Queen Elizabeth Hospital ‘Getting Better Together’
Equipment Prospectus
Foreword Over the past 3 years, the Board of Management of the Queen Elizabeth Hospital (QEH) has expended significant financial resources towards the recapitalisation of the ageing hospital plant. If we are to keep apace of the constant changes in medical technologies, we must find innovative ways to finance ongoing capital acquisitions.
Significant strides have been made in exploring and exploiting the benefits of Information and Communication Technology (ICT). We have adopted teleradiology as an approach to expanding capacity for real time reading and interpretation of diagnostic images. By year end, we will complete the installation of a Radiology Information System (RIS) that will permit hospital-wide access to all diagnostic images. Dispensing at the pharmacy is now fully computerized with the installation of the ABACUS Pharmacy Plus software. The Datix application software allows us to track complaints, accidents and incidents which have significantly improved our ability to mitigate foreseeable risks and errors thereby improving our risk profile and patient safety. The laboratory has recently completed the installation of a Laboratory Information System (LABIS) which allows for the electronic distribution of laboratory reports throughout the hospital. We are at early stages of evaluating tenders for the digitization of medical records which when implemented will lay the foundation for the introduction of electronic medical records. These are but a few technological initiatives that leading to the implementation of a computerized Hospital Information System.
In furtherance of the above initiatives, we invite private sector partnership to assist the QEH in its continued modernisation programme. This Equipment Prospectus presents a list of equipment of the highest priority that would have the greatest impact on patient-care and improvement to quality and
good outcomes. In that regard, we take this opportunity to invite companies, NGO’s, philanthropic organizations, individuals and the Diaspora to be a part of our vision in transforming the QEH as a world class provider of acute care. To echo the sentiment of our Chairman “...we want to be recognized as the best place to work, the best place to practise medicine and the best place to receive healthcare”. Become a partner on this journey towards ‘Getting Better Together’.
Dr. Dexter James Chief Executive Officer Queen Elizabeth Hospital
Contents Background 5 QEH Medical Equipment Necessity List 7 How Can I Make a Donation?
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Background The Queen Elizabeth Hospital (QEH) is Barbados’ primary acute care medical facility which provides emergency care on a 24-hour basis. Additionally, this 600-bed facility provides 94% of all hospital beds on the island and is a referral centre for patients from other English-speaking Eastern Caribbean states. It is also an accredited teaching hospital affiliated with the Faculty of Medical Sciences of the University of the West Indies (UWI).
Since its establishment in 1964, the QEH has undergone major improvements in its capability to provide care for the acutely ill, with the development of Medical, Surgical and Paediatric Intensive Care Units. While the institution continues to experience growth, many environmental changes have impacted on its operations.
Among the most important factors are the demographic changes in the population and changes in disease profiles which account for the growing demand for varying health care modalities. These trends, along with economic constraints present challenges in the QEH’s ability to deliver more innovative and pervasive interventions for health care delivery.
The QEH currently provides specialist services in Paediatrics, which is supported by the Neonatal Intensive Care Unit (NICU) and the Paediatric Intensive Care Unit (PICU); Medicine with its various sub-specialties; and Surgery. A health service for men is provided by the Urology programme, while the department of Obstetrics and Gynaecology provide complete women’s health services. The work of these departments is complemented by paramedical and clinical support services which provide diagnostic, therapeutic and social support.
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If the QEH is able to replace its equipment and have more modern technology integrated into all areas of its operations, patients would experience greater efficiency at the lone acute care facility on the island and have access to many sophisticated tests and procedures.
As the QEH continues to fulfill its mandate of becoming a World Class provider of acute care, the improvement and expansion of the quality of patient care remains the main focus. The primary step which will therefore be implemented in addition to the replacement of obsolete capital equipment and purchase of new and advanced equipment, are some special infrastructural and operational initiatives which are planned for the 2012-2013 Financial Year.
