Director Regional & Clinic Services say new changes will aid in better service delivery at New Amsterdam Hospital
(GEORGETOWN, February 01, 2019)- Health officials are mulling construction of a separate building to house outpatients at the New Amsterdam Hospital, East Berbice/Corentyne (Region Six).
The current building is occupied by the Outpatient (OP) and the Accident and Emergency (A&E) Departments and has become a headache for doctors and other health workers attending to patients. The integrity of record-keeping in the crowded environment is also of major concern, Dr Samantha Kennedy, Chief Executive Officer (CEO) of the hospital said.
Patients’ medical and other information is compromised by the use of 10cm x 13cm sheets of paper instead of the universal patient chart and this is “unacceptable” and cannot continue to occur in a regional hospital which is considered a level four institution, said Dr Kay Shako, Director of Regional and Clinical Services (RHS) at the Ministry of Public Health, 1 Brickdam, Georgetown head office.
Kennedy noted that New Amsterdam Hospital officials usually discard patients’ information documented on the slips of paper. The chart is not that easily disposable.
A patient’s chart has utility, because it helps in sharing of relevant information and multidisciplinary team communication. The chart also aids in continuity and coordination of care; is vital evidence in a court of law; and helps in targeting diagnosis and treatment plans without unnecessary repetition.
At all Regional Hospitals throughout the country, doctors provide ‘on call’ duties for the A&E and OP departments. This is problematic among NA doctors. When CEO Kennedy requested their services, doctors at NA Hospital resisted triggering an artificial staff shortage.
“Based on information from the Chief Medical Officer (CMO), Dr. Shamdeo Persaud, it is common practice that doctors participate in at least 3 on call daily sessions every seven days to allow for adequate coverage of the 24-hour service offered at any public hospital”, Shako explained.
According to labour regulations, the extra hours are considered additional work time to the eight hours and attract an on call allowance as determined by the Public Service Department, Ministry of the Presidency.
“On calls are mandatory and rosters are created on a periodic basis by the department and approved by the Medical Superintendent (MS). There are special circumstances whereby doctors who cannot be on call can request a waiver, but this must be recommended by the Medical Superintendent and approved by the Director Regional and Clinical Services or Chief Medical Officer, both at the MOPH level”, Shako said.
“Anyone who visits the emergency room is categorized as emergent or immediate, urgent and non-urgent; therefore any case that is considered an emergency based on assessment MUST be seen first.” the RHS Director said.
“For example, if someone comes in with a heart attack, and someone comes in with a cough, obviously the person with the heart attack will take precedence. The next case will be urgent to pay attention to. An urgent case is one in which there is no immediate danger or threat to life, health, property or environment but if not taken care of in a given period of time, then the situation may worsen”, the Director further explained.
Recent changes at the NA Hospital have seen 11 doctors working at the A&E Department in addition to doctors from surrounding health centres who work “on call” for 4 continuous hours in the evenings.
Meanwhile, Shako said the NA Hospital morgue had to be closed for electrical repairs and a private provider was detailed to undertake post mortem (PM) services.
“The Morgue had electrical issues (and) there were frequent shutdowns during the day due to low voltage and power outages. When the freezer opens it gets hot and it takes 2 hours to regain the correct temperature”, Shako said.
The X-ray services at the NA Hospital were also unavailable because the unit was out of order due to a small leak. That has been corrected and the unit is now fully functional, Dr Shako assured.