The South-West Regional Health Authority’s Public Board Meeting was held at the San Fernando City Hall Auditorium, Harris Promenade on Wednesday 29th March, 2017. Dr. Alexander Sinanan, Chairman of the SWRHA Board of Directors highlighted initiatives undertaken to strengthen processes and systems geared towards improving the quality of healthcare at the SWRHA. Mr. Anil Gosine, Chief Executive Officer, reviewed the organisation’s main activities and key accomplishments during the fiscal period 2015/2016 and presented the core strategic priorities and plans for 2017. Staff, clients and members of the public were also given the opportunity to voice their concerns and questions to the Board of Directors during the open forum session.

Kindly view the Chairman and Chief Executive Officer's Reports below. 

 

Chairman's Report- Public Board Meeting 2017

Good afternoon everyone.

On behalf of the entire Board of Directors of the SWRHA, it gives me great pleasure to welcome you all here this afternoon to our Public Board Meeting. I wish you all a warm welcome & I would like to thank you all for attending. Your presence at this meeting demonstrates your continued commitment to assisting the SWRHA to improve on trying to provide first-rate public healthcare at our institutions.

At this point, I would like to take the opportunity to introduce you to the other members of our Board.

·        Mrs. Valerie Alleyne-Rawlins, Deputy Chairperson

Our other Board Members include:-

·        Dr. Shalini Pooransingh

·        Mr. Anil Bhagowtee

·        Ms. Jennifer Marryshow

·        Dr. Harry Smith

·        Ms. Jayselle McFarlane

·        Mr. Dexter Bailey

Also sitting at our head  table and,  an  ex officio  member of  the  Board, is  Mr  Anil  Gosine,  the Authority's Chief Executive Officer.

This public Board meeting gives us yet another opportunity to look at methods of improving the quality of healthcare we provide for you, the citizens of the South-West Region.   It serves to reinforce our commitment to the effective delivery of healthcare services by providing the opportunity for us to share information on our goals, achievements and challenges.  Most importantly, today is an opportunity for us to obtain your feedback on what is working well and what requires improvement. This afternoon, you will be presented with information by the Chief Executive Officer, Mr. Anil Gosine on the utilisation of services, our achievements and the strategic plans for the SWRHA. We also hope to be able to clarify your questions on health issues in our region.

In particular, at the Public Board Meeting, in accordance with the RHA Act, the SWRHA Board is obligated to list its achievements for the fiscal year 2015-2016, and we are also required to state our objectives for the next year, in accordance with our Strategic Plan.

Our Strategic Plan is in the process of being developed and finalized and is the product of the involvement from all levels of staff within the organization.

Just over one year ago, we, the Board, stood here, at our first Public Board Meeting, having sat in office for just under 2 months. One year later, we are here again and we must take full responsibility for the operations of the SWRHA over the past year.

The last year has been an eye opening experience for myself and for the Board.

As you are all aware, our country is experiencing challenging economic conditions and we, at the SWRHA are therefore trying our best to run a Public Healthcare system with limited financial resources.

This has therefore practically forced us to find ways to run a more efficient machinery and effectively ‘trim the fat’.

Honestly, if I had to give a title to my speech this evening, I would have entitled it: ‘Trimming the fat!’

The meaning of this statement is two-fold. We are trying to cut down on the wastage of our valuable resources, but at the same time, we are also trying to strengthen our Primary Care Services – and one of the objectives in Primary Care is to cut down on childhood obesity and to reduce the level of sugar consumption.

As a consequence of the limited financial resources, I cannot stand here this evening and boast that we have opened a multitude of new buildings or purchased expensive equipment.

Instead, we have simply been trying to strengthen our processes and systems and we have been trying to offer a more efficient service, while trying at all levels to improve our customer satisfaction.

As a medical doctor, I usually make a point of never referring to our patients as merely customers, because every patient is an individual with unique needs. However, patients are our ‘external’ clients or customers, and one of the mantras which we have been preaching since we took office, is that we simply want to make the facilities at the SWRHA, facilities that any one of us, would be comfortable with, if and when, we need to bring our relatives here to receive healthcare.

The other group of ‘customers’ which I must refer to, is our ‘internal customers or clients’ – our staff.

At the SWRHA, I would like to think that the majority of our staff are performing their jobs, not just for the money, but they are doing it for the patients, and I would hope that they obtain a level of job satisfaction.

