GREAT BAY—The first reports of the review of the St. Maarten Healthcare Chain has been released by the Ministry of VSA, which shows strengths within the healthcare system and areas for improvement. According to Minister of VSA Emil Lee, one area the report found that needs improvement was the need for the St. Maarten Medical Center (SMMC) to improve its quality management system. “The auditor has found a number of areas for the SMMC to improve its quality management systems. This is the same process that all quality hospitals worldwide have to do on a regular basis. The audit was performed to be able to identify the specific areas for improvement in SMMC’s quality management system in a constructive manner. In the report these areas have been identified and are combined with specific recommendations for action to be taken,” a summary of the report said.
“What is encouraging is that the SMMC has fully embraced all recommendations to improve its procedures and the Health Inspectorate is also in agreement with this plan of action. Some of the areas of the needed quality improvements had already been started at the time of the audit. SMMC has employed a full-time quality control manager,” the summary added.
Another area is the verification of health care providers that come to work at the SMMC. “SMMC is the cornerstone of the healthcare system being our largest, most complex and most important systemic institution and therefore presented the first priority. The Ministry’s Department of Public Health is the front line on policy, development of synergistic laws to support quality and accessibility of care, and the screening of medical practitioners. The Inspector General of Health is responsible to verify that healthcare providers follow the laws and acceptable standards. Our signed accord with Aruba and Curacao further accelerates and improves this process through pooling of knowledge and resources,” the minister said in a summary of the report.
The minister further argued that procedure to establish qualified specialists that meet our legal standards is a very big challenge for the SMMC. As a result, first in the review process was how the Public Health Department evaluates specialists and the amount of time that it takes for the Department to process and approve new specialists that look to come to St. Maarten to practice. It has happened on more than one occasion, the minister disclosed, that a specialist has been identified by the SMMC and the processing time has resulted in the doctor finding other employment. On the other hand, time is required for this review process as it is the responsibility of the Public Health Department to ensure that the advice given to the Minister for medical professionals establishing themselves in St. Maarten meet the standards of the Netherlands in education and training as stipulated by law.
Meanwhile, the ministry noted that steps are being taken already to improve the specialist establishment process and the results of that process. An action plan from the present through 2019 is in place. The ministry is looking at a number of short term measures, such as accrediting degrees obtained from non-Dutch institutions whose curricula and content are at the least equal of that of the Netherlands. An exchange of specialists between St. Maarten, Curacao and Aruba is also being investigated.
Regarding the Health Inspectorate, the auditor found that the Health Inspectorate is highly motivated and committed to the quality of healthcare. The last major audit by the Inspectorate was carried out in 2012 which resulted in 36 areas of improvement identified. The auditor assigned to the review, Everard van Kemenade notes that the SMMC is making progress on compliance with the Inspectorate’s evaluations. The Inspectorate will conduct a fresh audit of the SMMC to assess this and further evaluate the current situation.
The SMMC has all the committees required by law and is quite proud of its low infections rate, but it can also be noted that not all committees function optimally and that certain data is lacking due to IT challenges. The IT upgrade being undertaken by the SMMC is robust and should meet the quality and data standards.
The SMMC is in a state of transition as it has embarked upon the human development to match the new hospital building development. The auditor found that SMMC has made strides on the action points from the Health Inspectorate’s 2012 audit, which have not yet been completed partially due to structural budget problems that were realistically solved last year. This financial improvement of the SMMC has allowed renewed progress on quality management issues the SMMC has now made the commitment to receive JCI accreditation in approximately four years. Both Aruba and Curacao hospitals have also made this same commitment.
The renewed quality management with the aim of JCI accreditation involves improving both people and system capacities and will require also the new facilities to be built with the new hospital building. The Management of the SMMC realizes this is an ambitious undertaking as JCI has over 1,000 procedures that must be verified and certified and is making a presentation for both the staff of the SMMC and the Ministry of VSA with a trajectory and timelines, the summary concluded.
The research question of this assessment has been: how can the Ministry increase the effectiveness and efficiency of the Process for Exemption to Federal Ordinance restricting the Establishment of Medical Professionals. This assessment took three days consisting of desk research and the topic was raised in six interviews.
Areas for improvement