I am writing in response to your recent editorial “HSA has work to do”.
Before your editorial was published, we had been following the results of your online poll with great interest. The team of health care professionals at all the Cayman Islands medical facilities agree with and understand your bottom line that “the paramount concern of the public is the quality of health care it provides.”
I must disagree, however, with your statement that “the poll sample is indicative of attitudes of the wider public.” The inaccurate nature of such polls is underscored by the recent acknowledgement by your competitor of how the results of their online polls were easily distorted. Much more informative are the results of the scientifically designed National Assessment of Living Conditions survey that does accurately reflect the attitudes of the general public. That survey found that 84 per cent of the respondents were either satisfied or very satisfied with the provision of health care they had received, and the vast majority of those respondents had received their care at our facilities. Nonetheless, we certainly appreciate that both surveys indicate we still have work to do to regain the trust of some of our patients. Our goal is 100 per cent satisfaction of every patient.
We all appreciate the turbulent history of the hospital’s leadership and our difficult financial position. Our ability to provide high quality health care depends on high staff morale, adequate finances, stable leadership and well-defined roles between Government, the board and hospital management. However, quality healthcare cannot be a discussion about a financial spreadsheet. That is why our relentless leadership message is about patient-centred care and continuous quality improvement.
We use every opportunity to respond to the concerns of our patients to continuously improve the quality of medical care, as well as the compassionate care, we provide. It is often the single patient’s voice that identifies improvement opportunities for us. Our clinical quality committee meets every week to focus on feedback we receive from our patients and families. We know that continuously evaluating our performance will help us to improve the way we deliver care. This forum has led directly to many improvements in patient access, patient safety, and quality care. Our patients identify weaknesses in our processes and systems that get in the way of good care.
One of the many improvements our dedicated staff has made based on this feedback is the redesign of our appointing system in our General Practice Clinic to improve patient safety and patient satisfaction. The public can look forward to improvements in our overseas referral process, specialist clinic access, and the operating theatre experience, all of which are currently being redesigned by multidisciplinary teams of our dedicated staff.
In addition, systematic reviews of our patient outcomes to compare them to internationally accepted standards of care are underway. For example, we recently examined the surgical outcomes of our dialysis patients who have had arteriovenous shunts placed here at the Cayman Islands Hospital, a highly technical and difficult procedure fraught with complications. We needed to know if we should continue this procedure here, or refer our patients overseas to specialty care hospitals. We were delighted to find that our patient outcomes and complication rates were significantly better than every established international standard.
The journey of transformational change to total patient-centred care and continuous quality improvement is well underway. Are we there, yet? Of course not. There will always be work to do. But, I know first-hand about the quality of care we provide. I also understand and agree with your point that we still have a “daunting public relations challenge” to regain the trust and confidence of some of our patients. And we will continue that journey together with our patients until we are the hospital of first choice for all of the Cayman Islands.
Al Ebanks– Board Chairman