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The Interview: October - December 2017

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OCT 2016

OCT-DEC 2017

INTERHEALTH CANADA TCI

THE

INTERVIEW

HEALTHY LIFESTYLES: LEADING BY EXAMPLE Welcome to TCI Hospital Newsletter, which features stories from across the health care organization. A new edition is published at the end of every quarter with news collated over three months.

Our Mission To provide the community and its visitors with high quality healthcare.

Our Vision To improve the nation’s health through the development of a sustainable and accessible healthcare system.

Our Values We value ethical and respectful behaviour, honesty, accountability and excellence in all we do.

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Educational Development

ADVANCED WOUND CARE

NURSES ATTEND SAWC CONFERENCE IN LAS VEGAS, UNITED STATES.

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ABOUT THE EDITOR


NEWS

ROCHE PHARMACEUTICALS DONATE $16,000 WORTH OF MIRCERA DRUG TO TCI HOSPITAL

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(L-R): TONY WILTON - IHC PHARMACY MANAGER; CHANTA WILLIAMS-GRAY ROCHE COUNTRY COORDINATOR FOR BAHAMAS, BERMUDA AND TURKS AND CAICOS ISLANDS; DOCTOR VANCELEE FORBES - IHC NEPHROLOGIST; DR ESTEBAN COTO - MEDICAL MANAGER FOR ROCHE PHARMACEUTICALS IN COSTA RICA; DAGNI PROSA - MEDICAL REPRESENTATIVE FOR ROCHE PHARMACEUTICALS; LEVY SALVE - IHC PHARMACIST.

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INTERHEALTH CANADA HOSTS SUCCESSFUL MULTI ISLAND 'STOP THE CLOT' FITNESS EVENT

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SCORES OF RESIDENTS ATTEND 'STOP THE CLOT' PROVO

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WORLD THROMBOSIS DAYÂ

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'TIS THE SEASON TO BE JOLLY. The Senior Management team at Turks and Caicos Islands Hospital would like to extend special wishes for a happy Christmas holiday to its devoted employees.

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cheshire hall medical centre

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cockburn town medical centre

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TCI Hospital introduces ECFMG’s Primary-source Credentials Verification to Physician Assessment Process Joint Press Release Turks and Caicos Islands Hospital, InterHealth Canada (TCI Hospital) and the Educational Commission for Foreign Medical Graduates (ECFMG®) are pleased to announce that TCI Hospital has incorporated ECFMG’s Electronic Portfolio of International Credentials (EPICSM) into its process for assessing the medical credentials of physicians seeking employment at the health care facility. TCI Hospital is a Diamond-accredited public hospital managed by InterHealth Canada TCI Ltd on behalf of the Turks and Caicos Islands Government through a Public-Private Partnership agreement. The Hospital’s primary goal is to ensure that patients receive highquality care, delivered within a safe, reliable, and patient-friendly environment built on the values of ethical and respectful behavior, honesty, accountability, and excellence. The Hospital deemed its partnership with ECFMG to be necessary for the continued improvement of the health care facility’s recruitment process.

ECFMG is proud to partner with TCI Hospital to enhance its recruitment process by adding primary-source verification—a best practice and the best protection against fraudulent credentials—to the Hospital’s tools for evaluating the qualifications of its physician applicants.

In the past, medical credentials were verified by TCI Hospital primarily via a robust internalised process, which include verification through medical councils and letters of good standing from previous and/or present employers. 14


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Physicians interested in employment at the health care facility must first apply to the Hospital through its Human Resources department. Successful candidates will be directed by the Hospital to have their required credentials primary-source verified through EPIC. Physicians can find complete instructions on using EPIC in support of their applications at www.ecfmgepic.org/instructionsturks-caicos.html.

About ECFMG Established in 1956, ECFMG is a private, nonprofit organization based in Philadelphia, Pennsylvania, with more than 900 full- and part-time employees. ECFMG is a world leader in promoting quality health care—serving physicians, members of the medical education and regulatory communities, health care consumers, and those researching issues in medical education and health workforce planning. ECFMG’s program of certification evaluates whether international medical graduates are ready to enter U.S. programs of graduate medical education, where they provide supervised patient care. ECFMG offers a variety of other programs for the world’s physicians and the entities worldwide that educate, train, register/license, and employ them.

