The Interview: October - December 2018

THE

Story on Page 18

INSIDE THE ISSUE •

Turks and Caicos Islands Hospital to launch Emergency Department triage first system

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IHC Infection Prevention and Control Program presented at global conference

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Cockburn Town Medical Centre dialysis patients receive free Wi-Fi internet access

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Information Technology Department acquires new governance certifications

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Pictorial highlights from InterHealth Canada's Staff Diamond Accreditation Celebration

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THE INTERVIEW

Table of Contents InterHealth Canada - Turks and Caicos Islands Hospital wishes to pause and take advantage of the holiday season to express gratitude and appreciation to our patients for entrusting us with their care.

We wish to also extend greetings to our beloved readers. May happiness, good health and joy be with you this season and throughout the coming years.

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Triage First System scheduled for 2019 in the Emergency Department

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TCI Hospital Clinicians continue to produce published research

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InterHealth Canada hosts second Stop The Clot Fitness Run across main islands

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Over 30 emerging leaders undergo leadership training at special 'boot camp'

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Surgical Suites host Minimally Invasive Workshop with global partners

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Employees rank TCI Hospital as 'a great place to work' with strong confidence in health care system

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THE INTERVIEW

Under the new system, patients in the waiting area will be called by a triage nurse in the order of arrival.

Patient verification will also be conducted during the triage assessment.

Following the assessment, the triage nurse will direct the patient to the registration window to complete the registration, NHIPeligibility verification, and payment process, and then wait to be seen by an emergency doctor, if clinically necessary.

InterHealth Canada - Turks and Caicos Islands Hospital continues to encourage efficient use of the emergency department (ED) and is seeking to improve patients’ access to urgent medical care with the introduction of a triage first system in 2019.

In accordance with international best practices, the new system features a slight adjustment to the current process that patients are required to undergo prior to accessing treatment by a medical doctor.

Patients who present to the emergency department will be assessed first by a triage nurse to determine their triage level prior to registration and payment. Under the current system, patients are triaged after registration.

Each patient will continue to be seen by a doctor based on their triage score, which may range from Level 1 – 5 based on the severity of their condition.

The Canadian Triage Acuity Scale (CTAS) is a five-level scale with Level 1 (Resuscitation) representing the most critical patients and Level 5 (Non urgent) representing the least ill.

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The Emergency Department at Turks and Caicos Islands Hospital treats cases of various acuity levels, including benign conditions, which can be treated by a primary care doctor.

THE INTERVIEW

A pilot of the triage first system is expected to be launched within the first six months of 2019 after a series of public sensitisation efforts. Â

Faster Access In order to provide non-urgent patients with faster access to the most appropriate care, patients may be transferred to the Ministry of Health Clinic from the Emergency Department after triage and registration. These transfer decisions will be further strengthened by the ED’s triage first system, which will provide clinicians with faster medical evidence to determine the most appropriate type of care shortly after a patient’s arrival.

Patients are therefore encouraged to consider the seriousness of an illness or injury in advance and determine the most beneficial and appropriate place for care, where possible. Primary care clinics operated by the Ministry of Health are primarily free of charge with shorter waiting times than an emergency department, and is conveniently open during extended hours.

Medical conditions suitable for treatment at a primary care clinic include common illnesses, such as colds, the flu, earaches, sore throats, migraines, low-grade fevers, prescription refills and limited rashes.

Minor injuries, such as sprains, back pain, minor cuts and burns, minor broken bones, or minor eye injuries.

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is it an emergency?

SOMETIMES IT IS OBVIOUS THAT A SITUATION IS AN EMERGENCY.Â

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NEWS

TCI HOSPITAL INFECTION PROGRAM PRESENTED AT GLOBAL CONFERENCE Nursing World Conference (NWC) 2018

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SURBRENA PEDICAN

Preventative measures implemented were shared with

The presentation was also shared at a Sub-Regional Meeting on Infection Prevention and Control (IPC)

attendees of the conference. These included changes

and Hospital Acquired Infection Surveillance (HAI)

in the skin preparation solution, surgical site dressing,

held in Castries St. Lucia on October 15-17, 2018. The

monthly surveillance data sharing, pre-operative clinic

Pan American Health Organisation (PAHO) facilitated

screenings, pre-antibiotic initiation and a

the three (3) day Castries meeting.

