STATEMENT BY THE MINISTER FOR HEALTH AND SOCIAL DEVELOPMENT
HONOURABLE CARVIN MALONE
 AT THE FOURTEENTH SITTING OF THE SECOND SESSION OF THE FOURTH HOUSE OF ASSEMBLY IN THE VIRGIN ISLANDS

ON TUESDAY 22^ND SEPTEMBER, 2020

BVIHSA ACHIEVES INTERNATIONAL ACCREDITATION

Mister Speaker I am pleased to give account of the achievements in health care at the British Virgin Islands Health Services Authority over the last twelve months.  

Let me take this opportunity to start with what can only be described as a red-letter day for health care in the Territory, a watershed event, and a turning point for the delivery of health services.  

The BVIHSA, this week, after much hard work by the team over several years, and culminating under the dedicated leadership of Chief Executive Officer, Dr. Ronald Georges, has achieved full accreditation with the accrediting body DNV-GL (Det Norske Veritas (Norway) and Germanischer Lloyd (Germany)).  

The CERTIFICATE READS …

I am proud to say that this is the first hospital in the Caribbean region to be accredited by DNV-GL, a body that accredits over 635 hospitals in the United States of America and 15 hospitals across Brazil, China, Iceland, Slovenia, Czech Republic, and Thailand.  

Regionally, Health City Cayman Islands, Barbados Fertility Center, Bermuda Hospitals Board,  and Doctors Hospital in Bahamas, are accredited by Joint Commission International, while Queen Elizabeth Hospital in Barbados, Bermuda Hospitals Board, and Interhealth Canada (TCI) LTD in Cayman Islands are accredited by Accreditation Canada.  It is noteworthy that the BVIHSA which manages the Dr. D Orlando Smith Hospital is therefore one of only three public health systems in the region that has achieved internationally accredited status.

For those who may ask what does achieving accreditation mean for the BVI, it signifies that as a Government we have chosen to pursue a commitment to excellence in health care that will help us to build more confidence among our population, attract more patients, enhance and promote safe and high quality care for the people of the BVI.  By achieving this distinction the BVIHSA has demonstrated its ability and commitment to providing health care that has been evaluated against global standards.   

International accreditation has been a long held objective of the Ministry of Health which has, in fact, spanned at least four administrations.  The facilities of the New Peebles Hospital were designed with accreditation standards in mind, significant financial investments have been made, and the recent award of an Accreditation Certificate is a result of many years of hard work by our teams.  Several hundred new polices have been created and rolled out, and extra effort has been made over the years to review and improve the key areas that can affect the quality and safety of the care delivered by the BVIHSA.

The DNV program was chosen because it is more supportive and consistent with the BVI Health Services Authority’s long-term commitment to patient safety and total quality. DNV-GL is one of the leading accreditation bodies and utilizes a developmental stepwise approach to its accreditation to ensure that organizations, like the BVIHSA are placed on a path of continuous quality improvement and learning to ensure that they meet internationally accepted standards and best practices.  Specially trained health care professionals who are experts in their fields assessed how well the BVIHSA:

• provides a safe environment for patient care

• educates the patient about the risks and options for patient  diagnosis and treatment

• protects the rights of  the patient, including privacy rights

• evaluates the patients’ condition, before, during and after diagnosis and treatment

• protects patients and staff against infection

• plans for emergency situations organization wide

Accreditation by the DNV-GL is considered the gold standard in health care. It uses NIAHO (National Integrated Accreditation for Healthcare Organizations) standards together with ISO (International Standards Organization) 9001 standards for healthcare and ISO 15189 for medical laboratories.  Going forward the BVIHSA will be expected to maintain these standards and be open to continuous monitoring and inspections.

The DNV-GL approach and certification also addresses and leverages guidance and best practices across US Centers for Medicare & Medicaid Services, Brain Attack Coalition, American Heart Association, International Organization of Standardization, and the World Health Organization.  The assessment process was thorough and involved annual surveys and feedback that lay the groundwork for a stepwise improvement in quality and customer service through the entire three-year accreditation process.  

The BVIHSA undertook a self-assessment, followed by a readiness assessment and finally the formal assessment of compliance for DNV-GL/NIOSH standards earlier this year.  Year two will involve a follow up DNV-GL assessment, and ISO 9001 Pre-assessment in February of 2021 to demonstrate continued progress and a review of the organization’s Quality Management System (QMS), specific to the ISO requirements, and finally in year three, an ISO 9001 certification audit is added to the process to certify the organization’s quality management system.  

Mr. Speaker, It is remarkable that the BVIHSA was able to achieve this goal while dealing with multiple major hazard impacts since 2017.  Several major challenges were overcome and the BVIHSA made significant progress and was able to continue the assessment process.  This was testament to the dedication of the Chief Operations Officer, Mrs. Patricia Malone-Smith, the Quality Director, Ms. Yvonne Morgan and her team, and the teams of nurses under the direction of the Nursing Director, Mrs. Pearla Sylvester-Thomas and all the other healthcare professionals who worked tirelessly towards achieving this goal. 

