QEH Rx: Reforms ‘to cut waits, ease staffing shortages’

A major overhaul of systems, staffing and surgical scheduling at the Queen Elizabeth Hospital is expected to cut waiting times from years to months, its chief executive said on Monday, as the country’s public general hospital confronts long-standing backlogs and critical workforce gaps.

Central to this operational overhaul is the immediate deployment of newly recruited medical personnel to shore up the hospital’s stretched accident and emergency (A&E) department, chief executive officer Neil Clark told the hospital’s Pulse radio show. 

Clark revealed that the QEH has successfully recruited six specialised A&E doctors from overseas, marking a significant milestone for the institution.

CEO Queen Elizabeth Hospital, Neil Clark (File Photo)

“In my two years here, we haven’t recruited one new A&E doctor, so I’m really pleased that now we’ve found six,” Clark said, emphasising that the new arrivals “will make a difference to that department in strengthening it” and providing crucial support for demanding 24/7 shifts.

In tandem with the incoming physician cohort, the QEH is integrating highly trained nurse practitioners into the emergency care workflow. These advanced nursing professionals can “work there independently alongside the A&E doctors” to manage patients presenting with mild conditions, such as minor asthma attacks, thereby freeing up specialised emergency doctors to focus on high-acuity trauma cases and major clinical incidents.

Beyond addressing immediate staffing deficits, Clark expressed deep concern over the systemic gridlock plaguing the hospital’s elective surgery pipelines. Responding to frustrated callers who reported languishing on surgical waiting lists for up to three years for critical procedures such as hip replacements, the CEO acknowledged that the hospital has historically been “driving blind” owing to fragmented, non-centralised data management.

To resolve this visibility crisis, the QEH is implementing a comprehensive health information system this year. The digital platform will consolidate surgical backlogs into centralised dashboards, granting leadership real-time insights into average wait times across specialties, clinics and individual doctors.

“The data gives you power of intervention,” Clark explained, noting that once the tracking system is fully operational, administration can dynamically shift resources and reallocate outpatient appointments to equalise backlogs between clinicians.

“I keep saying that health information systems will be a game changer for the QEH as we get the information and we can see where those delays are.” The hospital is targeting a shift in which patients move to the operating theatre within months rather than years, with Clarke asserting, “We wouldn’t want anybody to be waiting, you know, over a year”.

The hospital’s newly tasked theatre user committee is also reforming the scheduling and prioritisation of operating rooms, particularly following recent infrastructure overhauls to the facility’s air conditioning units.

The committee is implementing key performance indicators to reduce late-day surgical cancellations, ensuring that if a procedure must be postponed for clinical or logistical reasons, the patient leaves the hospital with a firm rescheduled date.

“Ideally you should be leaving with a new date and, and not looping back round the whole system starting again,” Clarke said.

The structural reforms will additionally extend to the pharmacy network to alleviate the systemic burden placed on outpatients. Currently, patients face logistical hurdles because prescriptions written at local polyclinics cannot be dispensed at the main hospital pharmacy.

The QEH is engaged in discussions with the Barbados Drug Service and the Ministry of Health to unify the cross-system dispensing of medications, he said. 

The overarching goal of these drug negotiations is to transition routine prescription fulfillment away from the central hospital and closer to patients’ homes, using polyclinics and private pharmacies.

“The last thing you want to be doing is having to move to different locations to pick up your medications or having to return back to the QEH to get your refill,” Clark said.

To bridge the gap in the interim, the QEH is promoting and expanding its dedicated home delivery courier service to ensure patients do not neglect vital therapies due to transport barriers.

As the QEH transitions into the second year of its transformation strategy — which encompasses five strategic pillars, 25 strategic objectives and 92 distinct initiatives extending through 2028 — Clarke reiterated his commitment to public accountability.

He promised that hospital leadership will return at the end of the year to match the systemic challenges raised by the public against measurable institutional progress: “We’ve got to make sure that we come back at the end of this year to—these are the issues that you’ve raised, here’s what we’ve done to address them.”

(RR)