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Departments, Specialised Units and Centres Highlights

HUGH WYNTER FERTILITY MANAGEMENT UNIT

The primary mandate of HWFMU is to utilize evidence based technological innovations in particular, Minimally Invasive Gynaecological Surgery and Assisted Reproductive techniques to provide quality women's healthcare to meet the needs and expectations of women in the community, nationally, regionally and globally. In addition, to provide excellence in research and training of nurses, undergraduate and postgraduate medical students and to promote awareness and provide preventative medicine services through outreach initiatives.

The Hugh Wynter Fertility Management Unit (HWFMU), under the stewardship of Dr. John Harriott, Interim Director, has made strategic moves to improve the four interconnected areas of focus, namely Clinical Services, Training, Research and Outreach.

Since February 2022, he has implemented initiatives to accelerate the income generative capacity of the HWFMU by upgrading and expanding the Minimally Invasive Gynaecological Surgery Unit (MIGSU) and operationalising the second operating theatre.

This included repair of operating room equipment (OR1 system, anaesthetic machines) and enhancing the video image quality by upgrading to 4K LED monitors. In order to facilitate the increase in throughput of the MIGSU, the first floor was renovated and repurposed as a 10-bed postsurgical suite. Furthermore, extensive effort has been made to increase the reach of the HWFMU both nationally, regionally and internationally, in particular, the diasporic population, using the digital space and through improvements in customer satisfaction. This was achieved by alignment of the quality management system with the quality objectives and the requirements of the stakeholders. The target throughput of the IVF laboratory has been increased to 30 new cases per month.

This strategic direction of this income generating centre is aligned to the Triple A strategic plan for the University of the West Indies to achieve greater access, alignment and agility in advancing sexual and reproductive health of the Caribbean and its diasporic population and improving research outcomes, service delivery, income generating activities, staff productivity and the satisfaction of the HWFMU’s staff, clients and other stakeholders.

This strategic direction of the HWFMU is aligned with the new strategic plan, “Revenue Revolution” for 2022–2027 and stands in readiness to bolster income generation within the University of the West Indies through leveraging income from our existing resources by improving efficiency, maximizing capacity and throughput.

This report is done in accordance with the first phase of The University Triple A, “The Reputation Revolution” that has been mobilised from 2017–2022. Furthermore, it contains the achievements of the HWFMU for the period from August 1, 2021, to July 31, 2022.

ALIGNMENT

PUBLIC SERVICE

Endometriosis Month 2022

Radio Interviews

Dr. John Harriott (HWFMU) – March 12 – Endometriosis and infertility (RJR interview)

In partnership with the Unit’s long standing relationship stakeholder, BASE Foundation, the Consultants participated in a series of radio interviews on KOOL 103 FM for the month of March that commemorated Endometriosis Awareness Month. The schedule was as follows:

  • Mrs. Shauna Fuller (BASE) on March 3 – Endometriosis: It's ok to talk...period
  • Dr. Giselle Harrison (HWFMU) – March 10 – PCOS vs. Endometriosis: What's the Difference?
  • Mrs. Shauna Fuller (BASE) on March 3 – Endometriosis: It's ok to talk...period
  • Dr. Giselle Harrison (HWFMU) – March 10 – PCOS vs. Endometriosis: What's the Difference?
  • Dr. Loxley Christie (HWFMU) – March 17 – Endo and fertility explained
  • Dr. Michelle Bailey (HWFMU) – March 24 – Treating Endometriosis
  • Dr. Sharifa Frederick (HWFMU) – March 31 – The emotional effects of Endo

Picture 1: A collage of staff who participated in Endometriosis Month

Social Media Outreach

In addition to the radio interviews, members of staff who assisted in bringing awareness to endometriosis by participating in a photo shoot and providing personal content on endometriosis for the Unit’s social media platform.

BabySentry Workshop

On March 31, 2022, a BabySentry Workshop was conducted in the conference room of the HWFMU. The IVF Jamaica staff were re-trained on how to use the platform.

ACCESS

ISO 9001:2015 Internal Auditor Training

Twelve members of staff attended an ISO 9001:2015 Internal Auditor Training on August 12–13, 2021, and were certified as Internal Auditors. The training was held online via Zoom and facilitated by Mr. Jacob McLean from Kaizen Training and Management Consultants Limited. This training provided the knowledge and skills needed to organise and lead a Quality Management System that is being implemented for the Assisted Conception of the Unit – HWFMU IVF-Jamaica. This process-based management system is based on risk-based thinking and implementing controls to minimize risks and increase performance of processes and targeted outcomes.

Picture 2: The IVF Jamaica team being retrained to use the BabySentry platform.

Additionally, the certified staffs have the ability to evaluate and report audit findings; evaluate corrective action effectiveness and carry out follow-up and routine internal audits that are mandatory for the accreditation process and preparation for the First Stage Audit scheduled for September 13, 2022, that will be conducted by the National Certification Body of Jamaica (NCBJ).

The certified ISO 9001:2015 Internal Auditors of the Unit are Dr. John Harriott, Dr. Loxley Christie, Dr. Michelle Bailey, Dr. Kamali Carroll, Ms. Deon Black, Mrs. Veronica Forbes-Blake, Ms. Nicole Campbell, Ms. Natricia Scully and Nurse Melrose Godfrey.

CLINICAL SERVICES

The Clinical Section of the HWFMU delivers three services, namely, family planning, minimally invasive gynaecological surgeries and assisted reproductive technology (ART). These services are delivered using state of the art technology and modern surgical techniques. The clinical team performed 478 surgical procedures during the period August 1, 2021 to July 31, 2022.