About EPIC EPIC offers primary-source verification of medical credentials to organizations and physicians worldwide. In verifying the authenticity of physician credentials related to medical education, training, and registration/licensure, EPIC employs the same world-class, primary-source verification process used by ECFMG to verify credentials for other ECFMG services, including ECFMG Certification, the standard for international physicians entering the U.S. health care system. For organizations that are responsible for evaluating physician qualifications, EPIC provides secure, no-cost access to primary-source verification—verifying the authenticity of a credential directly with the issuing institution—for the purpose of evaluating their applicants’ credentials.

ECFMG’s organizational members are the American Board of Medical Specialties, American Medical Association, Association of American Medical Colleges, Association for Hospital Medical Education, Federation of State Medical Boards, and the National Medical Association. For more information, visit the ECFMG website at www.ecfmg.org. About Turks and Caicos Islands Hospital

For the world’s physicians, EPIC is an innovative way to build a digital career portfolio of the credentials related to their medical education, training, and registration/licensure—a portfolio that can grow with their careers. Using EPIC, physicians can send their credentials, and reports verifying their authenticity, to organizations worldwide. For more information, visitwww.ecfmgepic.org.

Turks and Caicos Islands Hospital consist of two state-of-the-art secondary health care facilities equipped with the very latest medical technology and highly experienced multinational doctors. The public facility, managed by InterHealth Canada (IHC), is one of few Diamond-accredited health care providers in the Caribbean region. For more information, visit the TCI Hospital website at www.tcihospital.tc. 15


CANCER STATISTICS

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world medical tourism congress

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Grace Bay in Turks and Caicos is the world's No. 1 beach.

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HURRICANE RECOVERY EFFORTS

CHILLER SYSTEM RESTORED AFTER MAJOR STORMS

While 95% of clinical services

The chiller system at Cockburn

offered at both TCI Hospital

Town Medical Centre on Grand

medical centres resumed some

Turk was eventually fully repaired

weeks following the passage of

and operated within the standards

Hurricanes Irma and Maria in

of the building. As a result, the

September, the restoration of

Operating Theatre was able to

other departments with

accommodate elective surgeries,

temperature-sensitive equipment

and most of the remaining routine

was dependent upon the

services resumed shortly

stabilisation of the hospital’s

thereafter.

chiller systems. 20


HURRICANE RECOVERY

THE CHILLER SYSTEM IS ESSENTIAL TO SOME CLINICAL SERVICES. The chiller system for Cheshire Hall Medical Centre arrived at the health care facility on Thursday, 02 November 2017. The installation and commissioning spanned three days with a full restoration of 100% cooling capacity. Overseas engineers arrived in country to assist local teams in the installation process. The industrial chiller system arrived on island inside a 40 foot container. A 60 ton crane was sourced to offload the system. The chiller generates 370 tons of cubic cooling for the Cheshire Hall Medical Centre facility, which spans 11,500 square meters in size. Cheshire Hall Medical Centre on Providenciales is the largest of the two medical facilities. An additional chiller system was also ordered. However, the newly arrived system operated within the standards of the building and exclusively produced the cooling capacity required. Specialist engineers also worked expeditiously and repaired any outstanding mechanical issues at Cheshire Hall Medical Centre in late November sustained as a result of Hurricanes Irma and Maria. These issues were connected to water pressure, internal supply and return feeds, which support the cooling system within the facility.

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INTERHEALTH NEWS FROM ELSEWHERE

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HEALTH CARE PIONEERS

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RDIF TOGETHER WITH INTERHEALTH SAUDI ARABIA TO INVEST IN THE CONSTRUCTION OF A HIGH-TECH MULTIFIELD PEDIATRIC REHABILITATION CENTER IN THE REPUBLIC OF TATARSTAN

Source: www.interhealthsaudiarabia.com

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INWARD PHILANTROPHY InterHealth Canada shares US$30,000 donation of Pharmaceuticals with Government Ministry of Health, Primary Health Care Department for Hurricane Relief. The Director of TCI’s Department of Disaster Management and Emergencies also provided guidance.An application process was completed by the local hospital management team and pharmaceuticals of value were selected from the organization’s inventory via a collaborative effort with Primary Health care. The donated pharmaceuticals will be provided to patient’s free of charge and will not be billed to the National Health Insurance Plan.

