JMDA concerned about patient surge

Doctors are sometimes spending up to 20 minutes searching for basic medical supplies during regular patient-flow periods, a problem the Jamaica Medical Doctors Association (JMDA) says becomes even more consequential when emergency departments are flooded with patients.

The concern comes as the University Hospital of the West Indies (UHWI) announced that its Accident and Emergency (A&E) Department is experiencing patient volumes beyond its normal capacity, resulting in longer waiting times, particularly for less urgent cases.

JMDA President Dr Jubilee Brown-Service said the current situation highlights inefficiencies that exist even before hospitals experience a spike in patients.

“We still have issues on a regular day [with] doctors having to be spending 15 minutes, 20 minutes looking for a blood tube, bottle, an IV access, and it impacts the efficiency of the system,” Brown-Service told THE STAR.

“In regular patient-flow periods, we have staff shortage, so we need to increase capacity doctors, nurses, janitors, emergency transport services. It needs to be increased.”

The UHWI said patients will continue to be prioritised according to the severity of their conditions, with the most critically ill receiving immediate attention. The A&E remains operational, but the hospital has encouraged people with non-emergency conditions to consider accessing their nearest health centre or primary-care provider where appropriate.

Brown-Service cautioned, however, that news of an overcrowded A&E could cause some people with genuine emergencies to delay seeking medical attention.

“So we will have people possibly deteriorating at home,” she said. For those who do seek emergency care, Brown-Service said increased patient-to-staff ratios can make providing care more difficult.

“If you have two patients and you’re attending to one, you’re better able to divide that focus, but if you have 10 patients and you’re attending to one, then the reality is that there are some aspects of the care that may be neglected,” she said.

She said this points to a need for increased staffing during peak periods, although Jamaica is already grappling with shortages of critical healthcare workers.

The psychiatrist said overcrowding is a global, multifactorial problem, and periods of increased patient flow are not unfamiliar to local healthcare workers. Brown-Service said increased patient numbers place additional strain on already limited resources.

“It’s more IV accesses being used, more IV fluid being used, more medications being used,” she said.

Brown-Service also pointed to fragmented medical records and the continued use of physical patient dockets as sources of delay when patients move between facilities.

“For UHWI, they do have electronic health records for some of its departments, so it is a little easier now, but we need to be expanding that across the health sector,” she said.

“Are we going to be trying to take a history of the patient from scratch when this is probably somebody who has been in the system for 10 years, but they just went to a different health centre? That’s a real issue that we face, very real issue, and when you come, we might not be able to find your dockets because things happen to dockets.”

Brown-Service said those delays can directly worsen congestion by keeping patients in the system longer. She opined that addressing staffing, resources and inefficiencies during normal periods is critical to preparing hospitals for surges.

“The issues are so many, but I believe if we move to having a robust health service in the period where it’s average patient flow, then we will be better able to manage the periods when they have that spike in the cases,” she said.

She also urged Jamaicans to take greater responsibility for preventative healthcare, particularly those living with chronic illnesses, by taking their medication and keeping clinic appointments. For people with respiratory illnesses, she encouraged precautions to limit transmission.

“If you know you’re unwell, don’t go to the office and be coughing in an air-conditioned room,” she said.