Mr Gary Howard

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– Dr Rambaran– Patients cannot be served on ‘first come, first served basis’With the intention of improving the Triage system in the Accident and Emergency Unit of the Georgetown Public Hospital Corporation, a Triage Training Course was recently undertaken for medical professionals.Triage is the sole process by which a health professional is able to categorise the urgency of a patient’s medical needs in order to direct them to the proper medical care. According to Director of Medical and Professional Services, Dr Madan Rambaran, medical professionals in the Emergency Unit should not deal with patients on a “first come, first serve basis” but rather on the urgency of need. And making such a determination has its peculiarities thus the Triage Course was seen as essential.Dr Madan Rambaran (at right) in the company of the Vanderbilt Medical Centre Team.The training course was held at the Project Dawn Facility located at Liliendaal, Greater Georgetown. According to Dr Rambaran, Project Dawn which has been offering varying levels of assistance to the health sector has also been supportive of the Triage Training course.The Course comes as part of the public hospital’s collaboration with the Vanderbilt University Medical Centre of Tennessee, United States, and saw the participation of 13 doctors and 22 nurses both from the GPHC and other hospitals. According to Dr. John Paul Rohde of Vanderbilt, the Triage Course was developed at the invitation of the GPHC with the particular need to improve the Triage System, thus it was a customised course.“This is the first time that this course has been taught anywhere because it was designed specifically for GPHC.”The course, he explained was strategically designed to be delivered to both physicians and nurses on the concepts of Triage over a two-day period.Participants in a session on SaturdayThe objective of the instant two-fold training process, according to Dr Rodhe, was done with an emphasis on the physicians and the nurses working as a team. The final day of the programme was characteristic of an instructor course in which about 10 persons were identified as capable to continue teaching the Triage course even after the Vanderbilt team has left. However, Vanderbilt officials will return to monitor how well the health professionals have implemented their knowledge.Co-ordinating the Nursing aspect of the course, Mr Gary Howard, a nurse himself with a business background, said that back in the United States it is seen as important that nurses and physicians work very closely together especially in the area of Triage. Howard noted that the course was so designed that participants could take their content back to their respective facilities in order to teach same to many different people.“You will be able to teach them to do a standardise approach to assessing patients and getting them to the right health care provider.”Getting patients to the right health care provider is however a challenge in the Accident and Emergency Departments worldwide, Howard noted.“Our organisation struggles with high volumes of patients and capacity issues. We don’t have enough rooms for patients, we have patients in the hallway, we have patients that wait in the waiting area for a long period of time.”And it is no secret that the Emergency Room at the GPHC is not the best and is froth with certain weaknesses, said Dr Rambaran. He noted his cognisance to some criticisms, adding that there are some truths to what is being heard.“From time to time people are kept waiting there at the Emergency Room and people did not notice how sick they were.”As such, he noted that efforts are continually being made to improve the Accident and Emergency Unit at the GPHC.“We have addressed some issues by assigning more staff to the department, we have hired trained doctors. All of these are advances towards getting the best Emergency Room department for our principal hospital. In the big picture, we have been collaborating with Vanderbilt for several years and through that we have developed the capacity for emergency cardiac care.”In order to further improve the service offered, Dr Rambaran said that the focus is now on nursing care and medical care at the Emergency Room, adding that the Triage Care Course is only a little component.Some of the bigger ideas he said, will include the introduction of a Post Graduate Nurse Training for Emergency Care and a Post Graduate Doctor Training for Emergency Care. These programmes, he said will be centred at the GPHC and will be delivered by officials from Vanderbilt hopefully by September 2010. At the moment, Dr Rambaran said that certain approvals and accreditations are being sought even as a curriculum is being developed.