The LesLois Shaw Foundation, alongside the Hospital for Sick Children, the Barbados Ministry of Health (MOH), Queen Elizabeth Hospital (QEH), and the University of the West Indies (UWI) commit to establish the Shaw Paediatric Centre for Excellence in Barbados over the next seven years.
The partnership has four main pillars. First, the program will advance paediatric education in Barbados by supporting Caribbean physicians to access four fellowships in paediatrics at SickKids. Additionally, SickKids, local educational bodies, and the Ministry of Health will partner to develop a one-year post-basic nursing program in paediatrics for approximately 40 nursing students.
Second, the program will support a partnership between SickKids and QEH to focus on quality improvement initiatives, leadership development, and clinical mentoring; and will create a patient amenities fund to support a finite number of critically ill children from across the Eastern Caribbean to travel to Barbados each year to receive tertiary care at QEH Paediatric Centre for Excellence.
Third, the program will collaborate with the UWI to increase the capacity for paediatric-specific research and innovation through six international fellowships in quality improvement; three targeted catalyst grants to explore new areas of paediatric research and policy; and funding for two academic post-doctoral positions to facilitate linkages between researchers, clinicians, and policy makers.
Fourth, the program will support the refurbishment of eight polyclinic waiting rooms and assessment areas with new seating, child play areas, and standardized medical equipment for health assessments and monitoring; the refurbishment of QEH paediatric ward, neonatal intensive care unit (NICU), and waiting areas; procurement of standardized vital monitoring equipment and more specialized equipment; and establishment of a simulation lab at QEH. In total, commitment partners anticipate reaching 100 nurses, physicians, and other hospital staff with improved paediatric education and training opportunities, granting over $400,000 USD to paediatric research and innovation, and investing over $1,000,000 USD in hospital and polyclinic infrastructure and upgrades.
Years 1 – 3 (months 1 – 36) will focus on the first pillar: improving paediatric education and establishing a critical mass of health workers with expertise in paediatrics. This phase will include project inception, design, development of the implementation and reporting plan; the development and launch of the paediatric nursing training program; and the recruitment of four physicians for paediatric fellowship. This phase will also lay the groundwork for the design and execution of the facility upgrades at QEH and the polyclinics.
Years 4 – 5 (months 37 – 60) will include mid-term evaluation and focus on the second pillar: the QEH-SickKids partnership on quality improvement (QI). This includes eight high priority QI initiatives, as well as the launch of the patient amenity fund to provide support for dozens of families needing access to care.
Years 5 – 7 (Months 61 – 84) will focus on the third pillar: launch of the UWI and QEH research and innovation program. This will include six international fellowships, three catalyst grants, and two local post-doctoral fellowships. This period will also include end of program evaluation.
The fourth pillar – hospital and polyclinic refurbishment – will begin in Year 1 and continue throughout the seven-year duration of the commitment.
Barbados is a small island developing state (WHO classification indicating sustainable development challenges), with limited ability to invest in paediatric health care. It has a significant shortage of nursing staff, with less than 50% of required posts filled. The Barbados health system lacks succession plans for key physician posts in paediatrics and has limited health services that target children after the age of five.
Queen Elizabeth Hospital (QEH) is the only public, tertiary-care hospital in Barbados. It has long wait times and limited capacity due to a significant burden from inpatients with treatable conditions such as asthma, sickle cell disease, and diabetes. The paediatric wards at QEH and the child health spaces at Barbados polyclinics are outdated, lack standardized equipment, and include workstations that negatively impact patient experiences and sometimes outcomes.
These systemic challenges compromise access to quality health care services for children in Barbados, and across the Caribbean region. Furthermore, they are only magnified in the face of growing threats from hurricanes and other climatic events in the region, when the need for services increases significantly, the health workforce is strained, and fragile health systems are tested. Initiatives to support the health workforce, improve healthcare quality, advance research and innovation, and improve the health-seeking experience have a significant role to play in improving both patient outcomes and the resilience of island nations in the face of the growing threats from climate change.