Direct Relief, a U.S. based non-profit medical relief and health assistance organization donated US$30,000 worth of pharmaceuticals to InterHealth Canada - Turks and Caicos Islands Hospital following a successful application by the healthcare management company. During a media briefing held on Monday October 16th, 2017 at Cheshire Hall Medical Centre, InterHealth Canada graciously handed over a portion of the supplies to the Ministry of Health to support and bolster the Primary Health care Department’s inventory. The World Health Organization also donated a supply of items via the British Military. The donation helps to reduce the operational expenditure of TCI Hospital and Primary Health care.

Direct Relief is dedicated to serving the poor and victims of natural disasters and civil strife in the United States and throughout the world. Assistance is provided by distributing donated medical goods to charitable health care institutions and organizations. The World Health Organization is a specialized agency of the United Nations that is concerned with international public health.

Daniel Carriere - TCI Hospital Chief Executive Officer, Doctor Denise Braithwaite Tennant - Chief of Medical Services and Tony Wilton – TCI Hospital’s Pharmacy Manager were in attendance. Doctor David Bernardo, a Medical Officer within the Primary Health care Department, accepted the supplies on behalf of the Ministry of Health and Human Services.

TCI Hospital Chief Executive Officer, Daniel Carriere said: “Direct Relief has been used in conjunction with InterHealth Canada in Sub-Saharan countries in Africa for humanitarian relief purposes. Hence, the company was familiar with the organization and the application process commenced. During any natural crisis, collaboration, cooperation and communication is essential among stakeholders. This is just one successful example of how these efforts can benefit both partners and the community at large.”

InterHealth Canada Corporate Board referred the international charity to the Turks and Caicos Islands Hospital following the passage of Hurricane Irma. 26


VIRGINIA DOCTOR AND PARTNERS DONATE RELIEF SUPPLIES TO TCI HOSPITAL STAFF Healthcare workers from Turks and Caicos Islands Hospital were among the persons affected by Hurricanes Irma and Maria while working immeasurable hours providing essential services to the country, before, during and after storms last month.

Board Certified Emergency Medicine Physician, Doctor Stephen Brock Blankenship, MD, FAAEM, based in Abingdon Virginia, United States contacted the healthcare facility expressing interest in volunteering his services for any mass casualty scenarios. Since there were no reported casualties in the Turks and Caicos Islands, Blankenship and his wife Jennifer partnered with other donors namely Highlands Fellowship Church, Chad and Amanda Rowland, Brian and Mary Dawson, Ron and Camille Sewell along with Michael and Cynthia Hackett to organize relief items deemed essential. A shipment was promptly received containing 59 battery operated fans including 50 packs of batteries, 46 bed linens/sheets, 53 packs of tarpaulin, 12 children-size inflatable beds, 36 adult size inflatable beds for usage in emergency lockdown cases and/or personal homes, 1000 sqft of roof plastic sheet, 19 inflator pumps along with LED headlamp sets.

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The items were distributed among Emergency Department workers along with other clinical and support services staff based on the need and severity of damages sustained as identified by the Management of Human Resources and Facilities. TCI Hospital Chief of Medical Services, Doctor Denise Braithwaite-Tennant expressed endless appreciation for the unexpected philanthropic gesture displayed by the aforementioned overseas donors, and Doctor Blankenship’s willingness to provide his services in a catastrophic scenario, if needed, as an act of community service. InterHealth Canada, the management company of TCI Hospital, formed a staff welfare and relief committee immediately following Hurricane Irma to also provide tangible assistance and counseling to employees who were displaced and distressed after recent storms.


HIRTAC (Hurricane Irma Relief Turks and Caicos donates relief items to hospital staff and patients Turks and Caicos Islands Hospital wishes to express heartfelt appreciation to members of HIRTAC (Hurricane Irma Relief Turks and Caicos) for the donation of relief items received on Friday, October 13th 2017. HIRTAC is a non-profit relief initiative founded by UKbased Turks and Caicos Islanders and past residents, which seeks to establish a mode of reputable, transparent funding to support the humanitarian response in the TCI following Hurricane Irma. The packages contained a cross-section of infant care and adult care items. As desired, these items will benefit patients who are expectant mothers in need, and other items were distributed among healthcare workers who sustained severe losses during recent storms. Thank you for your thoughtfulness.