decolonization program. Institutional regulated practices were also incorporated in accordance with

The program sought to achieve a 50% reduction in the

evidence-based information to ensure consistency

number of Dialysis-catheter and line-associated

among diverse practitioners.

bloodstream infections (D-CLABSI) and Lower Segment Cesarean Sections (LSCS) healthcare-

The IPC Department performed active surveillance of

associated infections (HAIs).

all positive laboratory cultures on a daily basis. The culture reports showed bacterial isolates in the

Interventions included staff education and

bloodstream and surgical sites of the reported D-

competency assessments, point of care hand

Clabsi and LSCS Cases. The LSCS infection rate was

sanitizers, hand hygiene audits, PPE enforcement and

5% in 2014, 2% in 2015/16 and 1% IN 2017, which is

swabbing for Multiple Drug Resistant Organisms. Pre

positively consistent with international benchmarks.

and post treatment abroad swabbing was also initiated and monitored to prevent the spread of MDROs within

Commenting on the IPC program’s success, Pedican

the Dialysis Unit.

stated: “The TCI Hospital operated by InterHealth Canada is obsessed with quality. We are committed to

The D-CLABSI infection rate was 12% overall among

good quality care for all of our patients whom we

dialysis patients in 2014 and 2016. After the

consider family. Education formed the foundation of

implementation of various measures, the Dialysis

this change process along with collaborative efforts

infections dropped from 6 per year to 2, which is a

across the various departments and disciplines.”

67% decrease.

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THE INTERVIEW

TCI HOSPITAL CLINICIANS CONTINUE TO PRODUCE PUBLISHED RESEARCH THE INTERVIEW

Research conducted on ‘Bacteriology and Antibiogram of Pathogens Isolated from Wound Infections’ at Cheshire Hall Medical Centre’s Laboratory has been published in a second globally recognised journal.

The findings provide unique insight into the degree and types of antimicrobial resistant species in the Turks and Caicos Islands. The aggressiveness and characteristics of resistant bacterial species can differ across countries and regions.

Lessonjulle Lyons-Dobney, Medical Technologist at Turks and Caicos Islands Hospital, conducted the research, which has been shared in the Journal of Nutrition and Health Sciences under Annex Publishers in November 2018, after a previous publication in The West Indian Journal. The research seeks to identify pathogens that are frequently isolated from wound infections in the Turks and Caicos Islands and formulate antibiogram based on their patterns of antimicrobial susceptibility.

Bacteriology and antimicrobial susceptibility data from 1343 wound swabs cultured at the Cheshire Hall Medical Laboratory between January 2013 and November 2015 were retrospectively analyzed. The Kirby-Bauer disc diffusion technique was used to perform antimicrobial susceptibility testing.

The study found that overall antibiotic resistance rates were below 50%, however, some isolates show resistance rates of up to 95.9%. Sharing of information concerning the antibiogram, as well as, future updates with community physicians is recommended.

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Other clinicians at the InterHealth Canada managed facility have also recently participated in research published with similar global companies. Springer publishes books, e-books and peer-reviewed journals in science, humanities, technical and medicine. Oncology Visiting Consultant, Doctor Dingle Spence and Oncology Specialist Nurse, Gemma Watson are listed as co-authors in the article ‘Palliative Care in the Caribbean Through the Lens of Women with Breast Cancer: Challenges and Opportunities’ in Current Breast Cancer Reports. The article was published in July 2018.

RESEARCH FINDINGS The research states that too many women are presenting with advanced breast cancer and dying with little or no access to palliative care across the Caribbean. No comprehensive assessment of current capacity to deliver palliative care in the region exists, largely due to limited data. The findings outline ‘an urgent need to improve access to palliative care and pain relief throughout the region. Regional challenges include insufficient healthcare infrastructures to support cancer care, tremendous unmet need for palliative care, pervasive opiophobia resulting in limited access to opioids for pain relief, patients’ reluctance to engage with clinical care, and the widespread use of complementary and alternative medicines prior to the acceptance of conventional care.’

