Problems in the CMC operating rooms threaten high-quality patient care

July 31, 2023  –WILLEMSTAD – Alarming signals have been raised by the staff in the operating rooms of the Curaçao Medical Center (CMC). This team of medical professionals has expressed a long list of concerns that urgently need attention, as they are jeopardizing the delivery of high-quality care to patients. 

The staff’s biggest concern is the shortage of personnel. There are not enough people available to train new staff, which means the shortage is likely to continue growing. The existing staff members feel an immense workload and are being scheduled more frequently, which can lead to exhaustion and potential errors. 

There have also been reports of a shortage of necessary materials. This scarcity includes nets, instruments, tools, and medical equipment. Additionally, the warehouse where these items are stored is disorganized, making it challenging to quickly locate the required items. 

A lack of clear structure is a recurring theme. There is confusion about when patients should be on the operating table, which staff members are responsible for specific tasks, and who is allowed to communicate with other departments, such as the Central Sterilization Department. The operating room staff points out that miscommunication between surgery and anesthesia can jeopardize patient safety. 

The operating room staff observes a language barrier in the operating room, both between specialists and operating room assistants and also towards patients. Operating room assistants have to act as interpreters between specialists and patients. This leads to confusion among the patients as they are unsure about what will happen to them. 

Additionally, the staff mentions technical issues with the printers, hindering the progress of work. This is exacerbated by the fact that surgeries often begin without all the necessary instruments present, leading to improvisation and potential risks for the patient. 

Despite the high workload and the need to learn new processes, there is no time for training. Moreover, there is no budget for staff to attend conferences, while this opportunity is available for specialists. This may result in unequal levels of knowledge and could impact the quality of care. 

Finally, there is a series of logistical problems, including a lack of space in the warehouse, insufficient scanners, and issues with responsibility for stored materials. All of these disruptions affect the workflow and may lead to delays and potential errors. 

Health Inspection 

In analyzing the identified problems, the Health Inspection identifies eight main issues in the operating rooms of the Curaçao Medical Center (CMC). 

Firstly, the problems reported by the staff are being addressed proactively by the Board of Directors. For instance, the issues with the delivery of medical supplies are said to be much better than before. 

According to the Board of Directors, the language issues with patients are not as severe as indicated by the staff. Patients have not reported any concerns about this matter, according to the board. 

The attitude of the Board of Directors and the insufficient tackling of the bottlenecks create a perception that there are no solutions to the problems, according to the Health Inspection. 

Furthermore, the Medical Staff Board should also be heard, as they have expressed important concerns and advice that align with the issues indicated by the staff, the labor union, the Association of Medical Specialists, and the operating room management. 

The shortage of operating room staff is considered a serious problem by all departments of the CMC, which is consistently addressed with temporary solutions but lacks a structural resolution. This leads to discontinuity in the operating room’s productivity, according to the Health Inspection. 

The issues experienced on the shop floor are partially acknowledged by the operating room management and the Board of Directors, but solutions and concrete action plans are lacking. As a result, the staff feels compelled to seek work elsewhere. 

The problems of the supporting departments constitute significant obstacles to the optimal functioning of the operating room complex, according to the Health Inspection. 

Not at ease 

Medical professionals who have read the report from the Health Inspection are not at ease that the problems can be resolved through a stronger approach from the Inspection itself. 

The bottlenecks, according to the Health Inspection, need to be further analyzed by an internal project team, while that was precisely one of the objectives of the Inspection’s report. 

The core of the problems identified by the involved parties is primarily the understaffing issue, too many fluctuations in staffing due to foreign influx, insufficient clear management, and a significant gap between the shop floor and the Board of Directors. 

However, the most significant problem is the budget issue, and it seems unsolvable in the current context.