 We received phone calls from different media houses regarding a female patient who passed away at the Accident and Emergency Department of the Owen King European Union Hospital on Sunday, 3rd of January 2021. First of all, we want to empathize with the family members of the deceased. One could well imagine the amount of pain or hurt that a family member or family members feel when they have lost the loved one. This patient came in on the Sunday at and was registered at 10.49 a.m. When I say registration, what do I mean? During the process of registration, series of information is guarded about the patient and that would include their name, their address, the date of birth, the next of kin, their denomination, occupation, etc. And that was done at 10.49 a.m. on the 3rd of January 2021. The patient was then triaged by the nurse at 11.01 a.m. and that's about 15 minutes after registration. During triage, the nurse, what the nurse does is that they take the vitals of the patient that would include their blood pressure, their respiratory rate, their pulse, the oxygen saturation, their blood sugar levels. They would ask the patient basically why they came in and that would give the nurse a good idea of how to rank the patient. There's an emergency severity index classification that is used so that patients are classified from one to five so that the nurses and then the physicians are given the information or they have a good idea on how severe the case is. Someone, if an emergency severity index of one is someone that is said to be an emergency case, that person wouldn't have to wait at all. They shouldn't wait at all or should be seen by the physician very quickly and someone if an emergency severity index of five is someone who is not a severe case, it's a mild case, that would be somebody with a mild rash or a burst. This particular patient had an emergency severity index of three. Having a meditative index of three, which placed them halfway between one and five, that person was clinically stable from what was documented on their vitals. They saw a physician two hours afterwards and after seeing the physician, the physician saw the patient giving instructions to the nurses so that they can start the treatment and that was done. The treatment was starting to give. According to our notes, we could have seen that the documentation and the time when the treatment was given. That particular patient was reexamined again at 3.50 p.m., which is two hours after the initial examination by the physician. Then the physician went back to look for that patient at 4.30 p.m. The patient was then reexamined at 5.30 p.m., which is an hour difference between the two. Then, unfortunately, at 6.00 p.m., the patient started to deteriorate very quickly, which was a sharp decrease from the vitals from when they came initially to what was happening at 6.00 p.m. Now, I just want to make it clear and let people know that when we have a case of that nature, whether family members complain or not, the clinical team in charge of the case would inform me as the medical director. It's important that we review cases, not because family members are complaining, but we need to review cases to see what we could have done to improve care or what we could have done differently and to improve our processes at the hospital. That is some of the things we do when we do an internal case review. What I could tell you is that in addition to reviewing the case, reviewing the files and the seeing exactly the time frames and what was done in the treatment regime, we also look at other things. For instance, I need to see, as the medical director, do we have staff members who were part of the treatment team entering or pushing information in the file that wasn't there before? That's important because if people, persons have to see a patient and you need to document and if the patient passes away and the file is taken away and information is included afterwards, that's cause for concern because then I cannot assume that you actually did what you did or are you putting it in because you feel that I need to put it in because the case is being reviewed and I don't want to get myself in problems. These are things I look at as well. The late reviews, the late entries, do we have persons squeezing in information? Is our information being taken off or removed? And so far in the CHAC review for this particular case, I have not seen any of this in the review of the file. Of course, I have to interview the different staff members who were involved in the clinical care of the patient, even persons that are in clinical support care because they may not very well be directly in contact with the patient, but they may have been part of the team, whether it be the security guard, the domestic assistance, and these are some of the persons you need to speak to to get a clearer picture of what's happening and what happened, what happened during a situation of that nature. Okay, so one of the things we also, another thing I wanted to bring on and I think it's important to let persons know is that we always encourage the physicians to speak to the next of kin and that is why during the registration process, we take the name of the next of kin and we take the number or numbers of the next of kin because the next of kin is the person that the patient would want information to go to or somebody that we can rely on if we have to do anything regarding the patients. So in that particular case, these patients in the next of kin happen to be a fiance, a boyfriend who we did speak to or my clinical team did speak to and inform of the situation and he was well informed. He was also very cooperative, I could tell you, and then he received the information well and he had a good conversation with the physician and I think very helpful in providing us with information to help us with the matter, the next of kin. It is up to the next of kin to decide whether he or she wants to inform the other family members. Okay, sometimes the next of kin would ask the physician and ask them to can you, can we bring in the mommy, can we bring in sister, brother, cousin, father to talk, we want to explain and the physician will say yes, sure, we'll agree. If the next of kin wants the rest of the family members to be there, when the news is given out or information is being shared then the next of kin would ask and the doctor would most likely say yes, we will agree to do so. But we leave it, the responsibility is that of the next of kin to decide who he or she wants to get information about the patient and most times the information are very sensitive and we prefer to share that information with the patient and if the patient insists with the next of kin because the next of kin is the person we have