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QEH Medical Equipment Necessities COBALT MACHINE The Oncology department like many others has suffered from a lack of necessary and sufficient equipment to perform optimally in the delivery of patient care. The current Cobalt Machine which is used to administer radiation therapy for cancer treatments is in need of a new radioactive source. Number required: 1 | Estimated Cost: $1.1M USD
GAMMA CAMERA AND BRACHY THERAPY TREATMENT Number required: 1 | Estimated Cost: $770,000 USD
UROLOGY EQUIPMENT Prostate cancer is the most commonly diagnosed form of cancer in men and Barbados has the second highest incidence of prostate cancer worldwide. The QEH is in need of a major capital injection of $150,000 USD for urology equipment to properly outfit and service the Urology department. This will go a long way in expanding our capacity to diagnose and treat patients.
COLONOSCOPES Colonoscopy is generally recommended when the patient complains of rectal bleeding or has a change in bowel habits and other unexplained abdominal symptoms. The test is frequently used to test for colorectal cancer, especially when polyps or tumor-like growths have been detected using the barium enema and other diagnostic tests. A colonoscope is a necessary tool in this process and the QEH needs two of them, however, this piece of equipment requires regular replacement. Number required: 2 | Estimated Cost: $20,000 USD each
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VITAL SIGNS MONITORS Every day critical patient care decisions are made based on an essential medical device called a vital sign monitor, which tracks a patient’s vital signs. The QEH needs twenty vital sign monitors which will be spread across various clinical service areas including the Medical Wards, the High Density Unit (HDU) and Accident & Emergency) Number required: 20 | Estimated Cost: $17,000 USD each
CARDIAC MONITORS The nature of heart disease in Barbados has changed and added to that, the number of cases being diagnosed has risen and is continuing to rise. With the move to expand cardiac services with the establishment of a cardiac unit at the QEH there is a need for cardiac monitors. Number required: 4 | Estimated cost: $28,000 USD each
VENTILATORS A ventilator is a machine that supports breathing. These machines: • Get oxygen into the lungs • Remove carbon dioxide from the body. (Carbon dioxide is a waste gas that can be toxic.) • Help people breathe easier • Breathe for people who have lost all ability to breathe on their own. A ventilator is often also used for short periods, such as during surgery when you are under general anaesthesia. The QEH needs 23 ventilators for replacement in its Intensive Care Units (NICU, PICU, MICU, SICU) and Recovery Room. Number required: 23 | Estimated Cost: $363,000 USD each
FOETAL MONITORS
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With an average of 3100 births at the QEH annually, foetal monitoring becomes a very valuable tool. These monitors are used for measuring foetal well-being and assessing labour progress. Due to the sensitivity of the monitor, it may indicate when a contraction is diminishing even before notice of the pain subsiding occurs. The QEH needs 17 foetal monitors for use in Labour wards, Obstetrics wards and Antenatal clinics. Number required: 17 | Estimated Cost: $11,000 USD each
WOUND CARE EQUIPMENT The increased prevalence of diabetes and the associated care of the diabetic foot has necessitated the expansion of our wound care management services. As such the QEH is in need of equipment to expand and facilitate these services. Estimated Cost: $15,000 USD
ANAESTHETIC MACHINES An anaesthetic machine is a complex collection of equipment used by our anaesthesiologists to support the administration of anaesthesia. These machines are designed to provide an accurate and continuous supply of medical gases, mixed with an accurate concentration of anaesthetic vapour, and deliver this to the patient at a safe pressure and flow. The QEH needs two of these machines for its Surgical department. Number required: 2 | Estimated Cost: $90,000 USD each
ERCP SCOPE The Radiology department at the QEH is in need of an endoscopic retrograde cholangiopancreatogram (ERCP) scope for use in conjunction with its Fluoroscopy machine. ERCP is a test that combines the use of a flexible, lighted scope (endoscope) with X-ray pictures to examine the tubes that drain the liver, gallbladder and pancreas. Many patients who need ERCP are hospitalised, but ERCP can also be performed as an outpatient procedure, depending on the patient’s condition and on the complexity of the required procedure. Number required: 1 | Estimated Cost: $23,000 USD
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INFUSION/SYRINGE PUMPS The QEH requires 30 infusion/syringe pumps for distributed use across all wards, Intensive Care Units (ICUs) and Recovery Rooms.
