OCT 2016
J U LY- S E P T 2017
NEWSLETTER INTERHEALTH CANADA TCI
THE
INTER-VIEW
RESTORING HEALTH CARE AFTER THE STORM Welcome to the September 2017 edition of TCI Hospital Newsletter, which features stories from across the healthcare organization. A new edition is published at the end of every quarter.
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.
“In an emergency, what treatment is given by ear? Words of Comfort.” - Abraham Verghese, MD
Our Values We value ethical and respectful behaviour, honesty, accountability and excellence in all we do.
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FOOD FOR THOUGHT
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THANK YOU MESSAGE FROM TCI HOSPITAL CEO
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SURVIVING HURRICANE IRMA AND MARIA
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TEACHERS LEARN A LIFE SAVING SKILL
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InterHealth Canada - Turks and Caicos Islands Hospital sponsored 10 children in a charity breakfast program.
Mr. Daniel Carriere sends a thank you message to clinical and facilities staff for their hardwork during recent storms.
A general editorial acknowledging the challenges faced by healthcare institutions located in zones of natural disasters.
Over a dozen educators are certified in bystander CPR in recognition of CPR Month.
FOOD BANK RESTORATION PROJECT InterHealth Canada restocks a critical food bank in the sister island during the peak of the Hurricane Season.
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ROAD TO DIAMOND
A closer look at the standards and organisational practices required for Diamond Accreditation.
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THROMBOSIS AWARENESS
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DIPLOMATIC TOUR POST HURRICANE IRMA
TCI Hospital devise plans to raise awareness of Venous Thromboembolism in the local community.
High ranking diplomats with ties to the Foreign and Commonwealth Office tours TCI Hospital post-Hurricane Irma.
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THE PLANK - EXERCISE OF THE QUARTER
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BREASTFEEDING ROOM UNVEILED AT CHMC
The Physiotherapy Department educates readers on The Plank in our featured exercise.
TCI Hospital opens a special room for mum's in observance of World Breast Feeding Week.
daily dose FOOD FOR THOUGHT BREAKFAST PROGRAM InterHealth Canada - Turks and Caicos Islands Hospital sponsored 10 children in a charity breakfast program operated by Food-For-Thought for the second consecutive year. The sponsorship will cover the cost of breakfast for a great portion of the school year. According to Food For Thought, more than 2,000 children currently attend public primary schools in the Turks & Caicos Islands, however, as many as 20% of school age children in the country do not have breakfast before school. The absence of this important meal can affect the physical and mental development, concentration and ultimately the overall academic performance and future earning potential of these children. The non-profit-organisation provides free breakfast to approximately 300 children in North Caicos, Middle Caicos, South Caicos and Salt Cay every school day.
Caption (L-R): Karen Savory - Founder of Food for Thought & Nikira John - IHC PR and Marketing Manager
The menu is designed to provide a nutritious and balanced breakfast. After the Breakfast Program commenced in September 2016, school teachers reported an improvement in the students’ attention, focus and attendance. The charity's website states: “the latest Turks & Caicos Islands Poverty Assessment Survey in 2012 showed that 16% of households live in poverty. Households with children accounted for over half of those poor households. It also showed that 60% of households have problems paying for at least one essential household expense, including food. Many families simply cannot afford to provide proper nourishment for their children. Not only is the earning potential of children likely to be hindered due to the difficulty to learn if not properly nourished, but the cost of lost productivity to the economy is substantial.” To learn more about the program and donate, visit www.foodforthoughttci.com.
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TURKS & CAICOS ISLANDS HOSPITAL Turks and Caicos Islands Hospital opened on 10th April 2010 and consist of Cheshire Hall Medical Centre and Cockburn Town Medical Centre. The health care provider offer a number of specialized services for NHIP members and
TCI Hospital has been Diamond Accredited by Accreditation Canada International since 2012.
self-paying patients throughout the Turks and Caicos Islands. The Cockburn Town Medical Centre is located on the island of Grand Turk and Cheshire Hall Medical Centre is located on the island of Providenciales. Both sites serve the local population and visitors across the Turks and Caicos Islands chain and have built-in capacity to double in size. The facility is a public hospital managed by InterHealth Canada TCI Ltd on behalf of the Turks and Caicos Islands Government through a Public-Private Partnership agreement. Services provided at both locations include Accident and Emergency care, General Surgery, Obstetrics and Gynecology, Orthopedics, Family Practice, Medical Oncology, Internal Medicine, Secondary Dentistry, Acupuncture, and Outpatient Hemodialysis.
