YOU can’t miss the excitement and passion in the voices of Donmayne Gyles and Dr Francene Gayle as they talk about current developments at Andrews Memorial Hospital.

Their fervour, though, is understandable as they have firmly set the hospital on a path to achieve international accreditation as part of their goal to transform it into the leader in health-care quality in this region.

“We have agreed that this is a four- to five-year journey. We have put plans in place along the journey to add services, add infrastructural changes to improve that quality. So we have approved the master plan and we are looking at building out the necessary facility to help us achieve that,” Gyles, president and chief executive officer of the Seventh-day Adventist Church-owned and operated hospital, told the Jamaica Observer.

Pointing out that the journey started on April 8, 2024, Gyles said over that time the hospital, which is marking its 80th anniversary, launched two new laboratory services.

“In January we launched our MRI [magnetic resonance imaging], which is an additional diagnostic service in our Radiology Department, and we launched our cardiac catheterisation service which is aimed at helping us to build out our cardiac and stroke programme, which we hope to launch very soon. We also intend to launch our critical care programme, which will support both our cardiac and stroke programmes; and so it is a journey,” Gyles added.

He acknowledged that the changes necessary to achieve their goals have presented challenges, but he and his team, which includes Dr Gayle, the chief medical officer, are up to the task.

“The change management process really challenges the system…it comes with any major change and culture shift in any organisation. Of course, we’ll get pushback, and we have been getting pushback — both from internal stakeholders and external stakeholders — because it is novel and it is not a system or process that is known in Jamaica. You’re gonna find a lot of naysayers because, how can we adopt a system that has no bearing on the system we have had for over a hundred years in Jamaica? So it’s like pushing against the pricks,” he said.

“Operationally we have challenges — supply chain challenges is one such, because, if we are going to implement a stroke programme and a cardiac programme, we will have to have all the necessary supplies and equipment that are needed to support those programmes,” Gyles explained.

“So it is a multiplicity of concerns along the way, but with every culture shift it gets worse before it gets better. And so we are in that phase of the paradigm and we progress because we are part of a global church that believes in quality healthcare,” he argued.

The changes, he explained, rest on five pillars agreed when the hospital administration was re-established in 2023: people, service quality, operational efficiency, brand recognition and growth, and financial stability.

“So, in 2024, when we started this accreditation journey, one of the things we agreed on as an administration is that we need to have a culture shift in the entire organisation. And so, we adopted the principle of being a high reliability health-care organisation as that vehicle for the culture shift; and the strategic pillars underpin that culture shift,” the CEO said.

High reliability, he explained, is the priority given to safety and quality, similar to what obtains in other fields, like engineering.

“The mantra that governs that high reliability drive is zero harm. So the result of that high reliability journey is going to continue throughout the organisation, and we’ll continue to adopt principles along the way. But the result of that journey is international accreditation,” Gyles told the Sunday Observer.

Dr Gayle explained the concept even further.

“When you look into the wider community, our health-care system in our hospitals…leaves a lot to be desired. And the reason why those systems are being challenged so greatly is because health-care quality is a specialty in and of itself, that is under-represented in our country. That is why, in the beginning, we made the distinction between public health and health-care quality. It is a separate specialty. And so, Andrews Memorial Hospital has gone even further by combining high reliability with international accreditation,” she said.

“This combination is thought to be the ideal combination — culture with a deep commitment and external validation of your international standards. When you combine these two, that is the best outcome for sustainable healthcare quality in a health-care facility. And it speaks volumes to the commitment of the organisation to the process of healthcare quality. That is the context of the strategic vision of Andrews Memorial Hospital. This process is momentous,” Dr Gayle declared with pride.

According to the hospital administrators, the push for international accreditation has resulted in them forging a partnership with Joint Commissions International, a United States-based global leader for health care, quality of care and patient safety.

“They are a really huge accreditation facility that has assisted many organisations across the world, primarily in the United States, to gain accreditation,” Gyles said.

“This process will see us aligning our processes, policies and procedures to 1,000 measurable elements, which will see us really being focused on ensuring that we meet the standards, [that] we meet the criteria for those 1,000 measurable elements,” he said.

Those measurable elements include prevention of infections, under which are a hand-washing standard and sterilisation of equipment, to name just two.

Dr Gayle explained that the hand-washing standard “states that every single health-care worker should wash their hands after every single contact with every single patient, every single time”.

“It will link us to an established standard that shows us how to wash our hands. So everything is linked to a best practice guideline… that has been proven over and over to be what is the best way to do things,” she said.

Another measurable element is international patient safety, under which health-care institutions are required to use two identifiers for each patient.

The CEO said the hospital, located at 27 Hope Road in St Andrew, has so far implemented more than 100 policies.

“The past year has been very successful, because we have not only started to implement new processes and policies, but we have gotten the organisation and the players within the organisation to an understanding of the strategic vision,” he said.

“We started the year with a self-assessment measured against the 1,000 measurable elements… and that saw us at just about 15 per cent of where we ought to go. We re-examined that self-assessment at the end of 2024 and we were basically at 33 per cent, which speaks to the fact that we are moving in a good direction,” Gyles said.

He and Dr Gayle had high praise for AdventHealth, one of the larger health systems in the United States, with which the hospital has had a partnership for more than three decades.

They also spoke highly of Loma Linda Health, an academic medical centre that operates six hospitals, a physician practice corporation, remote clinics in the western United States, and affiliate organisations worldwide.

“It is the result of some of the efforts of Loma Linda why our hospital exists. They have been making groundbreaking, traditions and procedures over the years, over a century,” Gyles explained.

“And so, our efforts to adopt this is not only just to bring us into being a leader in the region but to also help us to integrate in a seamless way with our global health partners. This will set us apart because of the quality that exists in these organisations and the impact that we can have as an organisation in Jamaica and the region to help,” he said.

Andrews Memorial Hospital Chief Medical Officer Dr Francene Gayle explaining why the hospital has combined high reliability with international accreditation. (Photo: Karl Mclarty)

Donmayne Gyles, president and chief executive officer of Andrews Memorial Hospital, telling the Jamaica Observer that the hospital’s international accreditation journey is a four- to five-year project. (Photo: Karl Mclarty)