Best: “We can take them in custody if they refuse” – Inspectorate imposes action plan

POSTED: 10/17/12 5:25 PM

 

 

From left to right Attorney for the Public Health Inspectorate Jairo Bloem, Inspector General Dr. Earl Best and Interim Inspector General in Dr. Best’s absence, Dr. Jan Haeck share a light moment on Tuesday after hearing that the court had ruled in their favor.

 

St. Maarten – A verdict handed down by the Court in First Instance yesterday resulted in the Inspectorate of Public Health emerging victorious over the St.Maarten Medical Centre in its implementation of what the Inspectorate now calls “intense supervision.” (see related story on page 3).

The court ruling cleared the way for the inspectorate to proceed with a 13 point action plan that it wants the SMMC to follow, failing which, the medical institution will be fined $500 per day per item for every day that they surpass the deadlines set  to remedy “various terminal deficiencies” at the hospital. The fines are capped at $50,000.

The inspectorate said that it had not received any response from the hospital’s management except initial meetings with the Supervisory board.  The 13 point action plan was submitted to the hospital last Friday in lieu of the court decision.

There are several measures which the inspectorate can take if the hospital does not cooperate, Dr. Earl Best, the Inspector General said at a press conference yesterday. “We can take them in custody if they refuse and if there are serious threats to care in the departments in the hospital, we can also move for closure if it is a direct threat to patient safety and quality care.”

“The purpose of the investigation was not to get the attention of any member of the board but to safeguard the good level of care. Despite these specific demands and if matters are not addressed and if the level of health care is seriously threatened more severe measures can be taken,” Bloem stated, adding that the intention is to stay away from a worst case scenario.

The 13 point action plan reads as follow:

Procure that on or before October 26there will be an approved Rules of Regulation for the Board of Directors of SMMC as per article 5 of the Articles of Incorporation of SMMC and article 16 of the national ordinance on Health Care Institutions;

On or before October 26 ensure that representation of Management of SMMC in absence of members of the Board of Directors is regulated by means of a formal appointment of a replacement representative with the requisite experience and expertise, in accordance with the profile demands that apply for Members of the Board of Directors within the SMMC. This to be issued mandate is aimed to guarantee as per article 5 of the Articles of Incorporation of SMMC and articles 8, 9, and 16 of the national ordinance on Health Care Institutions;

That the Board of Directors is adequately represented in absence of one board member on St. Maarten. Consequently the quality of care and safety in the hospital is warranted (as per article 5 of the Articles of Incorporation of SMMC and articles 8, 9, and 16 of the national ordinance on Health Care Institutions);

That on or before October 26, ensure that the Member of the Board of Directors who is representing SMMC is at all times accessible by means of a service telephone. The medical specialists and all service providers at SMMC must receive the telephone number of the service telephone. (as per article 5 of the Articles of Incorporation of SMMC and articles 8, 9, and 16 of the national ordinance on Health Care Institutions);

Send an overview to the Inspectorate detailing all the dates whereon the present sole member of the Board of Directors of SMMC intends to not be physically present on St. Maarten for more than one day. This overview must warrant the physical presence of adequate representation by the Board of Directors in SMMC on St. Maarten. (as per article 5 of the Articles of Incorporation of SMMC and articles 8, 9, and 16 of the national ordinance on Health Care Institutions);

Procure that on or before October 26 all medical administrative data, medical data, files and computer files required for an adequate representation and care are placed on one (1) location within SMMC; (national ordinance on Health Care Institutions art 18);

Realizes that on or before December 8 the Board of Directors of SMMC is expanded with one member who will take on the portfolio  “Medical Technical matters”  and as such guaranteeing the continuity of the management; (Articles of Incorporation SMMC art.5; national ordinance on Health Care Institutions art.8, 9, 16);

To fill out the vacant Personnel Formation places within SMMC on or before December  8  for  the basic specialist medical care of: surgery, internal medicine, Ob-Gyn, pediatrics, anaestiology and radiology  (national ordinance on Health Care Institutions art. 9, 18);

On or before December 8 show  that the Board of Directors is actively negotiating with the medical staff pertaining to an Admittance Contract for  the Medical Specialists that will result in a mutually accepted Admittance Contract on or before January 1, 2013; (Articles of Incorporation SMMC art. 12; national ordinance on Health Care Institutions art.16, 18, 19);

Provide a suitable action plan on or before December 8 in conformity with the conditions imposed by the inspectorate as mentioned in the report with regards to findings pertaining to infection prevention in the surgery theater (national ordinance on Health Care Institutions art. 8, 9, 10, 20);

On or before December 8provide an appropriate action plan pertaining to the emergency care department (ER), the supervision, improvement of expertise of the medical staff, file management and a proper notification system for acute issues, a methodology to determine which patience needs must be addressed more urgently, introduction of protocols for to most common diseases and finally made working agreements with stakeholders (national ordinance on Health Care Institutions art. 8, 9, 10, 20, 21);

On or before December 8 deliver an updated disaster plan and a plan to promote “disaster awareness” and establish annual drills for the staff of SMMC (Vastgesteld Rampenplan Sint Maarten 4 Maart 2002 AB 2002 no. 8; national ordinance on Health Care Institutions art. 8, 9, 10, 20, 21);

Ensure that on or before December 8all committees in charge of safeguarding and managing the quality of care are staffed with at least three (3) persons and that these committees report quarterly to the Board of Directors of SMMC on various matters (national ordinance on Health Care Institutions art. 17).

“The Inspectorate sincerely hopes that SMMC this time around will devote its scarce resources and energy to ensuring that these demands are properly and timely met, instead of again resorting to litigation and continuing to resist the supervision exercised by the inspectorate,” Dr. Best added.

The  inspectorate believes that the sooner SMMC understands that it is subject to the external supervision by the inspectorate and must abide by the imposed demands to improve the level of care, “the sooner the quality of care on St. Maarten can be brought to what the St. Maarten citizens can and should within reason expect.”

The focus of the 9 month investigation by the inspectorate was into the quality of care at the hospital and not into financial irregularities of exorbitant travelling expenses of its director.

 

Did you like this? Share it:
Best: “We can take them in custody if they refuse” - Inspectorate imposes action plan by

Comments are closed.