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Visiting consultants from North America and the Caribbean region also provide periodic care in the specialties of Nephrology,
Urology,
Oncology,
Neurology,
ENT,
a
High
Ophthalmology and Plastic Surgery. Cheshire
Hall
Medical
Centre
has
two-bed
Dependency Unit for patients requiring more intensive monitoring, and a Special Care Baby Unit or neonatal intensive care unit for infants in need of specialized care. Our diverse and experienced team of doctors, nurses and physicians are always committed to providing compassionate care to patients, and delivering service with a smile.
ABOUT US
INTERHEALTH CANADA
Established by an initiative from two Provincial Canadian Governments, InterHealth Canada was created to export Canada’s intellectual expertise in healthcare to an expanding international market. With the mandate to deliver the greatest benefit to communities, InterHealth Canada brings to its clients the internationally recognized quality and efficiency of the Canadian healthcare system, while maintaining cultural sensitivity and tailoring its solutions to the local need. InterHealth Canada is a world leader in healthcare operations and management with diverse activities in planning, management and consulting. We deliver cost-effective, culturally sensitive solutions that meet international quality standards in both the public and private sectors. As recognized pioneers in healthcare Public Private Partnerships (PPPs), we are
Our vision: “Strength is our people and sustainability is our focus.” THE MANAGEMENT COMPANY InterHealth Canada’s aim is to be the first choice partner for the operation and management of healthcare projects and facilities worldwide, providing superior clinical outcomes for patients, and commercial success for our clients. We ensure that every one of our projects are underpinned by these values, and leverage the best of our core strengths. The InterHealth Canada team is prepared and engaged to discover
new
opportunities
delivering healthcare demonstrating
our
services, and looks forward strengths
in to
and values to all
clients we partner with.
able to deliver innovative financial solutions to enable access to effective
OUR MISSION
healthcare.
Enabling evidence-based solutions across the globe applying cultural sensitivity and corporate sensibility by fostering the collaboration of talented minds to deliver results that bring positive change to communities
CORE VALUES Since our values constitute the very make-up of our mission, we are committed to stand by the four core pillars of our values: Skill, Motivation, People, and Practice.
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HELLO Dear Valued Staff in Clinical and FM services, Thank you for your continued support. You are all outstanding professionals.
Daniel Carriere Ch i ef Exec u t i ve O ffi cer
THE MESSAGE Our deepest appreciation to all the teams who worked around the clock to ensure a seamless secondary care emergency response during the passing of hurricane Irma. I wish to express gratitude to all staff who were on standby, ready to respond, if needed. Your dedication is so “AWESOME”. You will set the standard with this type of focus and determination for the entire organisation in the years to come. I’ve frequently conducted rounds throughout CHMC and hope to do more in Grand Turk. I know that behind your brave smiles, you are worrisome of the impact of Irma and what the future may bring for your family and friends. But remember, you are not alone! I have no guarantees for the future. I will continue, everyday, to focus my attention and that of our Senior Team, on helping our people in every way we can. At times, that help may seem painfully slow in arriving for some, and others might think that the help is just not enough, but my commitment to you is that we will not stop trying, readjusting and stretching our minds and resources to determine ways in which we can offer you support and relief in these trying times.
Above all, stay strong and positive and enlist the help of the BIG GUY above who has been watching over us since the storm struck. Thank you for your tremendous efforts for our patients and for making a measurable difference.
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MEET
OUR SENIOR MANAGEMENT TEAM The Senior Management Team is the top leaders of various departments, clinical and non-clinical, across Turks and Caicos Islands Hospital.
Dr. Denise Braithwaite- Tennant Chief of M e d i c a l S e r v i ce s
Martin Dawtry
Facilities General Manager
Douglas Moore C h i e f o f C l i n i c a l S e r v i ce s
Terrell Kuula Fi n a n ce M a n a g e r
Eleanor Hall
Ryan Smith
Lorenzo Seymour
Chie f o f Allied S er vices
IM&T Manager
H u ma n R e s o u rce s M a n a g e r
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Celebrating Our Doctors Our patients are treated with expertise, precision and tender care by experienced and highly-trained board certified doctors from across the globe that specialize in a wide range of healthcare disciplines.
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Specialists in the area of Plastic Surgery, Urology, Neurology Ophthalmology, Oncology and ENT offer specialty clinics and conduct surgical procedures at TCI Hospital. These specialty consultants visit the island on a quarterly basis; however the frequency of some specialist visits is dependent upon demand and availability of the specialist.
