Changes At Princess Margaret Hospital To Deal With COVID-19

The Princess Margaret Hospital in St. Thomas has implemented significant changes to deal with the coronavirus (COVID-19) pandemic and stands ready to continue to deliver high-quality healthcare to its clients.

Chief Executive Officer (CEO) of the Type C health facility, Melecia Linton, tells JIS News that with the advent of COVID-19, the hospital, which is the only secondary healthcare facility in the parish, had to make adjustments in order to respond effectively to the new disease. These included the retrofitting of some areas and scaling back some services.

“With the assistance of the regional office, our Accident and Emergency (A&E) Department was recently renovated and expanded and it has allowed for a better flow of patients. We have also had the appointment of a new A&E Supervisor, and since then we have seen a reduction in waiting time, so there is greater efficiency in the delivery of clinical care,” she says.

“One of the things that we did was to reconfigure a section of our Accident and Emergency Department to allow for donning and doffing of personal protective equipment (PPE),” the CEO adds.

Miss Linton explains that donning and doffing is the process of putting on and removing PPEs, and that having a dedicated spacious area for this allows the staff to perform this activity unencumbered, thereby decreasing the possibility of cross-contamination.

She says that the hospital has also benefited from donations of equipment, which will help in the response to the new disease.

“Our three-room isolation unit in the A&E Department has just been outfitted with a surveillance system and this will allow for us to reduce the nurse-patient contact time,” the CEO notes, highlighting that the system is a donation from the St. Thomas Chapter of the Lay Magistrates Association.

“COVID-19 is a highly infectious disease, so with the installation of this camera surveillance system, the staff will be able to sit in the nurses’ station and monitor the patient. They can determine if there is deterioration in the health condition and respond. If there is no deterioration, then they can monitor from a distance,” Miss Linton notes.

She adds that with the first confirmed case on the island, the hospital had scaled back outpatient services. These included surgical and gastrointestinal clinics. Services were, however, continued on the high-risk and gynaecology clinics.

The CEO says that since June 1, the clinics have resumed in a limited way and the team sees a maximum of 15 persons per clinic, while slowly trying to resume full service and seeking to not further delay delivery of care to its patients.

In terms of clinical management, Senior Medical Officer (SMO) at the facility, Dr. Samantha Walker, says that in dealing with the COVID-19 pandemic, the team at the hospital has relied on a strong collaboration between its technical staff (nursing and medical) and primary care facilities (health centres).

“That is done through the public health department and by using a robust contact tracing mechanism, where we have been able to identify potential or suspected cases. From that, we are able to isolate the positive cases of which we have had two identified so far, which we’ve managed to treat successfully,” she points out.

“For others, we have placed them in quarantine and in so doing reduced the stress on public health in terms of spread to the community,” she adds.

Dr. Walker says that in looking at the other clinical services that the hospital has to offer, the decision on what services to scale back was made in collaboration with the Ministry of Health and Wellness and the South East Regional Health Authority (SERHA).

“We then did a case-by-case assessment of the patients where we decided who could be delayed with close observation, and those that were emergencies, whose clinical issues would be addressed immediately,” she explains.

The SMO points out that the hospital recently went through an extensive reconstruction and renovation of the A&E Department and that the three isolation rooms are housed within that department, in keeping with the structural mandate from the Ministry of Health and based on international guidelines.

The isolation rooms were a part of the hospital’s development plan before the advent of COVID-19.

According to the SMO, the hospital has improved emergency medical service to the parish of St. Thomas and adjoining parishes, as the facility, being the only public hospital along the country’s most easterly belt between the Kingston Public and Port Antonio Hospitals, serves a population of approximately 120,000 persons.

She says that another Health Ministry mandate that has been fulfilled was the renovation of one ward to be used as a dedicated COVID-19 ward.

With this change, the hospital now has a 10-bed dedicated COVID ward, which along with the three-bed isolation facility brings the bed complement dedicated to COVID-19 treatment to 13.

The SMO, Director of Nursing Services, along with their obstetric and paediatric teams also identified a specialised area of the maternity block to deal with potential cases of COVID-19 among their maternity patients.

“Two rooms have been designated for suspected or confirmed cases to allow for delivery in a safe environment and also to reduce risk to the other patients on that ward,” Dr. Walker says.

Reconfiguration was also carried out in the area to facilitate the construction of a separate entrance for suspected cases.

The hospital has also split outpatient clinics into separate structures, yielding an area that is dedicated to women’s health issues and psychiatry, while the other accommodates medicine, surgery and a new paediatric outpatient department.

The SMO says that the hospital, although classified as a Type C, has much more to offer.

“We are the only Type C Hospital in the entire country that has a specialist gastroenterology service, which is a sub-specialty in internal medicine. We also offer, as part of our gynaecological offerings, a colposcopic service which is being revamped and generalised to offer more care,” she adds, noting that it is very important in services such as cervical cancer screening.

In addition to this, she says that the hospital is one of the few Type C hospitals that offer laporoscopic (minimally invasive) surgical services, which reduce both wait time and downtime for patients.

There are two paediatricians in the parish, who are based at the hospital, including the SMO who is a sub-specialist in neonatology, being a recent graduate of the Programme for the Reduction of Maternal and Child Mortality (PROMAC). This has allowed for better management of neonates and infants, and resulted in a reduction of having to refer children to the Bustamante Hospital for Children.

Princess Margaret Hospital celebrates 65 years in 2020. It was constructed to replace the Morant Bay Hospital, which was destroyed by Hurricane Charlie in 1951.

The facility was relocated to its present location in Lyssons and officially opened on February 23, 1955.