Wed | Aug 16, 2017

Editorial: Hospital managers must pay the price

Published:Sunday | October 25, 2015 | 10:00 AM

We can only assume that Sterling Soares, the chairman, and the other members of the board of the University Hospital of the West Indies are not lying on themselves in protection of the health minister, the hapless Fenton Ferguson. Indeed, no other member of the board has challenged Mr Soares' account of who knew what, when, or how regarding a cluster of recent deaths at the hospital as a result of infection from the klebsiella and serratia bacteria.

The question, therefore, is, who is being held to account for what, on the face of it, was a blatant breakdown of systems and protocols at the University Hospital, as well as the Cornwall Regional Hospital in Montego Bay, where there was a similar bacterial epidemic? Neither the board nor management of Cornwall has publicly offered an explanation of its management of the situation.

We understand that nosocomial infection is not an infrequent feature of health-care facilities, where ill persons with weakened immune systems conglomerate and in circumstances where viruses and other nasty stuff have grown increasingly resistant to antibiotics. The related klebsiella and serratia bacteria are among this breed.

They can be found in the gut when they cause little harm to healthy people, but when they get out, they are likely to go on the rampage against the vulnerable, who are often the old, and, as was the case at the University Hospital and Cornwall Regional, the very young and sickly. They are transferred by physical contact, and, in hospital settings, the most susceptible patients are those who require intravenous treatment or require the use of breathing apparatuses, covering their noses and mouths. The most effective way to battle such bacteria is by maintaining basic personal hygiene, especially among caregivers and others who come into contact with the patients.

 

obviously lapsed

 

Clearly, at the two hospitals, the basic protocols for the delivery of patient care - maintaining a clean environment, the washing of hands, and the wearing of gloves and gowns when moving between patients - obviously lapsed. And based on Mr Soares' statement on behalf of his board, something equally egregious happened at the University Hospital: When the epidemic developed, they kept the information to themselves. In fact, Mr Soares claimed to have learned of the outbreak via the media on October 16, several months after the first case. It was then that he informed the minister.

"The infection control team at UHWI who identified the agents was confident that the cluster of cases could have been controlled as on many previous occasions," Mr Soares reported. And they may have been. But that misses the point.

There are domestic and international protocols for the management of reporting of infectious diseases, which contribute to coordinated approaches and processes for their management. These were not adhered to, for which there has to be accounting. Further, it was a failure of management that hygiene standards were breached in these hospitals. For that, there should be a price.

We can't be sanguine given Minister Ferguson's absence of transparency with regard to the findings of a recent review of the operation and management of public hospitals. That failure makes Dr Ferguson, too, culpable.