Patients can now expect shorter waiting times at the Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital with the completion of its $1.1 million renovation on two departments, as well as the establishment of a Day Care Unit.

The renovation and extension projects, aimed at improving efficiency in delivering healthcare services, have been carried out in stages since November 2016 involving the hospital’s Emergency Department and its Acute Medical Unit.

UPGRADING THE EMERGENCY DEPT

Previously, the Emergency Department had only undergone minor improvements not affecting hospital infrastructure. With the recent renovation and extension project, $104,000 was dedicated to upgrade the department with new equipment.

“Whatever issues that we have we do look into it, and we do strive to continuously make ourself better,” said head of department Dr Linawati Hj Jumat, who is also a consultant emergency physician.

The department is divided into three zones.  The red zone — designated to treat life-threatening emergencies — has been expanded to accommodate 11 beds compared to the previous six.

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The yellow zone, designated for non-life threatening but urgent cases — now has 21 trolleys with the potential to add six more. Previously, the area could only accommodate 10 trolleys.

Meanwhile, the green zone is for non-critical and non-urgent emergency cases. The department now has specific rooms catering for psychiatric patients (who are under police investigation), isolation cases such as tuberculosis,  as well as child emergencies.

Dr Linawati Hj Jumat (L) and Dr Irenawati Abdul Samad (C) speak to the media about RIPAS Hospital’s recently completed renovation. Photo: Rasidah Hj Abu Bakar/The Scoop

REDUCING LONG WAITING TIMES 

A total of 135,000 patients visited the Emergency Department last year, however 70 percent of these cases were non-urgent. “The long waiting time [to see doctors] is a very hot topic,” said Dr Linawati.

The function of the department is to treat critical and life-threatening emergencies, as well urgent medical problems.

“In terms of waiting time for the red zone and yellow zone, we are keeping to the standard. We have to see the patients immediately. The waiting time for patients in the green zone is also affected by the number of emergency cases we have,” said Dr Linawati.

Examples of non-urgent cases include patients with a cold, light fever or requesting blood pressure or sugar level checks.

“If we look at the statistics, we are seeing them within four hours. Looking at this statistic and comparing it with our regional counterpart [Singapore] we are actually on par.

The doctor urged patients with non-urgent medical issues to visit health clinics such as Berakas Health Clinic as they offer similar services as RIPAS Hospital.

Berakas Health Clinic provides primary healthcare services, and also offer services outside office hours (until 9pm).

RIPAS Hospital’s Medical Superintendent Dr Hj Ahmad Yazid Hj Abd Wahab added that patients can make appointments with a doctor by calling 2333991 to ensure they do not have to wait long to see a physician.

“This is not unique in Brunei, it is the same in the region and around the world. Our challenge is public education and disseminating information,” he said.

SAFETY AS A PRIORITY

Safety is also high among RIPAS Hospital’s priorities, especially following a fire at the Outpatient Department in October 2014 that prompted a mass evacuation of patients.

Dr Hj Ahmad Yazid said a committee was set up to look into the incident and they have been following recommendations put forward by relevant agencies, which include training their staff to be fire marshals. A Standard Operating Procedure (SOP) has also been put in place and fire drills have been conducted to test the hospital’s readiness level.

“We have nurses trained as fire marshals with the help of Fire and Rescue Department. These fire marshals are the ones in-charge of evacuating patients. We have more than 200 trained fire marshals and the training is still ongoing,” he said.

”If we look at the statistics, we are seeing [patients] within four hours. Looking at this statistic and comparing it with our regional counterpart [Singapore] we are actually on par.”

ACUTE MEDICAL UNIT 

More than $700,000 has been invested into RIPAS Hospital’s Acute Medical Unit.

It was set up in December 2011 to allow for further assessment and management of patients; facilitate the admission of patients; and to reduce the waiting time for patients in the Emergency Department to minimise potential of adverse outcome.

Acting Senior Medical Officer, Dr Irenawati Abdul Samad, said: “Acute Medical Unit is not a new concept in the medical world, but it is still something new for Brunei”.

The unit was originally set up in Ward 4 where it was a 32-bed mixed ward for male and female patients.

With the renovation project, the unit has been relocated to Ward 1 and 2,  with its capacity increased to 50 beds — enough space for the division of male and female patients.

Each ward is equipped with a bay of six beds that have close monitoring facilities for unstable patients.

“Once the patient is stable, usually within 48 to 72 hours, the patient will be transferred to other medical wards for other specialties to take over,” she said.

CUTTING UNNECESSARY ADMISSIONS

Established in September this year, the Day Care Unit is aimed at improving efficiency and avoiding unnecessary hospital admissions.

“Rather than admit patients unnecessarily, why can’t we just receive the patient in the morning and get everything done quickly by afternoon?” Dr Hj Ahmad Yazid said.

The Day Care Unit will also act as a one-stop assessment centre for patients about to undergo big operations.

Although the newly-opened unit is still a work in progress, it already has 12 beds and two reclining chairs for patients’ use.