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Today I am pleased to be invited to speak on this occasion, as we launch the Queen Elizabeth Hospital’s Community Health Workers Programme.
For approximately two decades Barbados’ healthcare system has been in the grips of a battle of epic proportions against chronic non-communicable diseases (NCDs). Research shows that in Barbados eight out of the ten leading causes of death result from NCDs, particularly heart disease, diabetes, hypertension and cancer. We estimate that approximately twenty-five percent of our population has one NCD either diabetes or hypertension and in some cases both. Furthermore, projections indicate that by the year 2025 at least one third of our population will have a NCD. Let that fact resonate with you. In the next 5 years projections indicate an eight percent increase in the number of Barbadians diagnosed with a NCD. According to the Barbados National Registry, in 2013 there were fourteen (14) heart attacks and fifty-three (53) NCD related strokes per month. If we extrapolate that data based on the projected eight percent increase in Barbadians with NCDs we will be looking at record numbers of heart attack and stroke victims presenting to our Accident and Emergency Department. In addition to the emergency medical care these persons will receive, these patients will also require intensive care, costing the QEH between $1,500 and $2,500 a day to treat these patients in a Medical Intensive Care Unit (MICU). For these and a myriad of other reasons the QEH has made a strategic decision to introduce a Community Health Worker Programme aimed at increasing treatment compliance and reducing the rate of readmissions of out-patients with diabetes and cardiovascular disease.
A wise man once said, (Henry Ford) “If you do what you’ve always done, you’ll get what you’ve always got” therefore it cannot be business as usual. We cannot afford to turn a blind eye to the impact these diseases have on our citizens. As of June 2020 the Cardiology and Diabetes Outpatient Clinics have over 2,250 active patients and on a monthly basis these over-crowded clinics receive approximately 260 new referrals from the Polyclinics and private physicians, and 80 to 90 percent of these patients are presenting with either deteriorating kidney function, diabetes, hypertension or all three. Therefore it is imperative that we establish a comprehensive management plan for dealing with NCDs. This means that in addition to a robust primary care system for early detection and our national health promotion programme, that we must meet these patients where they are and provide them with the necessary support at the community level. This is the pillar on which the QEH’s Community Outreach Programme rests.
In its first year the QEH Community Outreach Programme will target 500 patients from the hospital’s Cardiology and Diabetes Outpatient Clinics. These patients have been identified as having poor compliance and social challenges which negatively impact their care, resulting in repeat hospital admissions. To this end, 40 Community Outreach Nurses are being recruited and trained, and will be deployed to visit these patients in their homes. These home visits will help us learn more about these patients, and the barriers which they face on their road to wellness. It will also allow for the creation of individualised care plans suited to each patient’s social and healthcare needs. It is our expectation that the implementation of this programme will facilitate better care transitions for vulnerable patients from hospital to the home environment, strengthen the communication between the QEH and vulnerable communities, improve adherence to health recommendations, and reduce the need for emergency and specialist services.
It is my hope that this programme will significantly scale up actions to treat and reduce complications associated with poorly controlled cardiovascular disease and diabetes, resulting in an improved quality of life and better health outcomes for the members of these vulnerable groups.