MOH tackles influx at PMH A&E department

Patients have been flooding the A&E department at the Princess Margaret Hospital
Patients have been flooding the A&E department at the Princess Margaret Hospital

The Roseau Health Center will be opened to the public from June 2, 2014 as the Ministry of Health (MoH) seeks ways to reduce the influx of patients to the Accident and Emergency (A&E) Department, at the Princess Margaret Hospital (PMH).

The center will open from 8:00 am to 7:00 pm Mondays to Fridays in a three to six month pilot program.

According to the MoH this will reduce the waiting time and the workload of the A&E at the hospital, especially for non emergency cases.

“Instead of going up to the casualty after work with a flu, a sore throat or just want to talk to a doctor, up to 7 O’clock the health center will be opened, there will be nurses available, a doctor will be available to attend to you,” Dr Charlotte Jeremy- Cuffy, Acting Director of Primary Health Care, explained.

She stated one of the main reasons is to avoid the waiting time for patients but the program will free the A&E department to deal with emergency cases quicker.

“The A&E department is for emergencies,” she said. “And so when persons go up there with minor illnesses, minor complains, they will have to wait a lot, up to sometimes 10 hours. With the Chikungunya outbreak persons had to wait for up to 12 hours and still not be attended to because of the workload of the casualty department…”

The entire Roseau Health District team will be part of the initiative. “We will using the skills of every member of the team, the nurses from Soufriere to Warner will be involved,” Dr. Jeremy-Cuffy noted.

All emergencies will be handled at the A&E department at the Princess Margaret Hospital.

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    June 1, 2014

    For those of you who do not understand, We have 7 Health District.Portsmouth,Marigot, Castlebruce, Laplaine, Grandbay,Roseau , and St Joseph, These districts operate at Type 1 and Type 111 centres and give primary heath care meaning it is available,accessible attainable,achievable and affordable.

    These districts all take care of patients outside of normal working hours that is between the hours of 4.01pm to 7.59am. Both the type1 and Type 111 give on call services. When clients come to the health centre claiming that they just develop a sick situation, or abnormal feeling or their asthma condition worsens or any feeling they claim they need attention for, also a nearby motor vehicle accident which they are always referred to PHM on the Ambulance or even pre-labour conditons.

    There are nurses and doctors on call during these hours mentioned who work very hard and still has to report to work for 8.00am next morning, even if they did not get a chance to SLEEP.
    The only district which has been unable to give this service was the ROSEAU HEALTH CENTRE, because persons keep going to Pmh as it is in Roseau thinking the care will be different given that it is a hospital. Our people need to be orientated on that. If after attending to you at any Health Centre, you need further care, the health care provider will ensure that you are taken safely to the hospital Emergency Department and there you will get further care through the Emergency door,, while others are waiting in the Sitting Room at the PMH. However, if you do have an emergency, meaning a life-threatening conndition for example, Shortness of Breath, Excessive Bleeding, Serious Burns, Motor Vehicle Accident,etc and you are in close proximity to the Hospital you should go there immediately and comunicate effectively and respectfully to the nurse at the desk or even the Security Officer. Your can also call the Ambulance but you must make sure it is serious because they will question you. I am SURE you will be treated promptly.No one is perfect, but the department tries.

    Having said all this, does that clear your mind? This was timely. Let us hope that all the Type 1 in the Roseau Catchment from Warner to Trafalgar/Laudat to Giraudel to Scotts head and Bellevue Chopin start doing on call night service as the rest of the districts.THIS IS THE WAY FORWARD. This was never fair to the other district nurses and the Causalty Nurses. And off-course when a situation overwhelms in the Type 1 the nurse is supposed to refer to the Doctor-on-call at the time at the Roseau TYPE 111 building, which is situated in the Botanical Gardens. There are usually 2 District Medical Doctors for Roseau area. It it is after 7pm and the Doctor has left, the nurse is supposed to have the Doctor emergency number and call him/her. Hats off Acting Primary Health Care Director. Right now the scale is balanced.

  2. Francisco Telemaque
    June 1, 2014

    This will be considered another of my negative comments; and though there is nothing wrong with an Health Center, as long as it is operated as one. I do not see a very effective health center which comprises of only one medical doctor.

    Even if less than one hundred people visit in a single day, the wait will be long and boring. And that is as long as that doctor follows a medical protocol, which allows the doctor to spend a certain amount of time with each patient; and that does not include the time of taking VT., which should be done by a nurse prior to the doctor seeing the doctor.