We have been trying to improve our Employee satisfaction and to this end, we have introduced an Open Forum for our Staff where they can give us honest feedback. We held our first Open Forum in October 2016, our second Open Forum is on April 7th. Based on the comments and feedback from the Open Forum, we have had meetings with the relevant Managers and we will continue along these lines.

Coming back to stating our achievements, as you may all know, we have several Board appointed Committees, which include a Clinical Governance Committee, IT Committee, & Quality Improvement and Risk Management Committees, to name a few.

Through each of these Committees, we have been trying to take a pro-active approach and we are trying to improve the ‘system’.

We, as a Board, are not about ‘putting out fires’, we would like to prevent the fires from ever igniting!!

Some of the issues which we have been working on, from our Quality & Risk Management perspective, have been developing a Pharmacy pathway, so that patients can access their medication in a more efficient manner. We are still receiving complaints about patients not receiving their medication at one area, but that medication is available at another facility and we are continuing to work on this pathway.

We have re-instated the Falls Prevention programme and we have commenced the installation of grab bars in the showers and we are making sure that all beds have railings to prevent patients falling – this programme is well underway,

A template for the recording of pressure sores – both on admission and those developed while in Hospital has been developed.

Attendants are once more being assigned to Wards to assist in the turning of patients.

We are also looking at our surgical cancellations and analyzing the reasons given for cancellations and we are trying to minimize unnecessary cancellations.

In the A&E Department, we are looking at the overall patient pathway and trying to develop techniques to avoid overcrowding at busy periods.

From a Medical Records point of view – we have realized that we need a re-vamp of our Medical Records System – and to this end, we are in the process of engaging an External body to assist us in getting the Medical Records Department sorted out.

Similarly, we are aware that we have had Employees who have retired years ago, and some of these employees have yet to receive their pensions – please rest assured that we are dealing with this issue, and we are also putting measures in place to prevent this situation from recurring.

For those of you in the audience with an idea of the concepts of Hospital and Healthcare Management – items such as Pressure Sores and waiting times in A&E form part of the Performance Indicators in any Hospital.

This Board has been trying to introduce the concept of Key Performance Indicators throughout the SWRHA organization from the top down, so that targets can be set and performance can be measured.

These KPIs are not only being established for the Clinical aspects of care, but are being set at all levels, so that the performance of all levels of staff can be assessed – our Honourable Minister of Health always likes to use the quotation - ‘you cannot manage what you do not measure’ and we are taking a page out of his book.

From an Infrastructural point of view, the first Phase of the Upgrade of the Labour Ward has commenced. Remodeling of the Observation Bay of the A&E Department is also due to commence, as is work on the Kitchen.

From an IT point of view, we have upgraded the SWRHA website and launched the Corporate Intranet. The E-mail server has been upgraded and we have also increased the storage capacity for the images produced in our Radiology Department. Image viewing stations have been installed in the A&E Department so that staff can view a patient’s X-rays once they are performed. The Area Hospital Point Fortin has also had a telephone upgrade, and work is continuing on the new Point Fortin Hospital which will hopefully be completed by the second half of 2018.

From a Primary Care perspective, we are actively looking in to the issue of our Medical Doctors once again performing home visits to those patients who are unable to visit their Health Centres.

Ladies and Gentlemen, I could stand here and continue talking, but this evening is really for you, the Public, to have your opportunity to speak up and be heard – and more importantly – be listened to.

We appreciate that improving the systems of any institution, particularly a healthcare institution, is always a ‘work in progress’ – on which we will continue working assiduously.

I would like to leave you with the knowledge that we are trying to inculcate the culture of “Prepare, rather than repair”.

Therefore, I would like to close by simply thanking you once again for your attendance and I would like to reassure you that we – your SWRHA Board – genuinely have your interest at heart.

Thank you.

 

Chief Executive Officer's Report- Public Board Meeting 2017

Scottish philosopher, Thomas Carlyle once said that,

He who has health, has hope, And he who has hope, has everything.”

As “Your Partners in Health”, this is our role in the South-West Region: to provide quality care and to give hope.