Within the Turks and Caicos Islands, many patients still present with advanced breast cancer, often due to decreased uptake of annual screening (eg. mammograms) and delays in seeking medical assessment.

Fortunately, the population of TCI has considerably better access to palliative care and medications, compared to many other countries within the region. It is hoped that as women start presenting more regularly for their recommended screening, the need for palliative care will decrease.

LESSONJULLE LYONS-DOBNEY - TOP RIGHT GEMMA WATSON - BOTTOM LEFT (PINK)

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Building

Stop The Clot

2018 FITNESS EVENT

"Staying active may help prevent the formation of blood clots."

InterHealth Canada - Turks and Caicos Islands Hospital held a sunrise fitness event on Saturday November 10th, 2018 on Grand Turk and Saturday November 24th, 2018 on Providenciales under the theme: Stop The Clot.

The event seeks to raise awareness of Venous Thromboembolism (VTE). A clot in the vein (usually in the leg or pelvis) is known as a deep vein thrombosis (DVT) and a clot that breaks off and travels to the lungs is known as a pulmonary embolism (PE). Together, DVT and PE form Venous Thromboembolism (VTE). One in four people worldwide die of conditions caused by thrombosis.

Staying active can help prevent the formation of blood clots. Participants were invited to walk, run or cycle. The event on Grand Turk started from the Cockburn Town Medical Centre to a demarked point on North Ridge road and return. The Providenciales event started from the Lower Bight Kids Park to The Sands Resort roundabout and return. Prizes were awarded to the first male, female, and cyclist to complete the route along with the youngest person to participate in the event.

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Run, walk, trot.

Building

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DIALYSIS WIFI PROJECT

Complimentary high-speed Wi-Fi

Representatives from InterHealth

internet access is now available to

Canada – Turks and Caicos Islands

Dialysis patients who receive

Hospital, Digicel executives and

treatment at Cockburn Town

the Minister for Home Affairs,

Medical Centre on Grand Turk.

Transportation and

Digicel officially launched the

Telecommunication, Honorable

service during a special ceremony

Vaden Delroy Williams were in

held inside the main foyer of the

attendance.

capital island’s medical centre on Tuesday, 16th October 2018.

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GIVING BACK

ENHANCING THE PATIENT EXPERIENCE TCI Hospital Chief of Allied Services, Eleanor Hall who is responsible for the dialysis unit opened the ceremony with a prayer. Honorable Williams expressed heartfelt gratitude to the company for the gesture and commended the organization on its corporate endeavor to provide greater Internet access across the islands.

Digicel Head of Business Solutions, Lydia Tucker delivered remarks on behalf of the telecommunications company. Tucker emphasized the company’s resolve to seek out opportunities to improve the community as a part of their corporate social responsibility.

TCI Hospital Chief of Medical Services, Dr. Denise Braithwaite-Tennant, flanked by other senior managers, praised the company for the partnership during the vote of thanks. The company ensured that dialysis units across both medical centres received the service at no cost to enhance the patient experience.

Dialysis patients, Linnette Simmons and Austin Robinson gave appreciation remarks and participated in the ribbon-cutting

The free internet access will allow patients to stay engaged,

section. Dialysis treatment for patients with

entertained and connected with their families via their smart

renal failure span several hours during each

phones, laptops and other gadgets during the recurrent

hospital visit and are typically required

treatment periods. The ceremony marked the final phase of

three times per week.

the Digicel free-Wi-Fi project that was launched at the Cheshire Hall Medical Centre earlier this year.

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EMERGING LEADERS BOOT CAMP InterHealth Canada – Turks and Caicos Islands Hospital hosted a special workshop for over 30 emerging leaders across the company on October 4th and 5th, 2018 at The Atrium.

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Employees are excited about the second instalment of the workshop scheduled for the first quarter of 2019.

A review of the post-workshop evaluation forms and the concluding statements at the session suggested that the participants benefited tremendously from the experience.

Following the boot camp, attendees were presented with certificates of attendance. The mission of the Turks Islands Hospital is to provide theÂ

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LOCAL CHAPEL DONATE FOOD SUPPLIES TO DIALYSIS PATIENTS

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TCI HOSPITAL DELEGATION ATTENDS MAJOR RADIOLOGY CONFERENCE IN CHICAGO Representatives of the Diagnostic Imaging Department at Turks and Caicos Islands Hospital attended the 104th Scientific Assembly and Annual Meeting of the Radiological Society of North America held on November 25th-30th, 2018 in Chicago, Illinois.