documented to give us the go ahead or to do that, to share that information with them. When I have noticed that other complaints were surging and that would have included persons using their phone regularly, people actually laughed at the patient when she fell down and that was cause for concern. When it comes to using off the phones, some of the staff are allowed to use, some staff members are allowed to use the phones and I'm talking about the physicians for instance before persons would have done x-rays and you would have to do it on a film and wait for the film to dry and you may have gone and you may have noticed that the physician would have to put the x-ray in an x-ray view box, viewing box. Now with health information, with internet, we've been able to change that and we allow the physician to get the x-ray so when it's done in the x-ray department, the physician can log into certain sites and get the x-ray on the computer in the accidental emergency department or on the ward or actually use their phone for them, their work phone, their work phone for them to see the images. The same thing would suffice or would happen, sorry, for the lab before persons would have to wait for the lab results, get it printed, send someone to collect the lab results and then the doctor would be able to decide the the way forward getting the lab results but now we have it in real time where when it's run and the results are there the physicians can go on particular websites, log on and actually get the results of their work phone or get it on the computer that's in the accident emergency department. So the physicians I would understand would have certain access, they would have access to their phones or the computer to be able to get information to allow the proper treatment of the patients but I do not think that every staff member in the accident emergency department should have access to their phone during working hours. So that is why it's very important that the family members, the next of kin along with family members who are concerned to come to the administration department of the Owen King European Union hospital and make their complaints. I think every single complaint is valid and I think that if you have one or two members of staff that they that they can pinpoint they may not know the name but they may be able to describe the person and say this is the person responsible for using their phone all the time, this is the person who was laughing at my love and my loved one when he or she fell off the bed then that would give us an idea of allow us to zoom down on the person who did that. We it's not difficult because we work in shifts and therefore we would know all the doctors on a particular shift, all the nurses on a particular shift, all the domestics or security guards on a particular shift or porters. So it's very is very important for us that the family members or the next of kin rather come in and complain and say this is this is a situation if somebody did something to you you may not be able to know the patient name the person's name sorry but if you can describe the person we'll be able to zoom down on the person on the shift because we have the notes and we know what time the person was seen at the facility and we may be able to deliver the particular person that that did that that did this to their family members. We have done a lot when it comes to customer service we've done customer service we've done rounds of training of customer service not only for clinical persons but clinical support care as well and I'm talking about our pharmacy our x-ray our lab our our persons when it comes to security our domestic assistance our porters all of these individuals were given the opportunity to do what you call customer service training and we've gotten very good ratings over the period over the months I could tell you that we've had we have persons right now who are calling to see x physician or y physician or they're asking to come in because this particular nurse is working it is not something that we try to encourage because you know it's an emergency department and we don't want persons to be coming into the department requesting to see one physician and wanting to see that physician all the time and they actually change it to a it's more like a clinic when they could really go to primary health care because it's not an emergency or they could go to their private physician but the fact that somebody wants to come or persons want to come in all the time to see certain physicians or because certain nurses are working because they like the care they receive that is a plus for us that tells us that not all our staff are bad we actually have some very good stuff that people feel comfortable with and they want to continue seeing despite the fact that they would have to wait for hours to see that patients because they're not very severe they actually just have something as mild as a filling a prescription which is running out or maybe maybe a headache or something that as simple as that that um that situation we also have um we also encouraging people um to come if you whenever you have a situation um at the hospital whether it be okay whether it be victoria hospital that we the administration department is is open and you is open we have an open door policy we we don't want persons to feel that if you come and complain about the the staffing or you have an issue when you the next time you come back you will not be treated fairly or you'll be victimized we have a way in which you can sit with you and speak to you and find out your challenges try to zoom down on the staff that is doing that to you and to make your state better the next time you come in because challenges exist and sometimes is through the patients that are complaining or family members that complain we can actually see the way in which we can improve the whole process okay so in um we're just letting persons know that um again management of okay which victoria hospital we do empathize with the family members um it is a hard time i do understand it's very hard for them um we we encourage the family members who are unaware of what happened to the patient to first speak to the next of kin who is the one that we share information with along the way and then if there are any challenges or they still feel that for the reason that they're not satisfied and they need to know more they can come with the next of kin at the administration department which actually we have it at okay uh and we'll be able to sit with them and even bring in the rest of the team so that they get more clarity on exactly what happened okay we are also looking forward to the post-mortem results which would give us a clearer definition on um the true diagnosis of the disease