Best Practices in Caribbean Health Care Healthcare Latest Issue May 2021 Trinidad

St. Augustine Private Hospital – “Where Patients Come First”

written by BVC May 14, 2021

St. Augustine Private Hospital

“Where Patients Come First”

Business View Magazine interviews Dr. Afraz Ali, Director of Obstetrics & Gynecology at St. Augustine Private Hospital, for our focus on Caribbean Health Care

When St. Augustine Private hospital first opened its doors in 1998, it was a small one-story facility in St. Augustine, Trinidad. The idea for the hospital was born when a local doctor, Dr. Jagdis Suratsingh realized a need for this type of facility on the Eastern part of the island. Working with three colleagues, Dr. Haffiz Warris, Dr. Denaesh Ariyanayagam, and Dr. David Strisiver, Dr. Suratsingh developed the first phase of the hospital, selling shares to other practitioners to raise enough capital to complete the construction. At its beginnings, the hospital offered general surgery, obstetric deliveries, routine gynecological operations and a small emergency service.

As the hospital’s clients and services grew, so did the need for expansion, resulting in two years of major construction, which was completed in 2009. Dr. Afraz Ali, Director of Obstetrics & Gynecology reports, “The hospital is now a four-story structure that has all the essential services you would want from a modern hospital, except for invasive cardiology, and a few other neurosurgical procedures. That’s where we are today. We have developed different departments – obstetrics and gynecology, general surgery, radiology and medical laboratory services – everything that you would find in a modern hospital.”

With only one other hospital in the area, St. Augustine Private Hospital fills an important need in the community and often works with the Trinidad and Tobago Ministry of Health. Dr. Ali acknowledges, “From time to time in our existence, we have had partnerships with the government, providing certain services for what we would call public health plans. Those services are bought by the Ministry of Health. For instance, St. Augustine Private Hospital was in a program with the Ministry of Health with respect to providing dialysis services. That was done for patients referred from the public service that require dialysis. Sometimes patients are referred who couldn’t be attended to at public hospitals because of the lack of available bed space, or because of the lack of the specialty that was required. Those patients would come to us.”

As a private facility, the hospital must also meet specific criteria set out by the Ministry of Health, in order to be licensed to operate. This license is renewed yearly, after an annual inspection from the Ministry.

St. Augustine Private Hospital has been committed to keeping all 180 members of its staff working, despite a 55 percent decrease in revenue when the country went into lockdown at the beginning of the COVID-19 pandemic. “Even though we had suffered from a revenue standpoint, we indicated very early on that we were going to ride this out, maintaining the staffing levels,” says Ali. “Nobody was terminated. Throughout the period we had constant consultations, developing certain programs within the hospital to provide counseling and stress relief responses and really teaching the staff how to cope. I’m sure everyone who was going through this experienced a certain amount of fear, trepidation, fatigue, uncertainty of their job security, etc. We also provided some training programs, so that as we come out of this, staff would be better trained and better qualified, in terms of being able to assist the hospital in moving forward.”

Although revenue increased slightly in August and September of 2020, the recovery was short lived. Ali recounts, “This had to do with the patient inflow into the hospital. The reason for that was really because of the pandemic. Patients were skeptical about coming to a hospital facility, even though we had put in place very early on all the screening protocols that the W.H.O. made very public, because we were following W.H.O. guidelines. We had screening set up before you entered the hospital, in the hospital itself, and with members of staff.”

As the hospital adapted to the changing situation brought by COVID, the need to add in-house laboratory services and PCR testing became obvious. Prior to the pandemic, those services were usually outsourced to some labs throughout the country. But COVID brought it to the forefront and St. Augustine Private Hospital saw the need to actually purchase that technology. According to Dr. Ali, “We see that now as a way forward because there is so much more in PCR aside from COVID testing. In addition to that, we’ve taken the opportunity to modernize some other equipment. Initially, there was a scarcity of medical apparatus like sterilizers. Towards the last quarter of 2020, we learned that there was a surplus of machines like ventilators and different sorts of sterilizers that could be bought for less than before. Being in touch with different parts of the world, we realized we could capitalize on that, so that as we get out of the pandemic, we would have new equipment – modernized and updated.”

The hospital is currently offering drive-through PCR COVID testing and is willing and ready to administer COVID-19 vaccines to the community, as they become available and if the Ministry of Health decides to use the facility as a vaccine distribution point.

Maintaining close relationships with local service providers such as St. Augustine Medical Laboratory has been beneficial for the hospital, as they develop their own lab services. “Dr. Bal Ramsaran and his staff have been very supportive to us in providing the quality of service from a medical laboratory standpoint,” says Ali. “We are into further developing our lab services, and we rely on some of his expertise in certain areas to partner with us going forward. We also have had great support from the medical supply companies in Trinidad and Tobago, as well as some of the pharmaceutical companies in terms of being able to be able to equip ourselves to provide the service we do. We pride ourselves in providing excellent service at a reasonable cost to our patients and clients.”

Prior to COVID-19, St. Augustine was already working to identify and meet workforce challenges. Dr. Ali shares, “Initially, it was a challenge competing with the public service. For example, with midwifery staffing, for the obstetrics and obstetric services, we tend to look at the pool of midwives that also work in the public health facilities. That sometimes proves a challenge in competing for their time. In the other sectors, we have introduced a training program where we get our own nurses trained. For instance, the operating theatre staff is trained in the scrub technician courses, and all our staff are receiving training in advanced life support services. We are looking to train in-house now, so we can rely on them and not have any deficiencies in staffing when it’s required.” The hospital remains committed to continued education, ensuring they can provide quality care to their patients through knowledgeable and experienced employees.

With plans to introduce invasive cardiac and neurological services in the future, the hospital is also working to become an internationally accredited health facility. This accreditation will allow St. Augustine Private Hospital to broaden their reach into the Caribbean and further, appealing to the health tourism industry. As they work towards this goal, St. Augustine Private Hospital also continues to plan their next steps as they move out of the pandemic and into the future.

Dr. Ali shares the vision for the hospital going forward, noting, “We will continue to provide efficient and cost-effective services to our clients. We also want to see that there are some better controls on the health services of the country and a greater public-private sector partnership. We understand that health care is extremely costly, and we understand that for a small island like ours, twin islands, to efficiently use the resources available, a public-private partnership, properly structured, will redound to the benefit of all the citizens of our country.”

As they continue their efforts to offer highly trained staff, up-to-date technology, and affordable services, St. Augustine Private Hospital is strongly living up to their tagline, ‘Where Patients Come First’.