Mon | Sep 25, 2017

UHWI under threat! - Overcrowding could cost hospital its accreditation to train doctors and nurses

Published:Monday | August 21, 2017 | 8:00 AMErica Virtue
Chairman of the board of directors of the University Hospital of the West Indies, James Moss-Solomon (left), and the hospital's CEO Kevin Allen.
A relatively calm day inside the Accident and Emergency area at the University Hospital of the West Indies last Wednesday.
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Administrators at Jamaica's only teaching hospital, the University Hospital of the West Indies (UHWI), are fearful that it may lose this designation because of the chronic overcrowding at the facility.

The 579-bed facility is bursting at its seams, and up to last Wednesday when officials of the hospital spoke with our news team, the demand for beds was greater than the number available.

According to chairman of the board of directors of the UHWI, James Moss-Solomon, the available beds are divided among the specialities at the hospital to maintain accreditation requirements.

"We are accredited by an overseas body which grants us permission to give you a degree in nursing or medicine. So the requirements are that if you are teaching these speciality areas, then you must have the facilities to have the practice, as all of these things are not classroom based.

"What we have found is that medicine is in greater demand for beds than surgery," said Moss-Solomon.

"So this is where the crisis comes in. We have to maintain accreditation. If not, all the doctors will not be certified. We would have trained our last doctor," added Moss-Solomon as he underscored that overcrowding can have an effect on the institution.

"We have been successful this year with accreditation, (which) is much more complex than just the ward and the environment. For a number of years, the settlement across the road, Mona Commons, has been something threatening accreditation. But it did not surface as a major issue on this round of accreditation," said Moss-Solomon.

"This time I think they were looking into speciality areas. So maintaining those requirements with so many beds available for practice based on the number of doctors we are training in the particular field is coming more to the forefront.

"This time, less of the external issues came in and more of the internal issues," he added.

He said the focus now is maintaining the requirements for accreditation based on the acceptable international norms.

In the meantime CEO of the hospital Kevin Allen said the present overcrowding is directly linked to the problems at Cornwall Regional Hospital (CRH) in St James, which is a referral hospital.

CRH is currently undergoing a recovery project with works being undertaken involving, among other things, repairs to the central air-conditioning system to address noxious fumes being emitted.

With the loss of theatre services at CRH, Corporate Area facilities such as the UHWI and the Kingston Public Hospital are housing persons who would normally be admitted to the Montego Bay, St James-based facility.

"We can accommodate anywhere between 20 and 25 patients in Accident and Emergency (A&E), but there are times when we have double that number," said Allen.

"And the situation is right through the year, but this is compounded by the situation at CRH. That leaves us without space for medical patients," added Allen.

Medical patients include those needing hospitalisation as a result of stroke, heart attack, hypertension and sedentary lifestyle illnesses.

"We have to block certain numbers of beds for the various specialties and subspecialties as per requirement for accreditation, so patients have been admitted to hospital without being put on a ward.

"Patients are in A&E in a wheelchair for 24 to 48 hours because the bed space is not available. But while care is offered, there is obvious discomfort for the patients and not the best situation to provide the care needed," said Allen.

"Overcrowding is chronic at A&E, and I would say it is always chronic there, and it's the first point of reference at the hospital. Treating patients from a wheelchair in the corridor is not desirable and not what should be done, as per requirement, to maintain accreditation. But we can't, and have not, refused anyone," added Allen.

He noted that wards such as those for dermatology and ophthalmology, which have capacities of 25 beds, might not be fully occupied.

"When we encounter a run on the hospital, like we are seeing now with medicine patients, we would convert some of these unused beds to patients so we can continue a high standard of service to our patients.

"(But) because we have accreditation to maintain for the various programmes, we must have certain numbers of beds allocated for these services. We try not to cram all the areas while trying to facilitate care as best as possible," said Allen.

The UHWI recently unveiled an ambitious plan to increase and modernise the hospital and Allen is adamant that it must be expanded to house between 100 and 150 more beds.

erica.virtue@gleanerjm.com