A SPECIAL THANK YOU NOTE FROM TCI HOSPITAL TCI Hospital Team would like to thank the following companies for their generous donation of pharmaceuticals: - Johali Medical Inc. - Quantum Pharmaceuticals - Alium Pharmaceuticals - Lowe’s Pharmaceuticals It is kind actions such as what you did for us that has been a great source of assistance in maintaining the services we provide to the community following the hurricanes in September 2017. 28


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NEONATAL RESUSCITATION PROGRAM TRAINING

ediatricians, NICU Nurses, midwives and other healthcare providers who initiate and direct advanced life support in neonates at Turks and Caicos Islands Hospital are staying at the forefront of neonatal care with refresher and certification renewal courses.

The training was facilitated by Doctor Samuel Julian, Neonatologist and Assistant Medical Director of Neonatal Intensive Care Unit at St Louis Children’s Hospital and Barbra Garrison, a 27-year Neonatal Intensive Care Unit Nurse at St Louis Children’s Hospital in Missouri, United States.

The Neonatal Resuscitation Program (NRP) course was held in early December at Cheshire Hall Medical Centre with ten health care professionals in attendance. The daily occupations of participants demand proficiency in neonatal resuscitation.

The Neonatal Resuscitation Program® (NRP®) course conveys an evidencebased approach to care of the newborn at birth and facilitates effective teambased care for healthcare professionals who care for newborns at the time of delivery.

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The program is based on the American Academy of Pediatrics (AAP) and American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care of the Neonate. NRP utilizes a blended learning approach, which includes online testing, online case-based simulations, and hands-on case-based simulation/debriefing that focus on critical leadership, communication, and team-work skills. Additional 20-year-old training sessions are being scheduled Marianne Teigen for other medical published specialties at TCI recently Hospital. her first young adult novel, and in only a month, it has reached the New York Times Bestsellers list.


Congratulations to employees of

Grace way IGA recognised the

Graceway Supermarkets who

importance of such training and

successfully completed training in

made an investment to educate its

by-stander CPR (Cardiopulmonary

staff. Due to recent hurricanes,

Resuscitation), which was

some training sessions were

facilitated by trainers from Turks

rescheduled for November.

and Caicos Islands Hospital during the month of November.

The Turks and Caicos Islands Hospital Life Saver Training

The American Heart Association

Centre partnered with the AHA

(AHA) designated the month of

during CPR month to provide

September as CPR

training to as many

(Cardiopulmonary Resuscitation)

persons/organizations as

month with a goal to partner with

possible.

other stakeholders to train 25,000 persons in life-saving CPR in September 2017. 31

The AHA Certified training centre also offer additional courses such as Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Support (PALS).


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THE INTERVIEW

FREQUENTLY ASKED QUESTIONS Here are some answers to questions frequently asked by patients to enhance their understanding of services offered by TCI Hospital and the country's healthcare system.

DIFFERENCES: NHIB & TCI HOSPITAL The National Health Insurance Board (NHIB) is the entity responsible for the management of all activities involving the TCI’s National Health Insurance Plan ( NHIP). TCI Hospital, managed by Interhealth Canada, is an entirely independent organization. It provides patient care to NHIP beneficiaries as the National Insurance Board’s preferred provider. TCI Hospital is not responsible for determining copay fees. These fees are dictated solely by the National Health Insurance Board. The Hospital collects co-pay fees on behalf of NHIB.

GOVERNANCE STRUCTURE TCI Hospital has two main governance structures: The Service Review Board is responsible for reviewing complaints, potential or existing litigations and key performance indicators with a clinical view. The board meets quarterly and consists of eight senior healthcare representatives from Turks and Caicos Government, Interhealth Canada TCI Ltd and an independent clinical chairperson.

CO-PAY FEES Co-pay is a common feature of many healthcare insurance plans, where the insured pays a set out-of-pocket amount for health care services. If you are NHIPeligible, the co-pay fee is $10. Between the hours of 11 pm and 7 am, the co-pay fee is $50 for non-emergency care. Additional diagnostic tests will incur an additional $10 co-pay fee. If you do not have NHIP, you will be billed at established rates. All NHIP co-pay fees are paid over to NHIP and are not retained by the Hospital. Co-pay fees are non-refundable.

The Contract Management Committee works collaboratively with Interhealth Canada to review performance and discuss strategic initiatives related to any changes in good clinical practice or good industry practice. The committee also reviews trends, new technology and relevant innovations in the health care Industry along with key performance indicators.

SERVICE EXPANSION

OVERSEAS TREATMENT

Since opening in 2010, additional services have been introduced and the Hospital remains eager to bring more services onisland to lower the cost of sending patients overseas for treatment.

