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Anaesthesia in Barbados
K B Shankar1, H S Moseley, P S Mushlin
1Department of Anaesthesia, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115, USA.
Insights
Barbados
Area of Science:
- Anesthesiology
- Healthcare Management
- Public Health
Background:
- Queen Elizabeth Hospital (QEH) is the primary healthcare provider in Barbados.
- The hospital faces challenges including financial constraints, infrastructure limitations, and administrative bureaucracy.
- These factors impact the availability of drugs, supplies, personnel, and equipment.
Purpose of the Study:
- To describe anesthesia services in Barbados.
- To identify challenges faced by the QEH Anesthesia Department.
- To outline strategies for optimizing anesthesia safety and cost-effectiveness at QEH.
Main Methods:
- Authors with extensive anesthesia experience at QEH.
- Consultation with the Dean of the University of the West Indies Medical School (Barbados campus).
- Review of Barbados archives and QEH records.
Main Results:
- Despite modern healthcare, QEH contends with resource limitations.
- The Anesthesia Department implemented proactive measures: an audit system for supplies, local equipment maintenance training, an oxygen concentrator purchase, reduced nitrous oxide use, and internal quality standards.
- These strategies aim to mitigate shortages and improve efficiency.
Conclusions:
- Sustaining high-quality, cost-effective anesthesia requires strategic planning and resource allocation.
- Close collaboration between healthcare administrators and clinical departments is crucial.
- Empowering departments to influence resource allocation ensures alignment with institutional priorities.
Purpose:
To describe the anaesthesia services in Barbados: to present the major challenges confronting the Anaesthesia Department of the government-owned Queen Elizabeth Hospital (QEH): and to describe the Department's approaches to optimise safety and cost-effectiveness of anaesthesia at QEH.
Source Of Information:
Authors (KBS, HSLM, RAH), who collectively provided more than 50 yr of anaesthesia at QEH; the Dean (ERW) of the University of West Indies Medical School (Barbados campus); archives of Barbados; and records of QEH.
Principal Findings:
The government of Barbados provides modern health care services to all of its citizens, primarily at QEH. Barbados, however, has tight financial constraints, infrastructural limitations, and a bureaucratic administration that predispose QEH's Anaesthesia Department to unexpected depletions of drugs and disposable supplies, sporadic shortages of personnel and functioning equipment, and occasional quality assurance problems. To deal with such problems, the Anaesthesia Department has implemented several pro-active measures: establishing an audit system to prevent depletion of imported drugs and supplies: training local personnel to maintain equipment: purchasing an oxygen concentrator to reduce oxygen costs: decreasing nitrous oxide use (expensive in Barbados): and initiating its own quality and safety standards.
Conclusion:
Continuous delivery of high quality, cost-effective anaesthesia care requires thoughtful planning by administrators and judicious resource allocations. Health care administrators and clinical departments need to work together closely to establish a framework that enables departments to play a major role in determining how the institution's limited financial resources are best allocated to meet the departmental priorities.