    My concern is in a health center there should be more than one doctor, and that should include different specialists, because there may be some problems that even a general practitioner cannot identify. Assuming this lone doctor who is qualify to simply treat minor problems, and someone comes in with a life threatening issue, and the unqualified doctor prescribes some medication and send the patient home; chances are before the person can see another doctor they might be dead.

    So, what purpose would have the Health Center serve.

    We remember the late Prime Minister Roosevelt Rosie Douglas who must have died minuets after a so called medical doctor was in his house, he died from something which could be avoided if only that so called quack had only taken his vitals.

    His quackery may have cost Rosie his life; because any first year medical student could have identify Rosie problem that fateful night, perhaps save his life.

    What happens when that lone doctor takes a break for eating, or going to the bathroom.

    Francisco Etienne-Dods Telemaque

  3. Approve of that move
    May 30, 2014

    Positive move. Whoever idea it was does not matter. the important thing is it was done to accommodate those who complain about the long wait at PMH. Dominicans stop looking for negatives and let us as a people begin to see and commend the positive! Way to go Dr. Jeremy-Cuffy………….reform is needed in this land.

  4. Time will tell
    May 30, 2014

    Firstly the initiative was not that of Dr Jeremy. The mandate to extend hours came from the bigger bosses and the Roseau health team were asked to implement . Unfortunately, no extra staff were provided to the team, which means that the same nurses and doctors who come to work from 8am are expected to be there till 7pm!
    At the A/E dept this time frame constitutes 2 shifts!
    So the PMH nurses will continue to watch videos on YouTube whilst people wait on the outside for 10-12 hours just to be told go to the health center. And the district nurses will continue to see upwards of 60 patients …this number soon to be doubled with the new extended hours.
    I hate to be a pessimist but exactly how us this going to work. Why the inequality in the division of labor?

  5. Really?
    May 30, 2014

    This will not solve the problems:.
    1. Need for more than one Dr at casualty.A&E dept.
    2. From the top, management is poor.

    This will back fire. the doctors at casualty may get a little break, they work less ours and have less responsiblity than the district doctors anyway. but the already over worked and underpaid doctors and nurse in the Roseau Health Centre will be carrying more loads.

    management needs to manage bettte.

  6. Pondera
    May 30, 2014

    Excellent initiative by the Ministry of Health.

  7. Ms Twitter
    May 29, 2014

    8am-7pm?? Good luck with that! Roseau Health Centre medical personnel always strolling in minutes to 9.

    • Stupes
      May 31, 2014

      They stroll in at 9am like say but would have more than likely already gone to see a home bound patient, visited a post natal mother or done a dressing for someone who can’t make it to the center.
      Be careful what you say….unless you have a million dollars to give away….then again if you did you wouldn’t be sitting at the health center you’d be at a private doctors office!
      Say thank God they willing to do the extra work to help our people who are turned away from casualty everyday.

  8. Histoire
    May 29, 2014

    No money for the Dr’s office. People always feel safer going to the hospital.

  9. Histoire
    May 29, 2014

    It is a Health Center. Not a real hospital. Thank God we have something. Thank God that generally Dominicans are healthy people.

  10. diaspora
    May 29, 2014

    why only now.? also can we have a PROPER hospital please Mr PM……….we need to stop calling the health we have their a hospital. raise up it status to hospital please, until then its a health centre……………….

  11. Ben Haynes PsyD
    May 29, 2014

    Well, they are paying attention. So it seems. But what is the protocol here if and when a disaster hits a community? My last visit there made me wonder how patients are treated with one doctor on staff, and one or two nurses with attitudes. Can the Health Ministry focus on treatment, the availability of more Doctors and Nurses around the clock to give care. An emergency room should expect casualties any hour of the day or night. No one can predict the hour, and to plan on the small scale and few hours per day, is somewhat a frightening thought. The plan that is in view does not make sense when dealing with emergencies. Certainly, freedom to see and talk with doctor “Who” is all well and good but, emergencies must be given priority here. But, we should give the powers the opportunity do what is best for all. We hope that this trial will bring forth a common sense approach so that the waiting game will not be so severe, and the treatment of emergencies will be accomplished with good results..