These pumps administer fluids, medication or nutrients into a patient’s circulatory system in ways that would be impractically expensive or unreliable if performed manually by nursing staff. For example, they can administer as little as 0.1 mL per hour injections (too small for a drip), injections every minute, injections with repeated boluses requested by the patient, up to maximum number per hour (e.g. in patient-controlled analgesia), or fluids whose volumes vary by the time of day. Number required: 30 | Estimated Cost: $9,000 USD each
BLOOD GAS MACHINE The QEH Laboratory requires a Blood Gas Machine also called the Blood Gas Analysis or the Arterial Blood Gas Analysis. This is used to diagnose and evaluate respiratory diseases and conditions that influence how effectively the lungs deliver oxygen to and eliminate carbon dioxide from the blood.
Lab Number required: 2 | Estimated Cost: $158,000 USD each
16 SLICE CT MACHINE The QEH currently has one 64 Slice CT Machine, however we are in need of a 16 Slice CT machine as this will serve as the ‘workhorse’ machine for routine CT’s in addition to serving as the redundant machine to allow for the service and repair of the other machine. It is anticipated that this will be a turnkey project. Number required: 1 | Estimated Cost: $1.5M USD
ECHO MACHINE & PICTURE ARCHIVING AND COMMUNICAITON SYSTEM (PACS) An echo machine or usually called an echocardiograph machine is used in the cardiac unit of the QEH and we are in need of a replacement machine. In conjunction with the Echo Machine is the need for PACS which is a medical imaging technology which provides storage of, and convenient access to, images from multiple modalities Number required: 1 | Estimated Cost: $300,000 USD each
TRANSPORT MONITORS When patients are moved to a new location, it is vital that their monitoring information goes with them. The transport monitor provides uninterrupted monitoring so you can stay aware of the patient’s condition even during transport.
The QEH is in need of two additional Transport Monitors to facilitate the quick and safe movement of patients throughout the hospital without losing a moment of critical monitoring information. Number required: 2 | Estimated Cost: $37,000 USD each
BARIATRIC BEDS & WHEELCHAIRS Bariatric patients often require specialised beds and wheelchairs in order to support their frame, enable access, let nursing staff move the bariatric patient, and to provide comfort for bed-ridden bariatric patients recovering from illness or surgery.
These
pieces
of
equipment
make
looking after a bariatric patient more efficient. Most technologically advanced bariatric beds suspend a bariatric patient on air cushions which can be individually raised and lowered by the patient or a
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nurse. This means that a patient can constantly shift the points of pressure on their frame, helping manage bed sores. It can also make helping clean, inspect and turn bariatric patients more dignified and safe for all parties concerned.
BEDS WHEELCHAIRS Number required: 2
Number required: 3
Estimated Cost: $150,000 - $250,000 USD each
Estimated Cost: $10,000 USD each
HOSPITAL INFORMATION SYSTEM (HIS) The role of information technology in the hospital has undoubtedly grown. Although we have started laying the foundation for a move towards a Hospital Information System (HIS), there is a dire need for significant investment for the procurement of additional computers, replacement of obsolete systems and upgrade existing units where possible across the hospital plant as we seek to exploit the use of ICT as one approach to driving internal efficiencies. We are seeking to adopt Tele-Medicine Solutions to expand access to specialist diagnostic and clinical services. There is always a need for computers to be deployed across the plant. Number required: Contact the Hospital directly for more information.
RADIOLOGY INFORMATION SYSTEM (RIS) The QEH has just implemented Tele-radiology solutions in A&E, Outpatients clinics at Enmore, Operating rooms and provides remote access by radiologists to provide more immediate access to radiological assessments. This is but one move to transforming the Radiology department into the digital era. A RIS would enhance this implementation towards making the retrieval of patient information along with their past and current radiological investigations more efficient. Number required: Contact the Hospital directly for more information.
WARD REFURBISHMENT The QEH is an ageing plant. As we seek to improve the level of service to our patients and become more patient-centred, the environment of care plays an important role in the delivery of that service. It has become necessary to upgrade our wards to accommodate the changes in our services and reflect a change in our service delivery. Contact the QEH directly for more information.