Seven (7) noteworthy efforts were included by the surveyors in their report following the first audit.  I pause here to indicate that note-worthy efforts are those practices which can be considered best practices across the DNV-GL network of accredited facilities.  The following were noted in the BVIHSA audit:

• A unified inpatient prescription sheet
• Continuous learning and commitment across the organization
• Investment in software to support integrated care pathways
• Excellent record keeping
• Excellent reporting and analysis of quality indicators in the Dialysis unit
• No expired medicines or packs in the organization
• A high level of cleanliness

All of this was achieved while continuing to work on the Health Information System implementation and providing routine health care in the midst of a global pandemic.  This is evidence of the resilient nature of our people and our ability to work together to achieve this level of success.

The achievement of this accreditation now signifies the beginning of a journey for the BVIHSA which will only see stepwise and continuous improvements in health care into the future.  The BVIHSA cannot rest on its laurels at this stage but must continue the work and actively prepare for the next stages of ongoing assessment in 2021 and beyond.  The challenge remains for them to continue to improve and maintain the increasingly more stringent conditions that accreditation now places on service delivery and quality in the years to come. 

Critical to this improvement is the planned expansions of the Laboratory and Clinic space in the old hospital.  These are necessary for the laboratory not only to improve its quality and delivery of service but also to effectively meet ISO 15189 standards and similarly for the Outpatient and Road Town Clinics in the old Major Peebles Wing.  The Outpatient clinic on the second floor is also being retrofitted in a manner to provide additional bed space if required to expand the ability of the Territory to handle hospitalized cases of COVID-19 in a separate space from the main hospital.

In fulfilling its role in response to the COVID-19 pandemic, the team at the BVI Health Services Authority was able to initiate and certify PCR testing in country thereby removing the reliance on the CARPHA laboratory, reconfigure the third floor ward to a special isolation unit for COVID-19 patients, install additional ventilators, and ready the facility to not only detect and treat COVID-19 patients while protecting staff with appropriate PPEs, but conduct multiple mass testing and routine testing exercises to facilitate the detection and control of Covid-19 in the Territory. For this they should be highly commended and recognized.

Mr. Speaker, this Government continues to make special funding available to improve our health care services.  Following the system-wide IT malfunction at the BVI Health Services Authority the Government invested in a complete system upgrade to the tune of 2.9 million dollars which provides new network infrastructure, threat management, required hardware for the new Health Information System, telephone system upgrades, MS office suite and disaster management.  This will provide a long service life for the IT systems into the future and support business continuity plans that have been designed by the BVIHSA to allow for health care to be available to the people of the BVI even after major devastating impacts like those that we experienced in 2017.

As I have already alluded, this is just the beginning of a journey of service improvement and maintenance of high-quality care for our people.  Accreditation, while it can open up the Territory’s health system to opportunities such as medical tourism, primarily it demonstrates to us that we can achieve a health system locally that can meet international standards.  We therefore need to continue to build on this and to transform all our health facilities to match global standards, whether they are operating on Tortola, Virgin Gorda, Anegada or Jost van Dyke.  Our services must remain exceptional, continuous and consistent throughout the Territory.  

Mr. Speaker, COVID-19 brings many challenges but also opportunities.  Like I always say “never let a good crisis go to waste”.  It is therefore important that in the midst of challenge we continue to seize opportunities for continuous improvement.  Accreditation and certification are pathways to improve our entire health system across the public and private sectors and provide opportunities to both improve services locally and develop services which can be marketed outside of the Territory.  Achieving accreditation makes a strong statement to the BVI community about the BVIHSA and your Government’s commitment to provide the highest quality health care services to our people.  We are therefore proud of our achievements and we are very proud of the team at the BVIHSA. 

Mr. Speaker, Government is resolved that, given the capital investment and generous corporate and individual donations over the past 15 years of over $200,000,000 in buildings, equipment and furnishings, the BVI MUST attain the BEST in Primary and Secondary care. Deliberate and specific efforts will be given to updating the 40 legislations; 50 regulations and 35 policies that are afforded the Ministry of Health and Social Development. The team that will be tasked to undertake these tasks will allow Health & Social protection bodies to function in the manner envisioned when instituted. Earlier this year this house passed the updated medical Act and during this session the new Nurses and Midwives Bill would be introduced and with the members consent would be passed and brought into effect. Legislations governing private hospitals and medicines, together must be updated.

I will like to end by offering congratulatory remarks to the Chairman of the BVI Health Services Authority Dr. Joel Stevens and his Board for their stewardship, the Chief Executive Officer Dr. Ronald Georges and the management team for their exemplary leadership, and all of the health care staff and workers who have made all of these achievements possible under such trying and difficult circumstances and we salute them all.  As I close, I would like to remind that this is simply the beginning of a continued journey in pursuit of excellence and service in the delivery of healthcare and improvement of the health of the Territory.

Thank you, Mr. Speaker.