  12. only now????
    May 29, 2014

    my my it take this long for the powers or people in charge do the nation the basic facility? a health people is asset to the state, more productive,

  13. Calypso
    May 29, 2014

    So what will be the cost will it be free or do we have to pay and receive a great service

  14. hope
    May 29, 2014

    When they are new in positions is so they want their presence to be felt.More doctors at the A&E period

    • Stupes
      May 31, 2014

      The A/E dept has a total of 7 doctors to rotate through 3 shifts. Leaves us to wonder why is only one doctor working each shift? They don’t need more doctors they need to double up on the two daytime shifts to lighten the load instead of sitting in their offices or teaching at the medical school. The government paying them to work, they need to work!

  15. Jayson
    May 29, 2014

    I propose that outside of every hospital in the country that a PATIENT SATISFACTION SURVEY be made available. We need to see where we are with our health services from a user stand point and NOT from a political one!

    I’ll always agree with what the Hon. Julius timothy said about our health services a few years back: Dominica’s health service requires better MANAGEMENT, to find out where the bottle necks are and deal with them. Start holding senor staff members accountable for the decisions they make, and theses decisions are PRIMARILY supposed to BETTER the experience of the public.

    If we are not seeing a higher satisfaction rating from the Dominican public then this ‘change’ will be a total waste of time and government resources.

    You can’t manage what you can’t measure.

    • Anonymous
      May 30, 2014

      Brilliant idea and observation. I think this should be enacted ASAP!!

  16. smh
    May 29, 2014

    The workload in the casaulty department is not that heavy majority of the times I dont’ think….and even so, it could be avoided by just adding more doctors, instead of forever having just one doctor. Do you really think that the waiting time will be reduced when persons go to the health centre?…..when you go there for regular clinic you wait hours and hours, now you are sending more people there…..honestly I beleive if you just add more doctors, things would be better….
    It seems like the nurses and their lazy attitudes won….you don’t know whose case is an emergency unless you see to them, but many times these nurses stare you in the eye and don’t attend to you….many times just a simple announcement informing persons of the status of things would be helpful…..Unbelievable

    • hmm
      May 29, 2014

      @ SMH… work at casualty man? It looks like Ministry of health has a closet full of idle doctors waiting so they should send 3 more doctors casualty to work.
      Seems like you missed the memo saying Ministry of health is short on Human Resource

  17. Hospital worker
    May 29, 2014

    That is the way to go,very good initiative.It was time,the waiting time at casualty is really too long,come on man,is true some of us are impatient,but 10-12,hours waiting time is really absurd.

    Now we just need to educate the public, because some persons,do not like the name health centre,at all,they will still come to casualty,for non-emergencies.

  18. marco
    May 29, 2014

    Why dont the Ministry Oh Health have 2 separate departments for the A&E at the PMH. They could have a section for minor emergencies and another area for more serious emergencies. That may help reduce the waiting time for patients and eleviate the stress on the staff as well as the patients waiting. The Health Center can also be utilized.

    • Anonymous
      May 29, 2014

      there is no such thing as a minor emergency… people need to go to the health center, some even stay home all day and wait after 5 to go to the hospital

    • ano
      May 29, 2014

      there is no such thing as a minor emergency… people need to go to the health center, some even stay home all day and wait after 5 to go to the hospital

    • Educator
      May 29, 2014

      Don’t you see the contradiction in your statement?

      If the ailment if minor, they do not belong at the A&E in the first place.

    • Gnibbs
      May 29, 2014

      Are you serious? presently there is no available space to set up another ER. The current one is almost to small. We are to think of properly staffing and equipping an efficient emergency room where emergent treatment can be given in a timely fashion by professionally trained doctors and nurses to help lessen the incidence off emergency room deaths.
      I am in total support with Dr.Jeremy’s idea that too many non emergent cases go to the main ER thereby extending and delaying treatment to genuine emergent cases.I strongly recommend educating the public about what constitutes an emergency.After all we are our brothers keepers, all for each and each for all.

    • Whoosshh
      May 29, 2014

      Minor emergencies? seriously.Either you have an emergency or not. I just think Dominicans need to be educated on what is an emergency cuz most of them think having an emergency is to visit Casualty at their own convenience.

  19. listener
    May 29, 2014

    Good idea, but just make sure you all give the nurses some incentive.

  20. Anonymous
    May 29, 2014

    I hope the doctors will get compensated for this too. Already the salary is so meager. Only one set can laugh all the way to the bank.

  21. Dr.
    May 29, 2014

    Good initiative, I never understood how people went to the emergency department with such minor complaints.

  22. huh.
    May 29, 2014


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