Garth Rattray

My article on security guards that screen patients at the University Hospital of the West Indies (UHWI) published two weeks ago ignited fireworks inside and outside that institution. Since then, even more doctors and patients have shared with me their sad tales of despair at the hands of the security personnel; some even stated categorically that they would never return to that hospital.

In all fairness, therefore, it's only right that I relate what has transpired since the exposé. The new chairman of the board, Mr. Hugh Scott, called and expressed his belief that bringing the matter into the public forum gives fillip to efforts aimed at improving discipline, courtesy and adherence to job parameters by the security.

Needed changes

Chief Executive Officer (CEO), Mrs. Stephanie Reid, requested a meeting with me. At the meeting she appeared somewhat embarrassed that the hospital's system of checks and balances flubbed its responsibilities to patients. She said that several staff members experienced security-related problems but never reported them to her.

She also used the opportunity to unveil a number of measures and future plans for patient-friendly systems at the UHWI. Among the changes are instructions to the security personnel to adhere to their mandate of crowd control and security concerns. Their involvement in matters of medicine is forbidden. Mrs. Reid also went on to outline her intention to have 'patient advocates' and 'patient assistants' play more high-profile roles in patient care throughout the hospital. She was open enough to detail some of her innovative long-term plans for patient education, comfort and safety even though they were not germane to the security matter.

As a spin-off from the meeting, other needed policy changes are to occur. Medical doctors will no longer be treated as security risks by guards. Doctors with valid (non-UHWI) medical ID's will now be given access to the wards even outside the usual visiting hours. The decision to grant 'outside doctors' permission to visit with their patients (especially after posted visiting times) will fall under the jurisdiction of the nursing sister/nurse-in-charge - as it should be.

As a rule, no 'outside doctor' is automatically entitled to read the hospital notes on his/hers or any other patient without permission from an attending physician. However, he/she should be granted reasonable access to said attending physician. To this end, efforts will be made to facilitate the free flow of information between physicians so that the needs of the patient can be better served.

Promises

The CEO also promised to design a form for in-hospital and clinic patients to take back to their (private or clinic) doctors with concise, salient information about their investigations, diagnosis, status and medications. This was always the hospital policy but it was more often than not ignored or forgotten. CEO Reid additionally articulated her desire for the UHWI to interact with primary care physicians on more than an academic level.

Since the dangerous situation with the UHWI security guards triaging at the accident and Emergency (A&E) was publicised, it appears that the administration is rapidly learning from its mistakes. Now, there are established channels of communication and things have already begun to change. I have had several positive reports of security guards directing A&E patients to appropriately-trained personnel and of courteous hospital staffers eager to help in anyway that they can.

If improvement efforts are sustained, the University Hospital is poised to make great strides in patient care with Mr. Hugh Scott's enthusiasm and Mrs. Stephanie Reid's organisation and vision.

Dr. Garth A. Rattray is a medical doctor with a family practice.