It is my honour to present to you, the members of the public and other stakeholders, the Annual Report of the South-West Regional Health Authority for the year October 1, 2015 to September 30, 2016. This is in accordance with the Regional Health Authority Act Chap: 29:05 Clause 12, wherein it states that the Authority will hold a meeting with the public to present and discuss the Authority’s performance for the preceding year, that is, 2015-2016. The Authority’s plans, goals and targets for the current fiscal year i.e. October 1, 2016 to September 30, 2017 are required to be presented as well.

This report provides an update on public commitments made and other key accomplishments of the SWRHA. Results are provided on the publicly committed strategies, actions and performance measures as identified in the Ministry of Health’s Strategic Plan 2012-2016, and the SWRHA’s Strategic Plan 2013-2016. Our report to you today is the final report of 2013-2016 strategic plan the theme of which is “Putting the “Care” Back into Healthcare”. It provides an opportunity to assess the accomplishments, results, lessons learnt and how to build on past successes for the benefit of the people in the south-west region.      

The strategic plan 2013-2016 comprised nine core strategic priorities and is a continuation of the transformation phase focused on continuous improvement in healthcare. 

  • Prevention, care and treatment of chronic non-communicable diseases
  • Prevention, care and treatment of communicable diseases    
  • Maternal and child health
  • Mental Health and Wellness
  • Health Human Resource Planning and Development
  • Information and Communication Technology (ICT) integration in the health sector
  • Continuous improvement of the management of the health sector
  • Continuous improvement of  health services delivery and;
  • Health infrastructure development and facilities management 

Just a reminder. As the largest of the 5 Regional Health Authorities in Trinidad and Tobago, the SWRHA serves a clientele of over 525,000 in a geographical expanse that covers more than one third of the land surface of Trinidad, extending from Freeport in the North, to Icacos in the South West, Moruga in the South East and Tabaquite in the North East.

Central to the vision and mission of SWRHA is improving the health status of its residents. Serving the Authority are over 4,800 members of staff working in partnership in very diverse settings from hospitals to district health facilities, health centres, public health units and services in ambulatory clinics. 

The Authority is responsible for the management and services of over 900 inpatient beds at the San Fernando General Hospital, the San Fernando Teaching Hospital, Area Hospital Point Fortin, and 2 Extended Care Centres.

Just like any organisation, or any household, for a matter of fact, we have resource limitations. And so as we remain dedicated in our role to deliver high quality care to our patients and offer a range of services from prevention, to diagnostic testing to treatment and a general promotion of health, we attempt to do so in a manner which is both efficient and effective.

We have recognised the growing need for improvements to our equipment, information technology, and physical infrastructure as we serve members of the public, our workforce, and other key stakeholders. As such, we have assessed our resource constraints and yet, our data illustrates that during the fiscal year 2015-2016, we were able to make strides in our systems and processes throughout the Region.

It should be noted that during the 2013-2016 period, the Authority continued to experience challenges in serving a growing ageing population, managing increased costs, maintaining ageing buildings, and operating with an inadequate supply of pharmaceuticals. There was no increase in budget allocations in the 2013-2016 period resulting in quality patient care being compromised at times.      

I will take this opportunity to share with you, our goals and targets undertaken for this period and the results commencing with the Financial Overview all of which are aligned to the nine strategic priorities I mentioned previously.

This table on the screen illustrates the allocation of funds and the actual expenses incurred. In Fiscal 2015 - 2016, we proposed a recurrent budget of $1.61 billion and were allocated $1.1 billion with a variance of more than $520 million which represented a shortage of approximately 33% of total proposed budget.

However, our expenditure for 2015-2016 was $1.274 billion, and the breakdown is as follows:

  • Personnel Emoluments -             $1.07 billion   i.e. 84% of total expenditure
  • Goods and Services -                     $199 million i.e. 15.62% of total expenditure
  • Equipment -                                     $5 million i.e. 0.38% of total expenditure

Analyzing our expenditure in terms of delivery of services, a total of $141 million was spent in Primary Care, $1.053 billion in Secondary Care, and approximately $80 million in Administration.

These figures revealed an increase in expenditure from 2014-2015 in the amount of $139 million resulting in an increase in liabilities to our creditors in the sum of $85 million and overall deficit of $190 million. If we are to continue with our current services and spending patterns, it is conceivable that the Authority would incur a further deficit. Taking into consideration the current economic climate and insufficient funds allocated to the Authority to carry out our mandate, we will need to relook our spending patterns, rethink our service levels, and increase efficiencies etc. in order to mitigate the deficit. This will certainly impact our ability to maintain and improve the lives of our patients, employees and services.          

