Standards Help Change Healthcare Facilities

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Published 20th December 2012, 1:0pm

The Health Practice Law (2005 Revision), Section 16, calls for the inspection of health care facilities to be "in accordance with the standards set by the Commission." The National Standards (NS) were published in Gazette #9 dated 26th April 2010 prior to the commencement of inspections, for appropriate public notice to be given.

Since Inspections began in May 2010, all registered health care facilities have undergone inspections for compliance with the National Standards.

The Health Practice and Facility Inspector (HP&FI) has seen some remarkable changes in that time. To date there have been 238 inspections, an annual total of 97 facilities.

The National Standards were developed by the Health Practice Commission with a view to regulating a level of quality in health care for the Cayman Islands.

The main themes of the NS are - Patient-Centered Services, the safeguarding and security of patient information, Management and Personnel, Accountability, Consistency and Safety and Quality Assurance.

The first, Patient-Centered Services are required under NS section A-5.0. This section requires that each facility has its own policies and procedures in place to ensure that the care provided is patient-centered.

The HP&FI has found that while most practitioners are trained to work in this manner, most were not familiar with the extensive body of research regarding "patient-centred care" and this has changed and improved their awareness.

Research articles have been utilized by the Inspector to guide the practitioners to write their policies. One such article defines patient-centered care as: "Patient-centered care is not just giving patients what they want, when they want it, regardless of value or cost. At its core, patient-centered care is about the healing relationships between physicians and patients and patients' families. This relationship is grounded in strong communication and trust, highlighted by clinicians and patients engaging in a two-way dialogue, sharing information, exploring patients' values and preferences, and helping patients and families make clinical decisions."

As trust is such a huge part of a healing relationship between the health care practitioner and patients and their families, the NS also require that patient records are secured either electronically or physically. Some local clinics have had to install locked cabinets for hard file copies, while others have ensured that their electronic database is password protected with back-up facilities overseas.

The National Standards also cross reference with other Government entities such as the Planning Department and the Fire Department to ensure compliance with the Cayman Islands Building Code and the Fire Brigade Law (1999 Revision), respectively. The Department of Health Regulatory Services and these departments have worked co-operatively to bring health facilities into full compliance.

For example, the NS require that "all staff shall be trained in fire response procedures, and fire drills shall be conducted regularly". The Fire Department has provided fire safety training to all staff employed in medical facilities seeking to be registered since May 2010. The NS also requires that "the structure and design of the facility shall be in compliance with the Cayman Islands Building Codes…", and the Planning Department has conducted inspections as needed to ensure all health care facilities comply.

"This is a success story of Government departments working together for the public safety," states Health Inspector Barrie Quappé.

She added, "We asked these departments for their assistance, and they have been there even in this climate of limited resources."

How do you know that your doctor's office has met the NS? Look for the health care facility registration certificate, which is required to be on display. Check that the date of the certificate is current.

During a recent inspection a practitioner told the inspector to thank the Health Practice Commission for the NS. The doctor commented that both the term "patient-centered" and the extensive research were unfamiliar to clinic staff. The doctor noted that the research required to write the policy drove some very positive changes in the clinic, and the policy has already improved their quality of care.

Endorsing this initiative, Minister for Health, the Hon. Mark Scotland said, "The health of our people is our nation's primary asset. Therefore, I am confident that this strategic approach will not only protect many patients but it will improve the safety, quality and reliability of the healthcare services."

Deputy Director Mrs. Lyria Josephs noted, "This work of the Department is a great precursor to the upcoming health conference that is focusing on patient centered care."