Christopher Tufton | Building capacity for child, adolescent health

From climate change to nature loss and pollution, we exist in a world of persistent existential threats that require of us a coordinated, elevated response in order to ensure our survival over the long term.

To succeed, it is necessary that we safeguard public health, giving priority to the health of children and adolescents. The Government and Ministry of Health & Wellness is progressing efforts to complete the fit-for-purpose Western Children and Adolescents Hospital (WCAH).

Designed to deliver quality of care and with a completion date of June 2025, the new hospital, located adjacent to the Cornwall Regional Hospital (CRH) at the western end of the island, is to directly serve the parishes of St James, Trelawny, Hanover, Westmoreland, and St Ann – with their collective population of close to a million people.

BANG FOR THE BUCK

The value of this facility is not in question. The new children’s hospital, which is costing some US$40 million to construct, is anticipated to tick all the boxes for an efficiently run service – from the offer of specialised care and expertise to comprehensive services, family-centred care and a child-friendly environment.

To that end, the hospital – which is being constructed with the support of the Government of the People’s Republic of China, will cater to patients from birth to 17 years and is to house eight floors and 220 beds. The ground floor will house the accident and emergency department, radiology including an MRI, pharmacy, staff cafeteria and staff daycare. The first floor will house the outpatient clinics, including dental clinic, haemodialysis unit, central sterilisation and supply department, laboratory, and administration.

ICU BEDS

An operating theatre suite with four operation rooms and 10 recovery beds, as well as a 15-bed intensive care unit, is sited on the second floor. The third floor will be the designated equipment floor. The remaining four floors have adolescent beds, child and adolescent psychiatry, maternal and nursery beds and paediatric medicine, surgery and subspecialties.

Given its range of offerings, the hospital will serve as a centre of excellence which provides a continuum of care (adolescence, pregnancy, childbirth, the postnatal period and childhood), integrating the community with outpatient and inpatient care services and offering research and education.

The hospital will facilitate the introduction of adolescent-focused healthcare services in Jamaica - the enhancement of sexual and reproductive adolescent health services and the provision of an environment for safe deliveries for teenage mothers with infrastructure and staff to deliver family-centred physical, mental and psychosocial care.

Of note is that the WCAH is a specialist hospital and will afford its young patients access to 17 specialities and subspecialties. The CRH and WCAH will share the campus and be physically connected. The CRH will provide access to other specialities. The specialities and subspecialties include general paediatric medicine; general adolescent medicine; neonatology; paediatric cardiology; nephrology; haematology/oncology; urology; otolaryngology; neonatal surgery; child and adolescent psychiatry; orthopaedics; anaesthetics; critical care; radiology, pathology and emergency medicine.

The specialities that will be accessed from the CRH include pulmonology, dermatology, neurosurgery; ophthalmology; obstetrics and gynaecology; general surgery for adolescents; and plastic surgery.

IMPACT

It is impatient of debate the impact that this new facility will have, in service to our children and teens. In 2023, the paediatric department at the CRH had 38 beds (special care nursery and paediatric ward), resulting in more than 100 per cent bed occupancy, 1,356 admissions and 3,536 outpatient visits with three clinics per week. The WCAH will have five times more beds and so the hospital is estimated to see five times more visits annually, a crude estimate.

Similarly, the outpatient visits will increase significantly, owing to the more frequent occurrence of clinics, as well as the speciality clinics that will be in operation. The Bustamante Hospital for Children had 8,891 admissions in 2023. A decrease in referrals to the Bustamante Hospital for Children is expected when the hospital becomes operational, and bed space availability for adults at Cornwall Regional Hospital will be improved with the repurposing of the paediatric ward in that facility, as well as the admission of adolescents to the WCAH instead of the CRH.

HUMAN RESOURCES

A comprehensive staffing plan has been drafted and submitted to the ministry for approval. The planned total staff complement is 1,208, to include 731 nurses; 125 medical officers; 77 in general operations, including porters; 39 in health information; another 39 in laboratory; 31 in maintenance and engineering; 28 in customer service; 22 in dietary clinic; 19 in food and dietary; 13 in radiology; and 8 in psychosocial, among others from areas such as oral health; safety and security; asset and inventory; and transport.

Since April, four positions have been specifically assigned to WCAH and have been filled. They include Deputy Chief Executive Officer (Camille Lewin); Senior Medical Officer (Carleene Grant Davis); Director of Nursing Services (Allison Chambers); and Senior Public Procurement Officer (Nicola Forbes). One other team member is to join in July, the senior human resource officer.

The WCAH team that assumed duties in April has been overseeing the operations of the Padiatrics Department at the CRH and with a number of critical tasks completed. They include the preparation of an operational commissioning plan that is to be presented for stakeholder consultations and approval; the finalisation of an operational budget for 2024-2025; as well as specification for additional equipment needs.

Among other things, ward rounds are being conducted and meetings convened by the WCAH clinical team, together with weekly tours of the building by the SMO with the paediatric team of nurses and doctors, as well as pharmacists. The goal is to keep the staff informed and motivated.

Our children and teens are faced with one challenge or another – from issues to do with their mental health to navigating interpersonal relationships and overcoming other social or economic hurdles. It is necessary, therefore, that we provide them with as much ease as is possible, through the provision of a health service that specifically caters to their needs and which helps to guarantee them the best possible health outcomes. That way, we help to enable their full and optimal participation in the future we want to see – one where the climate is secure and where nature loss and pollution are a distant memory.

Dr Christopher Tufton is Jamaica’s minister of health and wellness and member of parliament for St Catherine West Central. Send feedback to cctufton@gmail.com and columns@gleanerjm.com.