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Natural disasters pose a whirlpool of challenges to even the most world-renowned, robustly engineered health care infrastructures while wreaking havoc over entire cities. In some cases, even the best disaster preparedness plans have been foiled. The impact of Hurricane Harvey on medical centres in Houston Texas, United States is only one example.
SURVIVING
IRMA & MARIA
The health infrastructure in Puerto Rico was already in crisis before Hurricane Maria – now a majority of the island’s 69 hospitals are without electricity or fuel for generators, according to the US Department of Defense. The island’s few functioning hospitals are at capacity and face frequent power outages. Despite a ripple effect of other challenges alongside roof damages sustained at both Cockburn Town Medical Centre on Grand Turk and Cheshire Hall Medical Centre on Providenciales, the Turks and Caicos Islands Hospital successfully protected its occupants during Hurricane Irma, one of the most powerful Hurricanes ever recorded, which battered the country on September 7th - 8th, 2017. The Hospital Emergency and Disaster Preparedness Response Plan was activated within 48 hours of Irma's impact, and non-emergency services and clinics were immediately cancelled until further notice. The hospital provided refuge for over 30 antenatal patients, geriatric and elderly patients from the Grand Turk Wellness Centre and other high-risk groups. Essential staff members including Emergency Room physicians, nurses and Operating Room teams remained on site to ensure the continuity of patient-care and manage any incoming emergent cases. Fortunately, there were no fatalities recorded in the low-lying cluster of islands, which was visibly more prepared for Hurricane Irma’s wrath than previous storms.
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As Hurricane Irma roared through the world famous archipelago, several surgeries were performed and two healthy babies were delivered by medical teams at the local hospital. The resilience and dedication displayed by clinical and nonclinical teams who remained on-site at both medical centres before, during, and after the storm is exemplary. Although more than 20 healthcare workers endured significant personal losses and infrastructural damages to their homes, these warriors remained patient-focused and selfless. TCI Hospital also provided tangible support to displaced employees. Essential services such as electricity, telecommunication, internet, city water and even domestic and international air travel were hampered country-wide for several days, weeks and potentially months, for some services. In the absence of these necessities, both generator-powered hospital centres strived to maintain emergency services and enforce contingency plans as restoration efforts progressed. The ultimate challenge for each healthcare facility during a disaster is the onslaught of occurrences, some beyond human control or prediction, which can impact the integrity of the physical building, mechanical and operational equipment such as chiller machines and water pump systems, which are just as intricately linked to service delivery as the need for an uninterrupted electricity supply. In some areas of a hospital, an air conditioning system isn’t just a welcome luxury – it’s nigh-on indispensable. These areas include operating theatres, where precise control of the humidity, the temperature, and the filtration is highly desirable. The same is true to a lesser extent of other sensitive parts of the hospital, like the intensive care ward, delivery rooms, X-ray, MRI, and CAT departments, or even IM&T Server Rooms. In addition, a sufficient and well pressurised water supply is an essential component of Haemodialysis, which uses up to 100 litres of water for each patient.
It only takes several hours for a hurricane to decimate structures in its path and uproot people’s sense of normalcy, but it can take a country, its residents and institutions, several months, and even years to recover and rebuild. Health care facilities are no exception. More than half of the 16,000 hospitals in Latin America and the Caribbean are in areas at high risk for disasters. Two weeks after Irma, Hurricane Maria impacted the Turks and Caicos Islands. All patients were transferred overseas from Cockburn Town Medical Centre as a safety precaution, following an assessment of provisional roof repairs, which were conducted after Irma. Grand Turk is traditionally among the hardest hit islands and was once again, earmarked for the strongest conditions. It must be stressed: Times of crisis, emergency and challenges have a way of bringing people together and can push people to excel at what they do. A contingent of consultants from Cheshire Hall Medical Centre travelled to Grand Turk to remain on stand-by to provide emergency services in the wake of Maria. First responders – police, fire, EMS with support from the British Military and Bermuda Regiment – banded together from all over the country and their immeasurable hours of work is commendable. The gradual resumption to routine services across both medical centres under the Turks and Caicos Islands Hospital umbrella is owed to a spirit of teamwork amongst the managerial teams and employees, other internal and external healthcare stakeholders, and restoration efforts from the country’s utility service providers who recognise and prioritise the hospital as a provider of essential services. Both Hurricanes left an atmosphere of vulnerability in the peak of the 2017 Atlantic Hurricane Season while countries limp towards recovery. As the new common mantra reads: 'The Turks and Caicos Islands, as a destination, may have been bruised, but is certainly not broken.' 11
THANK YOU TO THE BRITISHÂ MILITARY HURRICANE IRMA RECOVERY SEPT 2017 12
INSIDE THE MEDIA
Health Education
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REGISTER TODAY! TCI Hospital offered training in Heartsaver CPR/AED for the month of September and onwards at an affordable cost of $80.00 per person, which includes a student manual, snack break, face mask, and a course completion card. To register for future training sessions email: Michael Williams via mgwilliams@interhealthcanada.tc at Cockburn Town Medical Centre Jacqueline Moe-Cox via jcox@interhealthcanada.tc at Cheshire Hall Medical Centre 14
The American Heart Association
establishments on a regular basis.