The delegation from TCI Hospital comprised of Radiologist, Dr. Raffat Soliman, Diagnostic Imaging Manager, Sandy Burgess, and HIS Manager, Detorrie Tennant. The conference attracted approximately 55,000 participants from around the world, including radiologists, radiation oncologists, and physicists in medicine, radiologic technologists, and other health care professionals.

RSNA Annual Meeting is a key event in the radiology industry featuring a series of dynamic educational sessions, lectures and networking events. The conference featured scientific papers covering the latest trends in radiological research and informatics exhibits. Attendees also were also given the opportunity to earn CME credits by taking part in select sessions.

The Radiological Society of North America (RSNA) is a non-profit organization with over 54,000 members from 136 countries around the world.Â

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SURGICAL SUITES HOST 'MINIMALLY INVASIVE SURGERY' WORKSHOPÂ

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Representatives of the Information Management and Technology (IM&T) Department at Turks and Caicos Islands Hospital have acquired a series of enhanced governance skill sets, which will further

The acquisition of new ISMS certifications is also

strengthen the department’s security practices.

aligned with the department’s continuous quality improvement program. The program seeks to provide

IM&T Manager, Ryan Smith and Health Information

an additional layer to the hospital’s current

Systems (HIS) Manager, Detorrie Tennant, conducted

information security strategy to protect the

IT Governance Training in New York and later

confidentiality, integrity and availability of patient

participated in live webinars for blended learning. The

and company administrative data.

training was held in October and November 2018 and hosted by the Organisation of Information Security

The knowledge acquired will improve the team’s

(ISO).

ability to further comply with contractual obligations under the project agreement with TCI Government

The certifications were acquired in Information

and conduct continuous self and third party audits to

Security Management Systems (ISMS). These are

ensure security controls for the hospital information

entitled: ISO Certification ISMS Foundation

systems remain rigorous.

27001:2013 – ISMS-F and ISO Certification ISMS Lead Implementer 27001:2013 – ISMS-LI. The tech duo also acquired a third credential in ISO Certification ISMS Lead Auditor 27001:2013.

The department is now more equipped with the skills and methodologies required to implement security programmes that meet internationally recognised standards established for information systems and security controls to mitigate evolving cyber threats.

IM&T department members with other trainees and trainers.

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Nurse Joan Clarke (centre) with members of the Human Resources and Education Department

The Outpatient Clinics Department also said farewell to Dr. Candice Price and Dr. Doshia Auguste 21

WORLD QUALITY DAY 2018 INITIATIVES

Network Engineer, Perfecto "Junior" Sevillejo (image) and Housekeeping & Portering Supervisor, Germania Urena (bottom) won the raffle.

orld Quality Day takes place every year on the second Thursday of November. According to the Chartered Quality Institute (CQI), the responsibility of the quality professional can be defined through five main areas – governance, assurance, improvement, leadership and context.

The Quality Risk and Patient Safety Department at TCI Hospital observed the occasion on Thursday 8th November 2018 via an ice cream happy hour, tagline competition and raffle. The raffle was drawn on Friday 9th October and one winner from the clinical and non-clinical division of the hospital won a Christmas hamper.

Reputations are built on trust.

Trust is a hard-earned commodity, yet one, which can be squandered in a moment.

Therefore, in 2018, TCI Hospital celebrated the role of every staff member in building and sustaining trust for all stakeholders: customers, suppliers, staff, regulators, shareholders and society.

The quality management profession is about helping organisations put in place competent systems to ensure that the activity of an organisation consistently delivers on its promises to customers and stakeholders.

This includes an assurance framework to help the organisation understand operational risk, and an improvement framework to mitigate it and improve.

These systems of governance, assurance and improvement combined with your culture of quality are our investment in trust and reputation.

