By Milton Grannum
The Georgetown Public Hospital Corporation (GPHC) yesterday lauded its achievements during the year, noting that over 60,000 patients were seen and groundbreaking interventions done but it is still in need of at least 700 nurses and more beds to perform at its best.
Speaking at an end-of-year press conference, several heads of Department hailed their efforts with head of the accident and emergency (A&E) department Dr. Zulfikar Bux celebrating a steep reduction in the wait time patients encounter when accessing services at the department.
“Our current waiting time is at 58 minutes. Our door to disposition is at 4 hours 3 minutes, which is above average. We have seen more than 60,000 patients for the year, a 9 percent increase to that in 2023. We’ve taken 7300 referrals most of which are very critical cases. We have done 14,100 admissions an admission rate of over 23 percent, a testament to the level of complications patients who go to the AE arrive with. We’ve taken care of 2698 motor vehicle collisions, sexual assault cases, 96, and interpersonal violence 2446 cases”, he said.
“This year we had 8 maternal deaths, of those 8 maternal deaths each and every one of them was referred to us in a very critical state. We wish we could’ve done better or more for them but, I will say the care they have gotten where they were and they got from us would’ve been the same because they were basically transferred and housed in the ICU in a very critical condition”, he said.
Additionally, the hospital recorded a total of 955 neonatal admissions with 41 neonatal deaths for the year 2024, a 50 percent reduction as compared to 2023. The leading cause of death for some 26 was listed as premature birth.
The paediatric medicine ward saw the admission of 1,319 children with pneumonia with 370 cases being the leading cause of admission, then sickle cell anemia, neurological conditions at 120, and blood cancers at 83.
One hundred and twelve joint replacement surgeries were also done.
In terms of training and development for staff to function more efficiently persons from different departments underwent training. One of the paediatric emergency specialists returned from training and is now equipped with the skills to handle emergency care for children, while a urogynecology specialist was also trained with Northwell Health Care. The hospital’s pathologist was trained in immunohistochemistry techniques, which are aimed at improving cancer diagnosis and determining where target therapies for these cancers can be improved.
Orthopaedics
Plans are also underway for the staff of the hospital specifically at the accident and emergency unit to undergo training in soft skills and customer relations to better assist patients.
Director of Medical and Professional Services, Dr Navindranauth Rambarran stated that “The department of orthopae-dics did a total of 2,218 surgeries, of which 1,048 were elective cases versus 891 that were emergency surgeries. Elec-tive surgeries are usually planned while emergencies come in and would require operation within a very short period.
The paediatric surgical department did a total of 274 surgeries. General surgery did a total of 2,207 surgeries. Neurosur-gical procedures came in at a total of 158.
The Ophthalmology department saw 2,933 electives and 36 emergency surgeries in total, 159 of which the patients were admitted. The hospital did 16 renal transplants for 2024.
Various accreditations and international collaborations were also celebrated.
“In March of this year, we were accredited by the kidney transplant centre. We worked in kidney transplant for a number of years, but obviously, in reaching the requirements of international standards, and with the new agency that we have, the Human Organ and Transplant Agency, we are meeting their new requirements and regulations. Then there was a ward paediatric project. There was also a mission where they completed ten surgeries for kids between the ages of 11 to 17, for scoliosis, and there was operation walk.
The management lauded the construction of a new Campbellville Health Centre to the tune of over $800 million, which is expected to commence in February of next year, merging the Kitty and Campbellville health centres. When the construction begins the Campbellville health centre will be temporarily housed on Duncan Street, just around two blocks away from the current location.
Additionally a new pathology lab was commissioned, which saw each equipment in the lab being repaired, and replaced with more modern equipment, there was also training, as well, for staff which is expected to provide the kind of results that the public requires. With the new lab the management is working with an accreditation agency from Canada for the ISO certification.
The refurbishing of a pharmacy in the wards of the elementary block aimed to improve medication management and pharmaceutical management along with the refurbishing of other wards and intensive care units to reduce overcrowding at the Liliendal centre was commended along with an expansion of the Festival City health centre.
Various procedures were done for the first time ever at the hospital. Some of those included a donor nephrectomy; the process of taking the kidney out of the person who’s donated their kidney by a minimal invasive procedure, a laparoscopic procedure, so that that patient actually would have been discharged in a day or two, compared to maybe five or seven days that would have been required if they had an open surgery.
Last year the hospital also performed its first liver resection by a local group of health professionals.
Director of nursing services, Leslyn Holder thanked nurses for their continuous hard work and openly expressed hope for improved numbers in registered nurses to deliver the standard of nursing care the hospital should be delivering. She stated that the hospital boasts a total of 996 nursing staff in all capacities up to the end of November of this year.
“For this year that is to the end of November we have a total of 996 nursing staff, and this is at all levels of practice, with a total of 212 registered nurses (RNs).
She stated that the health ministry is currently training over 1,000 RNs, and approximately 800 nursing assistants to fill gaps.
She added that “we would like to improve our nursing numbers, especially our registered nurses, while continuing to train staff who supplement care, and that is our nursing assistants and our patient care assistants. We would like to finalize our model of care with greater emphasis on patient and family education and research for nurses. Research puts us in a position where we’re able to use evidence-based practice to deliver care”, Holder stated.
Staffing
The hospital continues to grapple with general staff shortages. Rambarran stated that despite the hiring of 36 Cuban nurses, a strategy the government has embarked upon to address the staff shortage at the hospital there is still a deficit of at least 700 nurses at the institution.
Space is another critical issue. Speaking to the shortage of staff and space Dr. Bux stated that the accident and emergency department has only 18 beds.
“If the numbers continue as they have over the years I am very concerned with 2025, 2026 because we will have to look at space, we will have to look at how we improve our morale and increase the number of staff we have. We do not have enough space. For you to have 18 beds to take care of 60,000 patients in a year that should tell you the challenge we have. And we still admit patients though we don’t have beds. Unfortunately our nursing shortage has been compounded by the punctuality of the nurses. Sometimes they are absent or not on time. Some of it has to do with reality some of it has to do with them being burnt out. Sometimes even the doctors fill in and perform nursing duties… As we move forward I think we need to look at our staff volume. Also the hospital will be focused on training nurses and other health providers to improve the efficiency, patient satisfaction to improve patient experience throughout the department.
Additionally the hospital is also facing issues as it relates to the turnaround time at the newly commissioned pathology lab.
“We were able to reduce the turnaround time at the pathology lab from 30 days to 7 days. We were aiming for less but unfortunately some human resource challenges have affected us as we weren’t able to hire enough technicians, medical technologist and pathologist so that has really affected us trying to be consistent”.
Citing the government’s initiative to hire Cuban nurses to address the employment gap, Rambarran stated that “it was a good strategy, and we would not have supported the strategy if it was not. The only challenges sometimes that we would encounter is a language barrier, but we have a programme that teaches English language as a second language. So they usually go through that before. Cuba produces some of the best medical experts”.
Additionally all chronic clinics the institution possesses remain a challenge. They are making efforts to decongest them, which will resolve one of their main issues. To address this challenge they have implemented an appointment system but the public has not yet adopted the initiative.