PATIENT TRANSPORT VEHICLES
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The Orderly department at the QEH provides transportation services for an average of 3100 patients per year, who have appointments at both the Hospital and other healthcare facilities for services not offered at the QEH or when equipment malfunctions. It is a service that is heavily depended on by the public and can seriously compromise healthcare I not efficiently provided. These vehicles are also used to provide transportation to nurses who need to get to and from the bus terminal at night before or after their respective shifts. Number Required: Contact the QEH directly for more information.
WARD BEDS Number required: 200 Estimated Cost: $175,000 USD
TRANSPORT TROLLEYS The QEH is in need of eight patient transport trolleys for the Operating Theatres, Accident & Emergency (A&E) and Outpatient Clinics. The key value to these pieces of equipment is that they facilitate moving patients and sheet onto a fixed bed or table in various clinical areas of the hospital. Number required: 8 | Estimated Cost: $8,100 USD each
PLANT ROOM PUMPS
Number required:4 | Estimated Cost: $20,000 USD each
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OPHTHALMIC MICROSCOPES The QEH continues its works to refurbish the Lions Caribbean Eye Care Centre (LCECC). The plan is to create a centre of excellence for eye care in the Caribbean. The need therefore is to fully equip the Eye Clinic and Eye Operating Theatres.
In Barbados, most blindness is due to cataracts and open-angle glaucoma. Treatment for these conditions may include surgery. Having a surgical microscope available for use in these and any ophthalmic procedure, allows the surgeon to experience the eye in more detail than ever thought possible. Additionally, this microscope adds to an efficient work flow and allows for more procedures to be done. Number required: 3 |Estimated cost: (LUMERA 700) $145,000 USD each (LUMERA S-7) $74,000 USD each
PORTABLE RADIOS The Emergency Ambulance Service (EAS) is currently in dire need of portable radios as all communication needs come from the fixed ambulance radio. If the ambulance crew are away from the ambulance and working on a patient e.g. in a hotel room or in a home, they have to wait until they return to the ambulance to make contact with headquarters or A&E medical personnel.
These portable radios also provide the option of being used as mobile phones should there be any problem with other radio communication.
Number required: 6 | Estimated cost: $5,000 USD each
AIR-CONDITIONING UNITS
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The QEH is in need of a number of replacement ducted air-conditioning systems for the patient-care areas in Oncology, the High Density Unit (HDU), the ICU Block and Obstetric Theatres. Number Required: Contact the QEH directly for more information.
OTHER ITEMS In addition to the large pieces of equipment outlined in the Prospectus, there are several other items which the QEH requires. A few are listed below however you may contact the Director of Engineering Services via email: des@qeh.gov.bb to find out more.
1. Zimmer frames – walkers
12. Manual blood pressure machines
2. Computers
13. Machines to measure blood sugar and strips
4. Televisions
14. Air flow mattresses
5. Crutches
15. Sphyg monitors
6. Commodes
16. Scales
7. Drip stands
17. Patient lifts – bariatric
8. Overbed tables
18. White boards for wards
9. Scanners
19. Sheets > 250 thread count
10. BP cuffs 11. Wheel chairs
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A portrait of our patient care.
Donate NOW! DONATE NOW!
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As outlined in the Equipment Prospectus, there are many necessary pieces of equipment required by the Hospital. We are pleased to offer you the opportunity to make a donation. Fax the completed form to: 1 (246) 429-5374. Donor Information (please print or type) Name Address City Country Telephone (home) Telephone (business) Fax E-Mail Contact Person Donation Information I (we) will make a donation of $_______________ towards the following item(s): 1. ___________________________________________________________________________________ 2. ___________________________________________________________________________________ Credit card type Credit card number Expiration date Authorised signature Acknowledgement Information Please use the following name(s) in all acknowledgements:
____ I (we) wish to have our gift remain anonymous. Signature(s) Date Please make cheques or other gifts payable to: The Queen Elizabeth Hospital Wire Transfer Information: The Queen Elizabeth Hospital Martindale’s Road, St. Michael, BB11155 Ac#: 018005512003 Swift Number: BNBA BB BB
REPUBLIC BANK #1 BROAD STREET BRIDGETOWN BARBADOS BB11000
Queen Elizabeth Hospital ‘Getting Better Together’