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Congratulations to the winners of

The biggest loser was re-launched

InterHealth Canada - TCI Hospital

on July 2, 2018 and concluded on

biggest loser challenge. Around 50

October 5, 2018. The primary

employees entered the

objective of the program is to help

competition.

employees reach their individual fitness goals and maintain a

The winners were Diagnostic

healthy eating ritual as part of a

Imaging Manager, Sandy Burgess

permanent life style change.

(top left)Â who lost 30 pounds and Quality Risk and Patient Safety

Phase two will be launched in

Manager, Isha Honore (bottom

January 2019.

left) Â who placed second with an 18-pound weight loss.

The first place prize was $500.00 and $200.00 for the second participant who lost the most weight during the period.

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Winners of the hospital's biggest loser competition 2018 announced.

. e v o l y it n u m Com

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hand hygiene awareness While it is impossible to keep your hands germ-free, washing your hands frequently can help limit the transfer of bacteria, viruses and other microbes.

Always wash your hands before: - Preparing food or eating - Treating wounds or caring for a sick person - Inserting or removing contact lenses

Health care professionals at TCI Hospital visited the International School on Providenciales in the last quarter of 2018 to raise awareness of proper hand washing techniques. Effective hand-washing is a simple, cost effective way to prevent the spread of illness and infections.Â

Always wash your hands after: - Preparing food - Using the toilet or changing a diaper - Touching an animal, animal feed or waste - Blowing your nose, coughing or sneezing - Treating wounds or caring for a sick person - Handling garbage - Also, wash your hands when they are visibly dirty.

Members also visited the Mills Institute School to raise awareness of proper hand washing techniques. Handwashing offers great rewards in terms of preventing illness. Adopting this habit can play a major role in protecting your health. 25

STUDENTS TO UR MED I CA L D EVICE REPROCESSING D EPARTMENT

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THE INTERVIEW

a great place to work Staff Work Pulse Survey reflect positive results

STEEL PAN CAROLLERS VISIT CHESHIRE HALL MEDICAL CENTRE WITH FESTIVE CHEER Students of the Long Bay High School Steel Band Group volunteered to perform a variety of mellow Christmas songs for patients inside the main foyer at Cheshire Hall Medical Centre on Wednesday, 12th December 2018.

The performance attracted scores of patients and health care staff to the main foyer who were dazzled by the students' musical talent.

CONTACT US

THE FINDINGS InterHealth Canada - Turks and Caicos Islands Hospital has been ranked a great place to work by an overwhelming majority of employees in a recent pulse survey on Work life.

The survey was distributed to 214 employees between September and October 2018. The organization received a total of 177 completed surveys, which is aligned with the predetermined sample size of 80-85%.

The survey’s confidence level was 99%.

88% of employees positively ranked their experience with the company and nearly 100% of respondents said they would recommend the company to family and friends who require medical care.

An employee pulse survey is a fast and frequent mechanism used to provide quick insight into the health of a company.

The survey was administered by the Human Resources Department to solicit valuable feedback on areas for improvement and action plans. The survey seeks to measure employee engagement, provide employees with a voice, increase employee engagement, direct organisational growth and benchmark results.

Programs are being developed for any areas for improvement to further enhance the employment experience of the company’s greatest asset.

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Do you have a topic or story idea that you wish to see featured in our newsletter?

Get in touch.

Email: info@tcihospital.tc ABOUT THE EDITOR

Nikira John is an enthusiastic Public Relations and Marketing Manager who has worked on a range of multimedia projects. Email: njohn@interhealthcanada.tc for more information.

UNDERSTANDING OUR ACUTE SECONDARY HEALTH CARE SYSTEM

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For more answers to frequently asked questions, visit our website FAQ section: www.tcihospital.tc

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TCI HOSPITAL WAS RANKED DIAMOND FOR THE 3RD TIME IN 2018 InterHealth Canada’s end of year staff party to celebrate its recent success in the accreditation 2018 assessment and the onset of the festive holidays was held on Saturday, December 1st on Providenciales at The Atrium and Thursday, December 6th on Grand Turk at Bohio Resort’s Red Deck. The celebration featured an explosive performance from the country’s most requested live band, V6 Band Boys along with a delicious array of complimentary hors d'oeuvres and drinks throughout the evening, and a signature welcome cocktail called the 'Blue Diamond'. The company continues to thank staff for their contribution to the process.

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