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UPDATE: The Bahamas National Laboratory Testing Strategy in Response to COVID-19 (Part 3 and 4)

Today, Wednesday, April 22, 2020, the Extraordinary Official Gazette of the Bahamas published the Emergency Powers (COVID-19) (Amendment) (No. 5) Reguations, 2020, in response to the novel coronavirus disease (COVID-19) pandemic. https://opm.gov.bs/emergency-powers-covid-19-amendmentno-5-regulations-2020/

Regulatory Oversight

** By the Emergency Powers (COVID-19) (Amendment) (No. 5) Reguations, 2020, 6A. Regulation of Care, “the Competent Authority may by order, regulate the sector of persons providing medical, therapeutic and other patient care.” The Competent Authority, or the Office of the Prime Minister, may assume the role and responsibilities of technical and professional regulatory authority for the ENTIRE healthcare system of the Bahamas. **

This is a major development, in the response to the novel coronavirus disease (COVID-19) pandemic and the national laboratory testing strategy. In other words, the Ministry of Health, the Department of Public Health, the Public Hospitals Authority, as well as, regulatory agencies and councils of healthcare services, such as the Hospital and Healthcare Facilities Licensing Board, the Medical Council, the Health Professions Council and their respective executives, even the National Reference Laboratory, the Princess Margaret Hospital and private healthcare facilities, may be directed and governed solely by the Competent Authority, as deemed applicable, in respect to the provision and regulation of healthcare in the Bahamas.

The Bahamas National Laboratory Testing Strategy in Response to COVID-19 (Part 4)

During the latest Ministry of Health (MOH) COVID-19 News Conference, Thursday, April 16, 2020, the focus was on the national laboratory testing strategy, which is 1) the testing capacity 2) the testing capability and 3) regulatory oversight, in respect to the MOH’s response to the novel coronavirus disease (COVID-19) pandemic.

Regulatory Oversight

By the Proclamation of Emergency and subsequent Emergency Powers (COVID-19) Regulations, 2020, the Office of the Prime Minister was deemed the Competent Authority. The Minister of Health, the Managing Director of the Public Hospital Authority (PHA) and the person charged with responsibility for directing the day-to-day operations of any other entity or public body charged with responsibility for protocols with respect to COVID-19, shall report to the Competent Authority, during the continuance of the public emergency.

Prior to the COVID-19 Pandemic

The Bahamas was ranked 94th in the world’s health systems and one reason for such a ranking is that the standards and regulation of healthcare in the Bahamas do not meet international standards, in respect to conformity assessment. Self-policing and internal auditing, for example internal validation of testing, by public and private healthcare providers has been the strategy used and relied upon by governing agencies, such as Hospital and Healthcare Facility Licensing Board and the PHA.

This methodology of quality assurance in healthcare has proven to be inadequate by various international reports and studies, primarily due to conflicts of interests, fear of retribution (silence) and competency maintenance. Even though technical regulations and laws in healthcare have been enacted in which provisions are made, the lack of implementation and enforcement of public policies has diminished the effectiveness of their purpose, in assuring the quality of care given to the general public of the Bahamas.

In Response to the COVID-19 Pandemic

On March 11, the World Health Organization (WHO) officially classified the global spread of COVID-19 as a pandemic. The Office of Prime Minister established the National Coordination Committee on COVID-19 (NCCC), which is co-chaired by the Chief Medical Officer (CMO) of the Bahamas. “In addition to serving as a coordination and steering committee, the NCCC will also engage with the COVID-19 multi-governmental agency task force to implement decisions of The Bahamas government, recommend policies to the Cabinet and provide sector and society impacted analysis and feedback to Cabinet, as applicable.”

On March 17, the Governor General signed a proclamation declaring a public state of emergency, in which the Office of the Prime Minister was deemed the Competent Authority. Around this time, the services of Dr. Merceline Dahl-Regis, a former CMO of the Bahamas, a public health expert and chairperson to WHO's Global Validation Advisory Committee, was enlisted as a healthcare consultant to the Office of the Prime Minister. In this role, she has become the lead in the national health response to COVID-19 in The Bahamas and the liaison to the Competent Authority, providing guidance and oversight to all aspects, including the National Laboratory Testing Strategy, in which her affiliation with WHO/PAHO assisted in the adherence of international regulations and standards in the diagnostic testing and reporting of COVID-19.

The Quality Factor (The Q-Factor)

What is Six Sigma and How Can it Help with Capacity Building of a Quality Environment in My Organization? - The Q-Factor Six Sigma is a quality assurance strategy used by many leading global companies such as Amazon, the Ford Motor Company and Dell. It is called Six Sigma because of the strategy’s heavy dependence on statistical tools. The name refers to six standard deviations between average and acceptable limits ...