(AHA) designated the month of
Since cardiac arrest can occur at
September as CPR
any time and anywhere, it is the
(Cardiopulmonary Resuscitation)
hospital’s corporate responsibility
month with a goal to partner with
to make TCI a safer place for all
other stakeholders to train 25,000
who live in as well as visit these
persons in life-saving CPR in
beautiful by nature islands.
September 2017. The Turks and Caicos Islands Hospital Life Saver Training Centre announced its partnership with the AHA to provide training to as many persons as possible. Various companies, schools and banking institutions were invited to capitalise on the course by reason of the large number of
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).
people that access these 15
LIFE SAVING SKILLS.Â
Nineteen teachers and administrators from Precious
Treasures International School Turks and Caicos enrolled to learn the lifesaving skill at TCI Hospital's Training Centre, which is certified by AHA. Graceway IGA has also scheduled a large group of employees to receive training. Successful completion and skills testing with an AHA Certified instructor can earn an American Heart Association Heartsaver First Aid CPR & AED Course Completion Card, valid for two years. Each year, more than 350,000 out-of-hospital cardiac arrests occur in the United States. This is an electrical malfunction in the heart that causes a disruption of blood flow to the brain, lungs and other organs. Despite the important advances in prevention, cardiac arrest remains a substantial public health problem and a leading cause of death in many parts of the world. In a cardiac arrest, seconds count. According to AHA, almost 90 percent of people who suffer out-of-hospital cardiac arrests die. CPR, especially if performed in the first few minutes of cardiac arrest, can double or triple a person’s chance of survival. Sadly, many persons witnessing someone who has collapsed are often unable to help because they do not know what to do. Individuals or employers can seize the opportunity to provide their staff with the necessary life-saving skills to enable them to respond in a timely and appropriate manner should the need arise. Remember - no one can place a value on life. You can save a life today.
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n io t a r o t s e r k n a Food b
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ROAD TO DIAMOND
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*Reviewing Client Safety Quarterly Reports *Ensuring Safe Surgical Practices *Transfer of Patient Information *Narcotic Safety *High Alert Medications *Heparin Safety *Infection Control Guidelines *Infection Rates *Safe Injection Practices *Pressure Ulcer Prevention *Client Safety Prospective Analysis *Dangerous Abbreviations *Training on Patient safety *Preventative Maintenance * Suicide Prevention *Home Safety Risk Assessment *Antimicrobial Stewardship
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Thrombosis Awareness 20
Turks and Caicos Islands Hospital is planning to join the global movement to raise awareness of venous thromboembolism (VTE). Recognised on 13 October, World Thrombosis Day (WTD) focuses attention on the often overlooked and misunderstood condition of thrombosis. With thousands of educational events in countries around the world, WTD and its partners place a global spotlight on thrombosis as an urgent and growing health problem.
WWW.TCIHOSPITAL.TC
VTE is often fatal, but the good news is that many, if not most cases are preventable.
stop the clot Thrombosis refers to abnormal, lifethreatening blood clots that form in the artery or vein. A clot in the vein (usually in the leg or pelvis) is known as a deep vein thrombosis (DVT) and a clot that breaks off and travels to the lungs is known as a pulmonary embolism (PE). Together, DVT and PE make up venous thromboembolism (VTE). TCI Hospital will seek to increase local awareness of thrombosis, including its causes, risk factors, signs/symptoms and evidence-based prevention and treatment. There will be specific focus on underscoring the unrecognised threat and serious consequences (morbidity and mortality) related to venous thromboembolism (VTE). One in four people worldwide die of conditions caused by thrombosis. Thrombosis is a leading cause of death throughout the world. Initiatives being planned include an educational exhibition in the main foyer and community walk hinged on the popular theme, ‘Stop the Clot’. Stay tuned for the dates and additional information. 21
2017 CLINIC EXPLORATIONÂ
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Post Hurricane Irma
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eat your veggies. eat them often. Eating vegetables provides health benefits people who eat more fruits and vegetables as part of an overall healthy diet are likely to have a reduced risk of some chronic diseases. Vegetables provide nutrients vital for health and maintenance of your body.
