Carl Gilchrist, Gleaner Writer
ST ANN'S BAY, St Ann:
OVER THE past two years, a wind of change has been blowing through the St Ann's Bay Regional Hospital, which sees workers now adopting a more positive approach to their jobs.
The emphasis on a team approach to service delivery is at the heart of this change, and Senior Medical Officer Dr Nicole Dawkins has been actively leading this transformation since she assumed the post in 2010.
The changes might not readily be discernible by outpatients, who might still be spending hours at the institution during a visit, but change from within is bound to reflect on the outside eventually.
In 2011, Dawkins inaugurated the Annual St Ann's Bay Regional Hospital Scientific Conference, which is aimed at developing the human resource capacity at the institution.
During the second conference, held last weekend at the Sunset Jamaica Grande Resort, Dawkins took time out to share her vision for the 250-bed hospital and explain her push for change at the institution.
Her journey at St Ann's Bay Hospital began in 1997 when she did her internship, after which she left to do her postgraduate studies. She returned in 2003 as an emergency physician and was promoted to senior medical officer in 2010. Since then, she has consistently pushed for change as she seeks to build a team capable of delivering efficient service.
"The changes I'm striving for probably comes from my real passion as it relates to being a physician, which is being an emergency physician. That's what I'm about," Dawkins explained.
Emergency medicine as a speciality is relatively new to Jamaica and Dawkins was in the first batch of persons trained by the University of the West Indies (UWI) and was the first graduate of the programme who left UWI to work in a rural hospital.
"When I came to St Ann's Bay Hospital in the capacity of emergency physician, I realised that I couldn't practise emergency medicine the way I wanted to, and I think that is probably the underpinning of everything - it is my love for emergency medicine that has gotten me involved in areas that I didn't see myself going into," related Dawkins.
She continued: "Administration was not what I wanted to do, but when I went there, there were junior officers in all categories of staff. There's no way I could work as an emergency physician because I didn't have the team at the level that I had. Not only did I not have the team, the infrastructure wasn't in place - infrastructure in terms of physical or even the system infrastructure, so that had to be sorted out.
"And emergency medicine can only be performed to the standard the rest of the hospital is performing at. For that reason, I wanted to see emergency medicine going the way I wanted it to be, not just at St Ann's Bay Hospital, but the whole of Jamaica."
This drove her to start imple-menting the necessary changes.
The annual scientific conference was one visible piece of evidence of such change. Last year, over 100 hospital staff members at the three levels - doctors, nurses and support group (paramedics and administrators) - benefited. This year, approximately 150 persons benefited.
But the change started before that. Dawkins had already started to lobby for change in the area of support services such as diagnostics and laboratory and X-ray services, which are usually available from 8 a.m. to 4 p.m.
"Emergency medicine cannot work like that (8 a.m.-4 p.m.), so one of the things was to lobby for certain standards that would see to emergency medicine practice and emergency medicine going into the ward. So there was an introduction of a category of staff at the facility. Other hospitals are now copying that structure because it works," she said.
"In terms of the support service that has been there, we had to lobby so that the service is available 24/7, and that is probably one of the biggest improvements that I think the facility has seen having diagnostic support and other kinds of intervention available 24/7, which, prior to the push for change, was not the case," Dawkins reported.
Over the last two years, she has managed to get everybody to look in the same direction, and she believes the staff is now gelling as a team.
"So much so now that we can have different services together successfully launching the laparoscopic conference, for example, a couple weeks ago. That could not have happened with one department; it had to be all the departments together," Dawkins pointed out.
The laparoscopic conference on June 17 saw the introduction of, and training in, the use of laparoscopic equipment at the hospital, with donations from the Alliance of Jamaican and American Humanitarians of over J$11 million.
That was a welcome boost for an institution fiscally challenged. And it is this fiscal challenge that stands in the way of Dawkins' dream for the St Ann's Bay Regional Hospital. The dream is for the institution to be eventually upgraded from Type B to Type A status.