Ramsammy outlines quality control tools of health care

Apr 23, 2010 News

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The Minister of Health, Dr. Leslie Ramsammy yesterday informed the National Assembly of the extent of the Quality Monitoring tools and programs being utilized in the country’s health facilities.
In seeking to address questions posed by Member of Parliament Sheila Holder, in accordance with the standing orders of the house, the minister pointed out that there were a number of instruments that were being used to assess the efficacy of the practices at the health care centers.
In 2007 a number of periodic assessments that required reports were introduced by the administration with the intent to track the numbers surrounding maternal and child health and mortality in these groups through childbirth.
The number of childbirths on a monthly basis fell under the Maternity Reports while the number of newborns and child illnesses were tracked under the Child Health Reports. Mortality in mothers and children was also tracked under monthly reports for these two groups, however, Internal Investigation and Assessment Reports are required in every single case of these deaths. Within 24 hours of death (of a mother in childbirth or through childbirth-related complications or any under-5 child death) submission of a report of notification is required while 48 hours later a report of an internal investigation is required as well.
In a similar line was the institution of the Morbidity and Mortality Committee which was introduced in 2002 at the Georgetown Public Hospital Corporation (GPHC) and New Amsterdam Hospital but is yet to make its way to all the regional hospitals and private health care institutions – although the Minister did indicate a change in this situation later this year. This committee was instituted to identify ‘unusual’ events in morbidity and mortality cases in hospitals, their causative factors and possible preventative measures.
According to Ramsammy, there is a Medical Advisory Committee that exists for the purpose of bringing about improvement in hospitals, however the committee is only functional at GPHC and has not been filtered down to the other health care facilities even though it was instituted some eight years ago in 2002.
There are also a number of performance-based indication reports and programmes which seek to ensure that the performance of the hospital in a number of critical areas is at a satisfactory level. These include chart quality – which will indicate the application of patient care and performance therein, laboratory proficiency and operating standards, as well as programme assessments and customer satisfaction.
In the area of laboratories, there exists the Laboratory Proficiency Programme which tracks the accuracy in performance of laboratory analyses, information which will attest to the use of resources and the dependability and error rate of results issued by the laboratory. There was also Quality Analysis/Quality Control testing for laboratories which would ensure that the required quality standards are being met in terms of analyses, equipment and performance.
In terms of customer satisfaction, Client Satisfaction Surveys were introduced in 2009 in a number of hospitals around the country. According to Ramsammy, these surveys show ‘acceptable’ patient satisfaction but reported issues with the attitude of the nursing staff.
One of the major quality control tools that Ramsammy mentioned was the Clinical Audit of the Health Sector. Initially introduced in 2005 on a small scale, the audit has been expanded with the assistance of a number of International Health and Aid Organizations and is to be launched on a graduated scale throughout the country. The second Edition of the Audit will consider performance of Maternal and Neonatal departments in a number of hospitals, Clinical and Environmental analysis of neonates and stillbirths and will also introduce for the first time a clinical audit for Emergency and Accident Rooms at a number of hospitals including GPHC and the hospitals in New Amsterdam and Linden as well. There will also be an audit of the charts to ascertain the quality of records being retained in the system.
According to Ramsammy, “the goal was for a comprehensive clinical audit to be completed with international reviewers every five years, thus the second edition of the Comprehensive Clinical Audit is to be done in 2010.” He also noted that the Comprehensive Audit for Maternal and Neonatal Services is slated for May/June of this year and there was mention of the fact that each year a limited clinical audit review with local investigators will be done.

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