Death of 70-year-old man: Word of mouth referrals inappropriate – Doctor

Source: Ghana| Myjoyonline.com | Naa Sakwaba Akwa | E: faustine.akwa@myjoyonline.com
Date: 12th-june-2018 Time:  11:41:37 am

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The death of a 70-year-old man at the LEKMA Hospital in Accra has sparked, again, the debate about the state of Ghana’s health care delivery system.

Anthony Opoku Acheampong died over the weekend after many attempts to seek treatment at some six hospitals – C&J, Korle Bu, Korle Bu Policlinic, Ridge, Police Hospital, Trust Hospitals – failed.

His son, Ishmael Opoku, who was with him throughout the 1hr 48 minutes (49.35km) journey described his father’s condition at the time as an emergency, one characterised by headache and dizziness.

But none of the hospitals they visited administered even first aid until he died at the seventh, LEKMA.

According to Ishmael, without asking about the condition of the patient, all the nurses they met upon arrival at each of these hospitals blurted out the usual phrase “there are no beds.”

Outraged by the development, Ishmael took to social media to share his story, urging others to do same to force the government to address challenges in the health sector.

And they did. A young lady shared the story of how she lost her father two years ago after he was neglected at the hospital.

Medical Director at the Medicas Hospital, Dr Yaw Osafo, described the incident as unfortunate but added that until the systemic and individual issues bothering the health sector are addressed, incidents like these will continue to occur.

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The Korle Bu teaching hospital is Ghana's largest referral facility

Addressing the issue of referrals, he said health care practitioners must understand that word of mouth transfers are unacceptable.

“Once you identify that a patient has to go up a referral chain, you need to issue a proper referral, a written referral…we do not operate with a word of mouth referrals. It is unacceptable.

“The referral is a communication between a doctor to another doctor. So the doctor from the referring facility must communicate in clear terms with the doctor at the receiving facility through that referral note,” he said.

In the case of the 70-year-old man however, “what we hear is that there was a word of mouth referral. That word of mouth referral isn’t appropriate", Dr Osafo continued.

But the work of the health care practitioner does not end at issuing a referral letter.

Dr Osafo said even when that has been done, the referring doctor must call the receiving facility and ensure that the reasons for which the patient is being referred can be addressed there.

“If you’re referring a patient to a higher facility because the patient is losing blood…and that is the only reason why you’re issuing the referral then you need to know whether or not the receiving institution has blood.

“Because if they don’t, then what is the point of the referral,” he queried adding “it is going to be a waste of the patient’s time and that might also lead to some adverse outcomes.”

He lamented over the failure of hospitals to adhere to this simple principle which is leading to very preventable occurrences.

Another difficulty with health care delivery in the country, Dr Osafo notes, is the lack of adequate Accidents and Emergency centres.

Citing the Ministry of Health’s 2011 Accident and Emergency (A&E) guidelines, he said all health facilities are required to provide accident and emergency services.

“The document also states that ‘an area in the health facility shall be designated as the accidents and emergency unit …and operate a 24hr service and provide initial treatment for a broad spectrum of illnesses and injuries which may be life-threatening and require immediate attention.”

A health facility that abides by this guideline, for Dr Osafo, is not expected in any instance to deny a patient treatment, but “most of the facilities don’t have a designated area as an A&E and they do not have the requisite faculties and equipment to run a designated place as an accidents and emergency centre.”

A lack of implementation of the guidelines by the Ghana Health Service and the failure to address the many challenges plaguing the health sector will only make things worse, Dr Osafo fears.

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