I will now provide key information on each of the nine core strategic priorities, the goals of which were incorporated into the SWRHA’s Annual Business Plan 2015-2016 including our major successes and challenges experienced:

Core Strategic Priorities 1&2 - Prevention, Care and Treatment of Chronic Non-communicable Disease and the Prevention, Care and Treatment of Communicable Diseases    

  • Reduce the mortality rate from heart disease per 100,000 population by 20%. Mortality from heart disease decreased by 22% at the SFGH from 2015 to 2016.
  • Reduce the mortality rate from diabetes per 100,000 population by 20%.  We recorded an increase by 10% at the SFGH in 2016.
  • Reduce the mortality rate from cancers per 100,000 population by 20%. We recorded an increase by 5% at the SFGH.
  • Reduce the mortality rate from cerebrovascular diseases per 100,000 population by 20%. We recorded a decrease by 3% at the SFGH.
  • Reduction in the level of obesity in school aged children by 50% in 2015
  • Increase health promotion reach in the region by 70%
  • Reduce morbidity and mortality rates for Tuberculosis by 50%
  • Reduce morbidity and mortality rates from other infectious diseases by 50%
  • Halt by 2015 and begin to prevent the spread of HIV/AIDS
  • Achieve by 2016,  universal access to all requiring treatment for HIV/AIDS

We continue to see the epidemiological shift from infectious diseases to chronic non-communicable diseases as the major cause of mortality and morbidity.

The top 5 diseases in the south-west region are: heart disease, cerebrovascular disease, cancer, diabetes and chronic kidney disease.

While we have recorded improvements, we are unable to confirm with certainty that we have met some of the targets due to the present system. We have since implemented systems to improve the data for more accurate analyses to be done.

A draft business case for the establishment of a Health Promotion Unit at the SWRHA has been developed and is currently under review. This will allow for the prudent management of health promotion budgets, and greater effectiveness and efficiency in planning and coordinating programs focused on healthier lifestyles.     

Other key points to note:

  • The SWRHA is of the view that if any meaningful and sustainable impact on Chronic Non-communicable Diseases (CNCDs) is to be made, a national intervention is required.
  • Some of the common challenges experienced in meeting our objectives in these two core strategic priorities include increased needs of the health population, inadequate funding (primary challenge); information technology; facility management/administration including physical infrastructure; human resources; medical education; preventative maintenance, implementation and monitoring.
  • Patients attending outpatients’ clinics increased from 229, 500 in 2015 to 240,868 in 2016.
  • There was an increase in total emergency visits at the emergency departments at the 2 hospitals and 3 district health facilities by 26, 000.
  • Surgical procedures completed at the San Fernando General Hospital and Area Hospital Point Fortin were 15,898 and 446 respectively. 
  • Our HIV/AIDS Community Outreach programme has impacted on 1,713 persons in Caroni South, 1,709 in the County of Victoria and 131 in the County of St. Patrick. Fiscal 2015-2016 saw 141 new visits and 5,632 revisits at our HIV/AIDS Clinic at the San Fernando General Hospital. We recorded 40 deaths from HIV/AIDS. In addition, records show that 370 persons for that period came into the clinic to be tested.
  • The number of prescriptions requested decreased from 1,541,832 items in 2015 to 1,469,540 items in 2016. 617, 618 prescription items were not available in stock and could not be dispensed to our patients.
  • Primary Health Care represented more than 62% of the number of prescriptions which were fully dispensed at the SWRHA.
  • The unavailability of drugs remains an issue as NIPDEC C40 experiences challenges in serving the requirements of all RHAs.
  • On behalf of our patients and stakeholders, we hope that the Ministry of Health can revise and develop their procurement system for pharmaceuticals as it relates to the increase in demand throughout our facilities.
  • Total lab tests completed in 2016 was approximately 1.3 million.
  • Total number of images produced was 224,686 in 2016 compared to that of 188,977 in 2015 – an increase of 19%.
  • The Imaging Unit at the Emergency Department SFGH recorded an increase of approximately 10,000 compared to that of 2014-2015.
  • Number of images produced by the San Fernando Teaching Hospital was 10,978 compared to 7,879 in 2015.
  • Images produced at the DHFs - Couva - 13,737; Princes Town -18,604, and Siparia 15,465.

