Close attention needs to be paid to staff morale. It’s an assertion made by the five-member Committee appointed to investigate COVID-19 treatment within the Parallel Healthcare System and Patient Outcomes.
Excerpts of the report were read by Minister of Energy and Energy Industries, and Minister in the Office of the Prime Minister, Stuart Young, in the Parliament on Friday. The 105-page Report also noted that international best practice was followed as it relates to the hospitalisation of those infected with COVID-19.
* Summary of the Report of the Committee which was appointed to investigate the factors contributing to clinical outcomes of COVID-19 patients in Trinidad and Tobago:
1. Admissions, discharge and transfer policies for COVID-19 patients were found to be within the ambit of international best practice, especially as recommended by the WHO.
2. The Committee said there’s an urgent need for electronic medical records, pointing out that the ambulance transfer database, hospital care databases needs to be urgently linked to support cost-effective and oriented patient outcomes.
3. Long-term recommendation to ensure the prevention and management of NCDs in young persons, noting the high rate of NCDs among COVID-19 patients who died.
4. National Survey urgently required and data used to guide the review and revision of health promotion and treatment programmes.
5. Committee recommends for RHAs to implement a specific feedback system to monitor the needs of staff on the frontline.
6. Recommend that supplies from C40 be continuously open, seven days per week to allow frontline staff 24/7 support during the pandemic.
7. Committee recommends oxygen requirements of all large institutions be reviewed with consideration of purchasing oxygen concentrators.
8. Recommend that close attention needs to be paid to staff morale and mental health, as well as purchases of some consumables.
9. Recreational facilities be included or expanded for medical staff, where open air gym exercises could be done.
10. The use of specific patient care assistants to help with the feeding and distribution of meals to COVID-19 patients, where quality and timing of meals is a concern.
11. The Committee recommends there to be more emphasis on patient communication, noting there should be daily communication with next of kind across all RHAs.
12. All healthcare providers are urged to have more empathy to patients in the parallel healthcare system.
13. One recommendation points towards temporary accommodations (tents and bathrooms) needing to be improved to more readily response to surges, citing issues of overcrowding.
14. The Committee suggests that data on the sits of where deaths occur (whether tents, ICU, A&E, step-down facility) be added to national database to allow for site-specific evaluation or quality of care.
15. Recommends that the policy regarding Tocilizumab use be reviewed, noting that most staff were impressed by its effects, despite its expensive cost.
16. A National Policy regarding ICU admissions for persons of different ages to be considered.
17. Recommend a formal survey of views of relatives of patients who were cared for in the parallel healthcare system, noting relatives had limited or no access to patients during admission.
18. The Committee suggests that further external assessments of the healthcare system be preceded by a written self-assessment. For example it said the evaluation of Ambulance transfer would be beneficial, if the Ministry in writing, indicated whether what was intended was in fact implemented.