The Millennium Heights Medical Complex (MHMC) hosted a year in review press conference this week to shed light on some of the challenges it encountered last year, as well as its plans and programmes for this year.
Dexter James, MHMC’s Chief Executive Officer (CEO), underlined some of the key issues at the facility presently, including high inpatient bed occupancy and long wait times in the hospital’s Accident and Emergency Department (AED).
Whilst the facility continues to battle various issues, it also had many victories, the CEO said. However, he added, sometimes these victories are not recognised.
“We have our fair share of challenges. The Accident and Emergency Department uses what is called an Emergency Severity Index as a basis for classifying or as we refer to it as triaging patients. Category one and two tends to be very urgent and life-threatening conditions. Category three; persons who are touch and go. They could be urgent or non-urgent but they require some form of diagnostic, at least two resources to be able to determine whether we classify them as (category) two or we deescalate them to four and five,” James said.
“Four and five are generally classified as your GP (general practitioner) type cases, so for the data for December you will see that for category one and two which are predominantly life-threatening conditions, we see about just over 300 patients and they consume at least 23-24% of the patients presenting to A&E (Accident and Emergency),”
The influx of patients visiting the A&E Department poses a major problem and typically affects those with less severe illnesses, James revealed. It’s a nagging problem for patients at the MHMC, however, the situation is hard to curb, James indicated.
“The category three, four and five tend to be the patients who wait between maybe an hour to six hours and it really depends on the severity of the patients’ condition. These are patients who were classified as perhaps non-life-threatening but require diagnostics. So for instance in December where we (saw an) excess of 25 patients who presented to our emergency room in life threatening conditions, the A&E staff now (had) to see about these patients. It means the category three, four and five (had) to wait longer,” James said.
According to him, the A&E Department has been unfairly criticized overtime due to long waiting times. The situation could be different, however, but there’s an important factor to consider.
“Ordinarily, category three, four and five really should be seen in a different setting where they’re in diagnostic services and not really present in the hospital but they present to us so we have to take care of them. I hope this message goes over well to the public because we really have hard working staff at our emergency rooms and sometimes they get these unfair criticisms,” he said, adding that “it is not a first come first serve basis, it is based on the doctors’ assessment of the severity of your medical condition.”
On MHMC’s triumphs, James said “you never hear that the 25 patients that came in in December in a crisis situation are all alive today. These are good news stories that we really need to celebrate in our public health system.”
With regards to high inpatient bed occupancy, a vexing issue for staff and patients alike, James said it’s rather unfortunate as it creates a number of challenges.
According to him, “high inpatient bed occupancy creates problems with the access to and use of our theatres, long wait times in A&E… I want to qualify that by saying it is mainly for those (in) category three, four and five. The A&E sees about 15-20 admissions on a daily basis so we understand that when patients have to wait an inordinately long period of time to get a bed it is because we really don’t have beds.”
Patients with uncontrolled diabetes and those with hypertension (some) spend an average of ten days in the hospital. They are discharged once their conditions improve, however, “while all that is happening you have patients who have been cleared for admissions in our emergency room waiting for beds.”
James said it is an untenable situation healthcare professionals agonize over and an unfortunate reality that must be addressed. Hopefully, however, the MHMC will see some redress “based on some decisions that might be pending on giving us some additional beds.”
Funding is also an issue. The MHMC is a relatively new plant that requires funding to sustain its operations, the CEO said. A lack of funds therefore, has created its fair share of challenges. Nonetheless, James is hoping for the best.
“The question of financing is a challenge. As we begin to evolve, hopefully we will become a lot more robust, pay off suppliers on a timely basis (and) meet the costs of vital drugs and supplies,” he said.
Further, he noted, “COVID has fractured the supply chain for many. When we have to buy, we have to buy in Economic Order Quantities and Economic Order Quantities could mean substantial sums that we have to pay upfront to get the supplies that we require. We’re having some challenges there and we’re working through that to find alternative supply chains to make sure that we could keep our plant going.”
“Of course, if we’re not able to receive the funding (at) the right time to maintain the plant then we have problems with keeping our diagnostic equipment working continuously; those are some of the early challenges that we encountered in 2022.”
On the brighter side, James noted, despite its challenges, the MHMC has received great reviews from patients. A number of patients have indicated that they would recommend the facility to family members and friends.
Patients have also expressed their satisfaction with MHMC’s nursing care.
“73% of the patients that were interviewed at this hospital in the month of December said that they were very likely and likely to make a recommendation for their friends or their relatives to use the hospital so in spite of what you may hear the hospital still enjoys a fair amount of goodwill with the constituents that we serve and the population. We measure that by what is called the Net Promoter Score; it’s a score we look at every month which gives us a gauge as to how happy the populations that we serve are with respect to the services we provide,” James said.
The MHMC has made several commitments for 2023. The MHMC is seeking to improve the overall performance of management and will also focus on service quality amongst other things.
“Our board has committed to implement what we refer to as a Quick Winds Programme that is beginning to focus the organisation around a set of deliverables. Our programme for this year will sustain the existing packages that we currently provide to the population and we’ll build it around this acronym call S.P.I.C.E. where the ‘S’ stands for (service quality enhancement) with a heavy focus on quality and patient safety,” James said.
“We will begin to strengthen our institution and build capacity in selected areas particularly our nursing area. We need to provide opportunities for training, developing new skills and competencies; our communications strategy both internal and external. We intend to have quarterly press briefings where we will update you on our performance and get feedback from you on any issues that you want to raise with us. Finally, we can’t do it without our employees, we really have to focus on our employees and their happiness and improving the staff morale. That will become a big part of our programme for the year,” James added.