Core Strategic Priority 3 Maternal and Child Health

The objectives were to:

  • Meet/surpass by 2015 the  United Nations Millennium Development Goal # 5 Target  which is to reduce by three quarters between 1990 and 2015, the maternal  mortality rate. This goal was met.
  • Achieve or surpass by 2015 the United Nations Millennium Development Goal # 4  which is to reduce by two thirds between 1990 and 2015, the  under-five  mortality rate.
  • Implement universal access to reproductive health services by 2015. This was achieved.
  • Increase health promotion reach in region by 70%.

The SWRHA continues to make progress in complying with child and overall family health standards to encourage and enforce maternal and child health with positive outcomes. Furthermore, Nursing continues to advance breast feeding introduction and time span, including development of the Baby Friendly program for both acute and communal care.

Other key information includes:

  • At the SFGH, infant births totalled 4,901.
  • Total new born deaths were 70 in 2016. This comprised of 12 Infant deaths, 14 Neonatal Death and 44 Perinatal Deaths.
  • The average immunization percentage in the Counties as at 2016 is: 96%, 93%and 92% in Victoria, St. Patrick and Caroni South respectively.  
  • Maternal and child health visits increased from 158,397 in 2013 to 240,751 in 2016.
  • Total C-Sections at the SFGH was 1,002 and at the AHPF – 96.
  • Maternal deaths were 0.

Core Strategic Priority # 4 - Mental Health

  • Reduce the admission rate due to serious mental illness by 20% by 2015.
  • Commence programmes for the reduction of stigma and discrimination towards mentally ill persons in the South-West Region.
  • Increase health promotion reach in the region by 70% (ie similar to what was previously stated in the Maternal and Child Health Core Strategic Priority)

In order to enable more persons to access mental services and in a manner that minimizes stigma and discrimination, 37 Doctors and 135 persons among other categories of staff from Primary Care were trained to adequately deliver mental health services  to persons diagnosed with mental disorders, as well as, their families.

During the period under review, training in Prevention and Management of Aggression and Violence was rolled out to 51 members of staff of SWRHA.  This specialized training is designed to equip staff with the required competencies to respond to volatile situations that may develop in the performance of their duties.

Through the professional competencies available in our Mental Health Department, in-house Employee Assistance Programme (EAP) services are provided to staff. Forty members of staff benefitted from these services during the review period including seven group counselling sessions.

In response to the ominous threat which mental illness constitutes to the population through a decline in quality of life, disability and mortality; the SWRHA has enhanced its mental health education and promotions to new thresholds. They include: health fairs, lectures/presentations in schools, places of worship, organisations and at community groups, marches, walkathons/marathons, seminars, radio presentations and workshops focusing on illegal drugs and bullying.

Core Strategic Priority # 5 - Health Human Resource Planning and Development

  • Ensure all Cabinet and Board approved positions for physicians, nurses and pharmacists are filled by 2014.
  • Increase the physicians per 10,000 population ratio to 18 by 2015.
  • Increase the nurses per 10,000 population ratio to 25 by 2015.
  • Increase the pharmacists per 10,000 population ratio to 8 by 2015.
  • Ensure an adequate supply of nurses in district health as in the community, midwifery, mental health and geriatric health care by 2015.
  • Develop an employee competency framework to inform recruitment and talent management, training, promotion, compensation and succession planning for staff development.
  • Improve the quality of working conditions to enhance employee confidence and engagement and promote work/life balance.
  • Promote occupational, environmental, safety and security in the workplace.

We continue to experience challenges at HR in meeting the modern needs while predicting and preparing for future necessities of the SWRHA. This is further aggravated by the absence of an HR Information System (HRIS) which results in work that is laborious and paper based.

There is need for greater investments in HR for focused approaches and building potential. No funds were allocated to support initiatives such as change management, leadership and development, and other developmental programs to support the work place culture. Key points to note:

  • 70 vacant positions were filled.
  • 120 officers received increments.
  • 742 contracts were renewed.
  • 787 employees attended training and development programmes.

Core Strategic Priority # 6 - ICT Integration in the Health Sector

  • Health data available in real time by 2015.
  • Full integration of health delivery processes by 2014.
  • Leverage ICT to generate financial efficiencies over time.
  • Establish an online repository for all major approved regulations, policies and key decisions for improved internal communication.
  • Enable technology solutions for learning and research.