Turks and Caicos Islands Hospital is an acute-secondary health care facility, and therefore complex tertiary level care is provided overseas through the National Health Insurance Board’s Treatment Abroad Program. If the Hospital clinical staff finds that a patient’s medical care needs cannot be provided at our facility, the NHIB is advised and takes over the management of the overseas transfer process. The NHIB is solely responsible for deciding the country and healthcare facility where the patient will be transferred. TCI Hospital is not involved in the decisionmaking process.

Under the Project Agreement, changes made to existing clinical services must undergo a Change Request Procedure seeking pre-approval from government. Change enquiries are submitted to TCI government once patient volumes and patient demands reach the necessary levels to create a sustainable service model.

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World Quality Day is celebrated every year around the world in November. The day was designed to increase worldwide awareness of the important contribution that quality makes towards both organisational and national growth, and prosperity.

BILLBOARD SHOWCASE World Quality Day is an opportunity to celebrate the achievements of the organisation, and recognise those that demonstrate leadership to sustain and improve performance every day of the year. Attendees were asked to develop their personal brand of leadership and imagine themselves as a billboard. Here is a preview of some billboards: Name: Lessonjulle Lyons-Dobney Billboard title: “Driven by purpose, not merely by success” NAME:- Surbrena Forbes-Pedican BILLBOARD TITTLE:- Caring and Kind NAME: - Moira Scott BILLBOARD TITTLE:- I’ll take care of your worst day NAME:- JACQUELINE MOE-COX BILLBOARD TITTLE:- I ASPIRE TO INSPIRE BEFORE I EXPIRE!!! Name:- Douglas Moore Billboard Title: Quality = Keeping the End in Mind NAME: - Tony Wilton BILLBOARD TITTLE:- Quality Service, Everyday Name:- Mikette Been Billboard:- Extremely organized person, Pay attention to details. Name:- Lurline Burnett Billboard;- I exchange I ILLNESS for WE wellness. Name:- Denise Braithwaite Billboard:- Leadership you can depend on! Name:- Isha Honore Billboard:- Here’s to Being better than yesterday! Name:- Juneth Reynolds Biilboard:- information is power, time is money documentation must be complete and accurate... records should earn their keep!!!

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ROAD TO DIAMOND ROUND THREE

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This annual process takes three days to complete fully, and the team work extensive hours through the night as required.

A I R PARTICUL A TE TE STIN G A T COCKB URN TOWN ME D I CA L CE NTRE

Congratulations to the Engineering, Housekeeping and Duty Management team for once again delivering the highest standards of hygiene and air quality supporting clinical partners in the delivery excellent standards of patient safety.Â

During the weekend of 26th August 2017, both Facilities Management teams worked with HEPA accredited technicians on annual air testing of the Operating Suites, High Dependency Unit, Medical Device Reprocessing Department, Neonatal Intensive Care Unit and Post-Anesthesia Care Unit.

HEPA stands for high-efficiency particulate air. A HEPA filter is a type of mechanical air filter; it works by forcing air through a fine mesh that traps harmful particles.

Following the deep cleaning, plate testing and swabbing regime, Facilities Management was pleased to be notified that all areas passed the required standard. Â

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Fire Extinguisher Training at Cheshire Hall Medical Centre STRENGTHENING FIRE SAFETY AND RESPONSE COMPETENCIES The Providenciales Facilities Management Fire Warden team were able to complete the first pilot session of fire extinguisher training supported by the Local Fire Service on 4th November 2017. The Facilities Management team is pleased to announce that all persons completed and passed the course, and were issued with certificates of competency.

Advanced Medical Post Training at Cheshire Hall Medical Centre

Further sessions will be completed at both medical centres in early 2018 to ensure that all registered Fire Wardens have completed these sessions and are fully conversant and confident in fire management and the use of an extinguisher.

The Facilities Team at Cheshire Hall Medical Centre completed Refresher training relating to Advanced Medical Post (AMP) set up and Mass Casualty on 12th August 2017. The team of Engineers, Porters and Duty Managers set up external AMP areas and completed training with regards to triage areas, flow and clinical support in the event of a disaster. Internally, a second session took place setting up the main reception with oxygen lines, emergency cots and standard equipment required in the event of an incident. The session included some new members of the team, who were trained and supported by coworkers relating to set up and expectation of support services to our Clinical partners during an emergency incident. Repeat sessions will be completed in Grand Turk in January 2018. 41


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