what was a missing link? What do I need to do? Was part of what inspired me to apply for the fellowship. Having been exposed to the fellowship program for a period of one year, it was an interesting journey and it enabled me to create some impact at my own level that I am proud of. For the first time in the history of the Biosha State Ministry of Health in 2001, the World Patient Safety Day was observed. We commemorated it in the ministry. I spearheaded the move for it, met with the Honorable Commissioner for Health and it was particularly important because it spoke about maternal safety and it was a collaboration with the key departments in the ministry and we were able to mark it. We had radio, television programs, health enlightenment programs and the public was educated and we had a rally in the city of Yeregwa to create that awareness on the issues of maternal mortality as it relates to harm that is suffered by our mothers in the process of childbirth and it became a topical issue. Fortunately I was able to influence a training for healthcare personnel over five hospitals in the state. This training was sponsored by the Shell Petroleum Development Company of Nigeria and the only state tertiary teaching hospital had the privilege to train their personnel on quality improvement and patient safety. I facilitated on the topic of the essentials of patient safety and monitoring and the measurement of safety and in that event I spoke on issues around never events and it became a key message to healthcare practitioners who had never had opportunity to have a training on patient safety and it was a great take home for participants across the states who for the first time had a training on patient safety and quality improvement. I was proud to be part of the facilitators in this training. So my period over this fellowship year gave me that opportunity to be able to impact knowledge and help to create transfer skills and competence to frontline healthcare workers who are practicing in healthcare settings and I also joined the quality improvement team in the Nigeria Delta University teaching hospital where I happened to be doing my projects for the fellowship here. My take home from the fellowship program is first the wealth of knowledge that I have gained from my facilitators Dr. Peter and every other facilitator that had impacted knowledge on myself and the fellows. It was a great huge opportunity and it exposed us a lot more to what we can do to achieving the aim of zero harm and what I can do is that we can start small in a small little way we can influence the culture that is prevalent in our environment and the culture that is prevalent in my environment is the blame culture which I am one of the advocates and ambassadors trained by the patient safety movement foundation to influence the practice and create a culture of safety. So this is a great take home that safety consigns everyone. Safety is not only attainable in the developed countries. Safety in healthcare is also attainable in the third world countries like my own country and it is a message that I have been trained and I have been enabled by the patient safety foundation to carry to the frontline healthcare workers. One of the key topics that I still always live on with is the topic on learning patient safety and the measurement of patient safety and it's a key take home that calls us to question and the key questions that will always ask and I will ask myself and I will always pass across is the fact that can we speak to our healthcare setting and ask ourselves like Peter would say has there been harm in our healthcare settings or in the environment we find ourselves in the past is there a reliable healthcare setting is there reliability in the care that we provide and then the question that will still ask ourselves is care safe today? Is care safe today? Is our healthcare operation sensitive to changes that we encounter every day and then are we learning what are we doing to improve healthcare? This is a synopsis of the whole of what patient safety may bring to bear and this is what we may want to be able to carry on in terms of advocating for healthcare settings to judge themselves, evaluate themselves. Is it care that we are providing safe? Have people been harmed in the past? What can we do to change a narrative? It was a robust discussion and I've been able to find a way to see what are the parameters that we can look at in our healthcare setting in developed or underdeveloped countries. Is it measuring the incidents that happen on a continuous basis and if we are measuring the incidents that happen on a continuous basis what does the data speak to us? Does it tell us if harm is occurring? If harm is occurring what are we doing about our data to ensure that care is safe? I am privileged to have learned all this from my fellowship here and it's a great take home. I want to say I am grateful to the Patient Safety Movement Foundation for this privilege to be impacted on and for the knowledge to be transferred to me and my competence to be developed. I wish that a lot more of us will be given this opportunity to have this kind of training so that healthcare can be reliable so that incidents of harm can be reduced so that our healthcare providers themselves too can also be secured and safe. My desire is that we have more people, more frontline healthcare workers that are trained on the skills and the tools of patient safety so that care can be safer than yesterday.