Some of the key achievements include:

  • Our uptime for Internet, email, servers and network is 99%; 98% for computers; 93% for printers and 100% for data backups.
  • Continued to roll-out our Patient Information System (CELLMA), in February 2016. This system serves as the portal to patient management with respect to their care and clinical and non-clinical personnel.

The ICT Department has not been able to meet its full mandate due to limited funding for the past three years. There were also challenges with recruitment and growing costs to sustain and improve ICT infrastructure and support.

There is a critical need to improve the organisational, technical and clinical aspects of ICT.

Upcoming projects include: the full implementation of the Patient Information System, the HRIS, and the Lab Information System.

We are also working on the full implementation of the Maintenance Management System, the Supply Chain Management System, electronic monitoring of wait times at SFGH and the use of healthcare analytics software.

When all aspects are given the importance they deserve, the resulting systems would be able to utilise health information in supporting patient needs to the highest level.

Core Strategic Priority # 7 - Continuous Improvement of the Management of the Health Sector

The targets were as follows:

  • 80% achievement of service/programme/project targets. We attained 60% of this target.
  • Strengthening of specific elements of the surveillance system to meet international health regulations (IHR) core capacity requirements within the timeframes of the IHR 2005 deadlines. The Public Health Observatory Unit within the Policy Planning and Research Department commenced in 2014.The Unit recently implemented a standardised non-communicable diseases registry in Primary Care; WHO Growth Charts; a policy for Universal screening of gestational Diabetes Mellitus among pregnant women attending antenatal clinics; and a policy for examination of diabetic feet.
  • 85% of all SWRHA facilities (clinical and non-clinical) are expected to meet accredited standards by 2015. The Ministry of Health is currently reviewing the entire program which has been in “start-stop mode” since its implementation.
  • Strengthening of the governance and accountability structures and systems. There are gaps that need addressing such as additional support to leaders, managers and those involved in governance. This is being addressed presently.
  • Complete the development and implementation of comprehensive and coordinated multilateral plans to facilitate interagency and interregional disaster preparedness by 2015. There are several challenges and emerging issues regarding disaster preparedness at the SWRHA which includes the internal capacity of the Disaster Preparedness Unit to effectively manage and coordinate disaster preparedness activities within the authority due to inadequate resources.  According to our Disaster Coordinator, the San Fernando Teaching Hospital is the only high rise hospital in the Caribbean with 18 floors. This has complex and dynamic challenges for evacuation of patients, staff and the general public during an emergency. Currently, a comprehensive disaster risk assessment of the entire SWRHA is being undertaken to identify the gaps and implement corrective measures.    

Core strategic priority # 8 - Continuous Improvement of Health Services Delivery

The primary objective was 85% client satisfaction by 2015. The client feedback reports from the Quality Improvement Unit indicates that this objective was met/surpassed in primary health care with a 93% client satisfaction rating, and an 85% client satisfaction level at our hospitals. We are reviewing the systems in soliciting client feedback since while I am happy with the results in the report; I am not totally convinced that this is a true and accurate reflection of the views of all our customers.

I make this statement based on frequent calls made to my office from our customers and some members of staff who continue to express concerns with a wide range of issues namely: - the overcrowding at Emergency Departments; long waiting times to be seen by medical professionals, at clinics, to be warded, for clinic appointments, for surgeries and surgeries being cancelled, and for lab and radiology results.

There are also reports of frequent breakdown of equipment; unavailability of pharmaceuticals; and poor attitude displayed by some members of our staff.

And core strategic priority #9 - Health Infrastructure Development and Facilities Management 

The objectives were to acquire, operate, sustain, restore and modernise facilities and infrastructure to provide safe, responsive, cost-effective, efficient and flexible environments; and achieve equilibrium between requirements and funding to provide modern, efficient and cost effective facilities and infrastructure.

The SWRHA embarked on a review of its systems and processes to ensure that the request for health care services from Hospital Administration, Property Services, Plant Engineering, Bio-medical Engineering, other facility management internal service providers, and other related stakeholders are handled urgently and efficiently.

We acknowledge that continuous facility management at our hospitals, district health facilities and health centres is urgently required in maintaining records of all maintenance costs, avoiding and predicting possible failures in equipment, enhancing productivity of labour, reducing idle time which is costly, reducing investments in inventory, and minimising total maintenance costs.   

