Health ministry seeking to reduce pressure on A&E
(CNS): The Ministry of Health and Wellness says it is working on optimising services that can reduce the pressure on Grand Cayman’s only accident and emergency room located at the HSA hospital in George Town. Officials said that as part of the ministry’s aim to improve overall patient outcomes, it is looking at how enhancing access to general clinics outside of traditional hours could impact the demand for urgent care, which would have a direct knock-on effect on the demand for emergency services and the wait times for patients.
Responding to queries from CNS, following up on information given to parliament last week by Health Minister Sabrina Turner about the number of hospital beds available as the population grows, officials said that given Cayman’s “transient population… data is always in flux”, which impacts the overall capacity to deliver healthcare services. But when it comes to the pressure on the emergency room and its staff and access to services, the population is not the only consideration.
A ministry spokesperson told CNS via email that other factors, such as insurance coverage, out-of-pocket expenses and accessibility outside of the George Town area, also have to be considered.
CNS also asked when the urgent care facility at Health City in East End would become an official point of triage so that people could be taken there immediately when necessary. Officials did not fully address that issue but told us that work was underway to reduce the pressure at the George Town hospital’s A&E room.
Cayman’s growing population is significantly impacting healthcare services in both the private and public sectors. However, a ministry spokesperson said that concerns about the number of hospital beds were a poor yardstick for understanding the local healthcare services’ capacity to serve the population.
“While the headcount is an important factor when it comes to our overall capacity to deliver healthcare services… the issue of capacity extends beyond hospital beds,” the spokesperson told CNS. “The number of hospital beds as a metric of healthcare, while common, does not paint an accurate picture of any nation’s healthcare services.”
There is no globally accepted standardised way that hospital beds are counted. Bbeds in geriatric or elderly care facilities might be included in the total numbers in some jurisdictions, but in the Cayman Islands, they are not. “Within our jurisdiction, we also provide for high levels of home-based care for the elderly that would otherwise be in healthcare facilities, impacting the demand for beds,” the ministry said.
“The main reason why the number of beds is a poor metric of healthcare is because modern healthcare systems are focused on process outcomes to maximise care pathways,” officials said in their response. “This means that the system itself has shifted away from a bed-based care model, which is expensive and does not focus on clinical interventions, to one that favours day and overnight care that is focused on clinical interventions supported by technology that delivers fast-recovery care. This is a significant shift as it greatly reduces the demand for beds.”
With concerns in the community that the growing population is having a negative impact on service provision and beds in all the hospitals, CNS has seen an increase in anecdotal reports of a decline in nursing care, not just in the government hospitals but also at some of the private facilities, which the ministry has also said is being tackled.
“This work will be supported by the [chief nursing officer’s] ongoing efforts to help establish local standards of care in nursing practice,” a spokesperson said. “These standards will address concerns about differing or seemingly declining standards of nursing care as the expectation of care will be clear for all who practice in the Cayman Islands, no matter where they obtained their qualifications or completed their practicum.”
Officials added that the ministry continues to prioritize strengthening and enhancing Cayman’s healthcare landscape, and ensuring timely access to high-quality care is a key component of this priority.
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Category: Health, Medical Health
None of this will matter if people can’t afford healthcare anyway. Not got immediate cash, a very good insurance, or SHIC exhausted? Sorry, no admittance.
She has been the Health Minister now for three plus years and finally she is trying to discuss issues that should have been top on her list of “things to do in four years”. I guess she is thinking, better late than never. Her ramblings are unintelligent but she is trying. Madam I don’t have much time today to spare, I have to get in the traffic to go down to George Town hospital to get a blood test done, but before I go I am asking you to please upgrade ( tear down and rebuild) the Bodden Town clinic into a fully equipped hospital( including fully equipped lab) so that all of us in the eastern districts can get more and better services up here. Oh, before I forget , build it big enough with around the clock staffing to accommodate about a dozen persons if overnight emergency care is required. Imagine the difference that would make, all emergencies from East End, Northside, Breakers, Bodden Town, Pedro, Savannah, Lower Valley. Heck that is half of the island right there!
They could promote a healthier diet. While it tastes great, the Caymanian lunch of meat with 14 starches isn’t the best for our health… Having that after a Pepsi and a patty for breakfast doesn’t help either.
I had to read 3 times and it still doesn’t make any sense to me.
How many people end-up in ER after they were discharged from a hospital?
There seems to be an assumption that the sooner a patient is discharged from a hospital making his bed available to a next patient, the better healthcare metrics are.
Focusing on reduction of the demand for beds is fundamentally wrong.
What “other factors” ( 3d paragraph) have to do with the pressure on A&E?
I don’t think she understands what she is talking about.
More hospitals in the US are purchasing robotic surgery equipment hoping to reduce the demand for beds. There are other factors of course.
I have just finished my 3mo contract with one of the largest the US hospitals which is also a teaching facility that “is focused on clinical interventions supported by technology”.
As a RN with 15 years of hospital experience in post-op wards, I’ll tell you that 8 out of 10 post surgery patients end up in ICUs; many who are discharged as soon as possible either die at home or end up in ICUs within 24hr. And if I told you how many die post-robotic surgery due to complications, you’d not believe me. I have never seen such post-op mortality in my career.
This 3mo were so traumatic that I decided to quit. I did save few patients by noticing the obvious to me signs of post-op life threatening complications while doctors were ignoring or dismissing it. Often I had to insist and persist, but is a doctor who makes a decision.
So go easy with technology and reduction of hospital beds. Not every healthcare model needs to be emulated. Especially with very little understanding of the process and its consequences.
p.s. My 9yo relative had a “routine” outpatient surgery last month. She was rushed to ICU 3 times, bleeding profusely. It is a miracle she survived the last episode having lost nearly 75% of her blood. Had she stayed in a hospital for a min 3 days, as it is usual normal and customary in other countries, this would not have happened. By the way she had tonsillectomy recommended by guess who? Her speech therapist.
True.
Things that patients don’t know:
Da Vinci Robot Surgical Errors.
Among the problems were: Instruments falling off the robot and into patients, causing injuries. Electrical arcing of instruments. Unintended operations.
complications that are specific to the da Vinci robot, such as:
Longer operative times
Longer anesthesia times
Robotic malfunction
If the system malfunctions, then surgery can be prolonged or the patient could suffer additional injuries. This increases the risks that something could go wrong with the surgery itself or with more time spent under anesthesia.
https://www.lawyersatlanta.com/amp/da-vinci-robot-surgical-errors.html
By the way,
HCCI introduces new robot to assist surgeons.
https://caymannewsservice.com/2022/06/hcci-introduces-new-robot-to-assist-surgeons/
How is it going?
The HSA is a statutory authority, something the Minister frequently reminds us of when dodging responsibility for any failures; how is it that suddenly “the Ministry” is fixing it?
That place has been run into the ground by a bunch of self serving board members who engage in gossip and news carrying instead of dealing with the governance and strategic issues of delivering efficient and effective healthcare.
If the Minister wants to do something useful, she should get rid of that Board and appoint a group that actually has some interest in fixing the place.
She also needs to get rid of half the Jamaicans employed there. Including in H/R.