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E X P L O R E
|
H E A L T H
C A R E
Nursing Observership A nursing student from Turks and Caicos who is pursuing tertiary level studies overseas spent portions of her summer break at the Cockburn Town Medical Centre in Grand Turk shadowing physicians in practice.
Shekia Francis, 18, is currently pursuing a Bachelor of
On the final day, Francis gave a presentation on the
Science in Nursing at University of the West Indies in
different roles of nursing with special emphasis on
Jamaica. Francis gained invaluable firsthand exposure
Patient Safety and Fall Prevention initiatives within
to internal healthcare operations during a near two
the healthcare centre. The presentation was well-
week observership, which commenced on August
received by clinicians and Francis expressed
14th.
gratitude for the unique opportunity. Upon completion of tertiary level studies and the required
Of all the departments explored, she favoured the
credentials, she will start off as a generalist and then
Dialysis Unit, particularly the level of Human and
likely develop a specialty during her nursing journey.
Social Biology involved in the nursing spectrum, and
We wish her all the best.
the close bonds between patients and nurses due to the frequency of treatments, typically 3 times per week for each patient diagnosed with chronic renal failure. 25
E X P L O R E
E X P L O R E
| H E A L T H
|
C A R E
O B S E R V E R S H I P S
Finance Observership Former graduate of British West Indies Collegiate A-Level Program, Lawrence Saintange, 20, concluded a three month observership at TCI Hospital’s Finance Department on August 31st. The accounting and economics lover who spent his summer working alongside the Finance team has absorbed a wealth of knowledge in the field of business and financial management.
“People don’t normally think about the corporate side
…Every company has an accountant, sometimes it is
of hospital operations. I realized this during my first
very typical for graduates to go for the obvious
tour while visiting departments such as Purchasing
companies, but if they go out and network, they
and Human Resource Management," said Saintange.
would meet people and possibly venture into companies where they don’t typically go for
He continued: "Working alongside Terry, Marie, Faith
experience.”
and Guru in the Finance Department, I was able to learn about technical terms, financial systems and
Saintange has been accepted into the University of
processes. It made me more excited to learn about
Lincoln in Lincolnshire, England.
finance. Image Caption (L-R): Terry, Faith and Marie of TCI Hospital Finance Department alongside Mentee 26
Saintange.
BASKETBALL TEAM SECURED 2ND PLACE IN PUERTO RICO TOURNAMENT
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A delegation from Interhealth Canada – Turks and Caicos Islands Hospital will be attending the 10TH World Medical Tourism & Global Healthcare in Los Angeles, California on October 2-4, 2017 as exhibitors and a bronze sponsor of the global leading medical tourism event. The healthcare organisation participate in the forum every year in some capacity, and utilise the platform as an opportunity to market the InterHealth Canada brand, healthcare services, available surgeries and the country at large, in an effort to pave the foundation for a potential medical tourism sector and inbound patients. The delegation will consist of IHC Chief Executive Officer, Daniel Carriere, IHC Chief of Medical Services, Dr. Denise Braithwaite-Tennant, IHC Visiting Consultant Coordinator, Kay Vanes-Williams and myself as IHC Manager of Marketing and Public Relations – all Certified Medical Tourism Professionals. The congress is one of the most comprehensive international healthcare conference and trade shows in the medical tourism industry and attracts up to 3,000 participants, 400 qualified buyers of healthcare along with industry forums and executive summits.
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EXERCISE TIDBIT
Exercise of the Quarter The Plank
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TC I HOSPITAL UN V EILS B R E A ST F E E D ING RO OM
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BREAST IS BEST. ALWAYS.
ON THE ROAD TO BABY-FRIENDLY
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Turks & Caicos Islands Accident and Emergency Surgical Services High Dependency Unit Obstetrics and Gynaecology Orthopaedics Family Practice Medical Oncology Physiotherapy Internal Medicine Secondary Dentistry Outpatient Haemodialysis Diagnostic Imaging Ophthalmology Pharmacy Nephrology Urology Neurology ENT
CALL US TODAY! +1 649-941-2900 +1 649-941-2800
Putting the heart into health care. 32