Some of the major related development projects completed include:

  • The expansion of Radiology services with 6 additional portable X-Ray units and 7 additional Ultrasound Units.
  • Renovation works at the Point Fortin Health Centre.
  • The expansion of the Occupational Therapy Room for Mental Health patients.

Ladies and gentlemen, at last year’s meeting, I said we will continue to implement the core strategic initiatives in “Putting The “Care” Back Into Healthcare”, by focusing on achieving excellence in patient care, improving safety, and maximising our resources in priority service areas.

Together with the Executive Management Team and Board of Directors, we have had to reassess and reprioritise our objectives for Fiscal 2016-2017 due to our economic challenges. This has been a major factor that has hindered us from meeting several of our objectives I mentioned this evening. I believe that we have demonstrated our resilience in coping with the challenges and the increasing demands of our stakeholders. We remain committed to helping persons to stay healthy through the delivery of a coordinated and an integrated range of services. We also acknowledge our responsibility to deliver quality care and hope, to all those who enter the doors of our facilities.

Where do we go from here?

I am pleased to announce that we have developed a draft five-year Strategic Plan to influence our delivery of key priorities. The underlying theme for the SWRHA’s Strategic Plan 2017-2021 is “Delivering quality care”. The Plan confirms our vision and mission and sets out four strategic directions for the next five years. These are aligned to those of the Government’s Policy Document for National Development “Let’s Do This Together”; and the eight (8) priority areas of health outlined in the Ministry of Health’s Work Plan 2015-2020.  The Strategic Plan is also anchored on the SWRHA’s commitment to quality, safety, transparency, and leadership.

The four strategic directions are:

  • Clinical Excellence and Quality of Care Improvement- Primary Health Care
  • Clinical Excellence and Quality of Care Improvement- Secondary Care Services
  • Strengthen Our Foundation in Building Capacity & Quality
  • Patient Ambience and Infrastructure Improvement

The SWRHA’s Annual Business Plan will articulate the progress made in achieving the key strategies and measures outlined in the Strategic Plan 2017-2021.

Some of our major plans in 2016-2017 include to:

  • Continue to strengthen the system of health and disease surveillance to collect, analyze, and interpret data on communicable and reportable diseases.
  • Implement and train on the perinatal information system in collaboration with the Ministry of Health and PAHO.
  • Continue the focus on integration of mental health into primary care.
  • Strengthen the integration of services between primary care and secondary care.
  • Establish a Health Promotion Unit.
  • Improve wait times and overcrowding at our Emergency Departments.
  • Pursue reduction in length of stay through the achievement of efficiencies.
  • Automate the Bed Bureau Management System.
  • Achieve a 100% utilisation of an electronic prescription system.
  • Enhance the Injury Surveillance System at the SFGH Emergency Department.
  • Continue with implementation of the Patient Information System (CELLMA).
  • Implement strategies to reduce readmission rates.
  • Reduce cancellation of surgeries by 20%.
  • Implement the Human Resource Information System.
  • Reduce the vacancy rate by 15% year over year.     
  • Install security cameras at Health Centres.
  • Complete refurbishment of the Customer Relations Office at the SFGH Lobby.
  • Continue with refurbishment at SFGH Emergency Department.

Conclusion

As we look to the future of health care at the SWRHA, we have positioned ourselves to “Deliver Quality Care”.

“He who has health, has hope, And he who has hope, has everything.”

Seeking to achieve clinical excellence and quality care improvement, building capacity and quality, and improving patient ambience and infrastructure, we at the South-West Regional Health Authority recommit ourselves to providing you with the gift of health and the gift of hope.

Regardless of budget constraints, we will do everything in our power to serve you, the residents of the Region.

Our Board of Directors is dedicated to the provision of expert guidance, accountability, integrity, and compassion as we continue to be “Your Partners In Health”.

I also want to thank the Management and all Staff of the SWRHA for their continued commitment to our noble institution.

At this point, I must inform you that we will start the Q&A segment.  All questions will be answered once the information is available at this exact moment. In the event that more details are required for a comprehensive answer to be given, please provide your contact details so as to ensure proper feedback and communication in a timely manner.

I thank you for the opportunity to present on the Annual Report of the SWRHA for the Fiscal year 2015-2016.