Overhaul to A&E operations at QEH coming

Minister of Health & Wellness, Ian Gooding-Edghill promised on Friday to fix several of the long-standing issues plaguing the Accident & Emergency department of the Queen Elizabeth Hospital (QEH), including an overhaul of the way it functions.

Gooding-Edghill said he was trying to “arrest” the situation, and a comprehensive approach was being used to bring the issues under control at the island’s primary acute care medical facility, and accredited teaching hospital.

The minister said he was able to draw on the experience of friends in the medical field overseas to help him further understand how an emergency room must function, and he had gotten a number of ideas that will help to form part of an improvement plan for the department.

“I met with the senior leadership team – we’ve had about three or four meetings – along with the Minister of State (Sonia Browne) to review an A&E improvement plan,” the minister told listeners to the Down to Brass Tacks radio talk show on VOB 92.9 FM.

“What we will need is some additional resources, and we are working on those resources. I have a follow up meeting with the A&E leadership team and that will happen early next week when I return from our PAHO (Pan American Health Organisation) meeting.”

He added: “But we have to remove some of the administrative functions and burdens from the doctors to allow the doctors in the A&E to focus exclusively (on patient care) … and it will free up the time of the doctors to do what they have to do.”

“There are instances where a doctor may have to go and fetch information. A doctor may have to go and source additional medical resources to execute or perform a task … so we are trying to work through that and we have that improvement plan that we are fine tuning.”

Gooding-Edghill said the QEH was a place for “reassurance” and people often turn up seeking immediate medical treatment when they are not feeling well – and it was important for staff at the medical facility to connect with patients no matter how serious their case.

“The A&E is often the first stop for Barbadians because if they can’t go to a private care facility, they will come to the QEH,” he said. “They know at the QEH they have access to the best treatment, and the best treatment will be given to them there.

“Now, some of the cases do not require urgent care, but for the patient, his or her immediate concern is about care. They are not concerned about whether it is major or minor, so therefore what we have to do in the A&E department is set up a Minor Cases Unit, which will allow patients to be fast tracked.”

The minister said he drew on his management experience of writing standard operating procedures in his previous job in the private sector and conducted a walk-through of the A&E to understand the practices and processes that will help to shape the improvement plan further.

He disclosed the A&E treated close to 38 000 patients in 2019, and only 46 had to be admitted to the hospital for further care – and 29 667 patients visited the following year and 49 were admitted.

“Those statistics alone tell you very clearly that not every visit to the A&E will require a hospitalisation, but the issue here for Barbadians is the time that they have to spend waiting in A&E,” he said. “If we continue to improve the processes, I think that we will definitely see some improvement.”

Gooding-Edghill said sometimes the long waiting times experienced in the A&E may be attributed to the types of cases that the doctors may have to be treating on any given day.

“A doctor may be getting ready to see a patient, but a trauma case comes through … which may require the attention of a cadre of doctors, who may have to leave and go and attend to that trauma situation,” he said.

But, the minister said, they were conducting a patient relations programme that will encompass every department of the QEH to be able to measure progress and restore the public’s confidence in the people working at the medical facility.

“Another thing we are going to do shortly is measure satisfaction and let the (patients) who experience it report to us,” he said. “…Once we get that feedback, we will be in a position to make critical improvements.

“I have communicated to the hospital (management) that once they hear somebody sharing their views and perspectives, they may see it as a criticism, but it’s not. It’s an opportunity where we can turn a negative into a positive.”

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