Observer article prompts big changes at Cornwall Regional
MAJOR changes have taken place at Cornwall Regional Hospital (CRH) since an exposé by the Jamaica Observer in October last year unveiled long waits for both urgent and non-urgent cases in the Accident and Emergency Department (A&E), nurses gossiping or missing from their stations, and patient embarrassment arising from having to sit with urine in hand for hours.
A visit to the Montego Bay hospital last week revealed the implementation of a game-changing strategy which now allows patients to spend less time at the institution, a well-kept A&E department, tight security measures and fewer patients in the usually highly trafficked areas.
Chief executive officer of the hospital, Everton Anderson confirmed that a number of changes have indeed taken place since November last year and suggested that some of them were as a result of the Observer expose.
“We noted your article and there has been total adjustment. We are still trying to improve, but it’s rough on CEOs because a lot of the things that you would want to do, you are constrained. But we are fighting it for the sake of Jamaica.”
“An Ambulatory Care Centre (ACC) was opened in November,” he said. “The ACC unit treats approximately 40 patients per day. Before, a patient who was not urgent could end up spending hours in the ER (emergency room) with patients who are very sick and that’s not right. So now, Mondays to Fridays from 7:00 am to 7:00 pm, the patients who are non-urgent are either sent to
the health centre or to the Ambulatory Care Centre. So they would be fast-tracked and they wouldn’t be left in the A&E for a protracted time period. This has allowed the Accident and Emergency Department to focus on urgent and emergency cases.”
Anderson explained that while all the patients who visit the hospital still go to A&E, they are triaged and if given a greencoloured card in non-urgent cases, patients go to ambulatory care.
“So you are actually sent to the health centre or ambulatory care. And this is really to free up the A&E to deal with critical cases,” Anderson said.
The Observer saw the new practice firsthand last week. Upon entering the A&E department at midday Wednesday, we saw not even one person sitting in the line of chairs waiting to be triaged. The usually packed waiting area leading to the ‘injection room’ was also empty. Only those who were already triaged and deemed urgent were seen waiting to be registered or examined by a doctor.
“If on a [given] day, we get many greens (colour-coded slips of paper indicating a nonurgent medical case) in the morning, all of those would be sent upstairs so they don’t have to be competing with serious cases,” Anderson said.
The visit also revealed tight security as each door leading in the building was manned by two uniformed security guards, one male, one female. Each bag taken inside was searched and forbidden items — like weapons and cameras — were removed, tagged and locked away in a drawer, with the bearer being given a numbered ticket to retrieve the items upon exit.
Bags belonging to females were searched by the female guard, making the experience acceptable.
My handbag was searched twice this time around — once upon entry to the A&E department, and again upon entry to the ACC. My small camera was confiscated both times. This was not the case when I visited last year.
Patients interviewed seemed pleased with the changes, a number of them adding that they had no problems with the hospital and its operations.
“It really nice and clean,” one woman said. “The place don’t even smell like hospital. I don’t really have any problem with them — just that the doctors probably can work a little faster.”
Anderson noted other major changes that have been made since last November, including the retraining of front-line staff, a number of whom were not only missing from their post but were gossiping while attending to patients.
“Key, front-line staff and caregivers were retrained in customer service and patient care representatives were assigned to all ward areas to interact with patients and assist in making them comfortable while in hospital,” Anderson said.
He said, too, that pipes have been run in all patient care areas for the purpose of administering medical gases. This will reduce the dependency on oxygen cylinders and provide a more acceptable mode of service delivery.
In addition to that, work has commenced on the refurbishment of two inactive operating theatres on the hospital’s fourth floor.
“With the opening of these two operating rooms in July 2012, waiting time for elective surgery for all surgical specialties will be reduced to within six months,” Anderson said.
Anderson said they have instituted measures that have led to the improvement in hospital revenue and the washing and sealing of the hospital building in partnership with the Tourism Enhancement Fund and Sandals’ ‘We Care Foundation’.
“We continued our focus on community participation with key partnerships developed with the Chamber and Commerce, the Jamaica Association of Administrative Professionals, Sandals ‘We Care Foundation’ and several other local and overseas organisations,” he explained. “This has led to fundraising efforts being spearheaded for a linear accelerator for the Radiotherapy Department, equipment being purchased
for the Accident and Emergency, General Surgery, Neurosurgery, Urology, and Plastic Surgery departments. In addition six dialysis machines along with Ophthalmology equipment and a Mammogram were donated from partners in Canada.”
There has also been pioneer work in laparoscopic prostatectomy and stone surgery initiated by the Urology department at CRH, active participation in international HIV research by paediatric consultants at the institution.
“The dialysis unit at CRH continues to offer good service, treating over 120 patients per week,” Anderson told the Observer. “General surgery department has initiated research work on Diabetic Foot Care.”
But, Anderson said, despite the improvements there are still challenges in providing care to the nearly 100,000 outpatients, 22,000 inpatients and approximately 70,000 Accident & Emergency patients annually.
“The major challenge at this time is inadequate bed space leading to delays in admitting patients,” he said. “The administration is however, committed to a process of continuous improvement which we are confident will lead to an acceptable and efficient level of care in all areas of hospital. As such we are currently moving to relocate the dialysis unit and add 40 new bed spaces for internal medicine which would reduce the time for patients to be admitted to wards.
“In addition, we endorse the move by the Government to construct a new paediatric hospital in Western Jamaica, as this will create more space at CRH as well as provide an improved service for paediatrics and adolescents in Western Jamaica,” Anderson said.