These procedures were Operative Laparoscopy (126), Diagnostic Laparoscopy (5), Operative Hysteroscopy (15), Diagnostic Hysteroscopy (253), Tubal Ligation (4), Vaginal Hysterectomy (1), Total Abdominal Hysterectomy (3), Total Laparoscopic Hysterectomy (10), Open Myomectomy (26) and Laparotomy (2) and the Procedures (D&C, Cyst Aspiration, Marsupialization) being 33.

Additionally, there were 1,503 users of family planning methods and a total of 193 new patients were registered for family planning.

HWFMU IVF-JAMAICA – TRAINING AND DEVELOPMENT

Students

Lanceford Sterling, PhD student is presently preparing his paper in Applied Physics, Assessment of the Relationship between Electromagnetic Radiation Emitted by Wireless Devices and Sperm Quality in Men Seeking Infertility Treatment (2021 – Present). Also, he was a finalist in the Three Minute Thesis (3MTTM) Competition: The UWI Edition

Dr. Michelle Bailey provided supervision of a 5th year elective undergraduate student during the period April 18, 2022 – June 6, 2022. The areas of interest were:

  • Exposure to more conservative surgical options to gynaecology, specifically laparoscopy
  • Management of women and men dealing with infertility
  • Understanding methods of Assisted Reproductive Technologies such as Egg Freezing and Embryo transfers

Dr. Kelly Fletcher educated pupil midwives, operating theatre nurses-in-training and medical students on intra-operative anaesthetic management.

Staff

HWFMU Cardiopulmonary Resuscitation Workshop

A presentation was made by Dr. Kelly Fletcher to the clinical staff followed by hands on demonstrations with dummies.

HWFMU IVF-JAMAICA PERFORMANCE

During the review the period, there was total of 311 assisted reproductive techniques performed. These were Egg Recovery (141), Embryo Transfer (64), Frozen Embryo Transfer (99) and Intra-uterine insemination (7).

A sum of 120 couples was counselled from a total of 122 couples seen at the Unit. From the 122 couples seen, 53 men had male factor infertility and 106 women had female factor infertility. There were three women who shared their eggs and four who were recipients of eggs. One of the 122 couples had an Intrauterine Insemination (IUI) using donor sperm.

There were 10 single women who registered for the HWFMU’s assisted reproductive services. Two of them used donor eggs while three of them had In Vitro Fertilization (IVF) done using donor sperm. The other 5 women were enrolled in the egg freezing programme.

There were 56 pregnancies of which 37 were clinical pregnancies and 19 were biochemical pregnancies. Additionally, there were 5 miscarriages and 29 deliveries.

There were 7 sets of twins delivered from the assisted reproductive procedures. These included 2 sets monozygotic/identical twin girls, 2 sets monozygotic/identical twin boys and 3 sets dizygotic twins (girl/boy). Additionally, there were 22 singletons (10 boys and 12 girls). Overall, there were 36 babies delivered during the review period.

ADMINISTRATION

The HWFMU Documentation Registry

The Hugh Wynter Fertility Management Unit IVF-Jamaica has initiated the process of obtaining International Organisation for Standardisation (ISO) certification by establishing a quality management system. One requirement of the Standard is to have all documents and records controlled which should result in the efficient functioning of the system.

Since September 2021, Ms. Nicole Campbell the Records Management Officer from the Registry, under the guidance of the Assistant Director, has created a procedure that manages all aspects of the Unit’s documents and the records, from creation to disposition. A standardised coding system that applies to all documents and records within the Hugh Wynter Fertility Management Unit – IVF Jamaica will be utilized for the period leading up to the First Stage Audit to be conducted by the National Certification Body of Jamaica (NCBJ) on September 13th, 2022, and further Audits.

TRAINING – M.Sc. COUNSELLING PROGRAMME

Student Enrolment

Five students were enrolled in the programme, all of whom were working on their research project. One student from Belize completed the programme, while ten received extensions of time to complete their studies.

Research Project

The Research Project COUN6301 was the only course offered during semesters 1and 2, 2021–2022. Students had already completed all other programme courses including the practicum.

Three students from Trinidad obtained ethical approval for their project proposals and were prepared to undertake field work. Two of these students have completed their project, while one student has been having difficulty obtaining approval from national health authorities in Trinidad.

Dr. Craig McNally, Senior Counsellor at the University of Technology, and Dr. Sharmaye Saunders, Head of the Belize Open Campus, continue to provide technical support to the research process.

Programme Approval

The revised MSc Counselling Programme was approved by the Board of Graduate Studies in May 2022. The MSc Counselling curriculum was revised to introduce a new structure and modality aimed at positioning the programme as an excellent online educational product that targets both the Caribbean and the global community. The revised programme presents revised and new courses, suggested arrangements for practicum, research and internship, proposed pedagogy and identified educational resource. Special focus areas in the revised programme include marriage and family, children and adolescents, crisis, trauma and rehabilitation as well as school counselling. The main goal of the proposed programme is to equip professional counsellors to deliver high quality mental health services that meet the evolving psycho-emotional needs of clientele. The new projected time for the start of the revised programme is semester 1 of academic year 2022–2023.

AGILITY

INCOME GENERATION

Clinical Section

The income generated by the HWFMU for the period August 1, 2021 to July 31, 2022 was $49,388,985.38. There was a 17% increase in revenue from financial year 2020–2021 to year 2021–2022 while expenditure increased by 16% for the same period. Overall, the net income of the HWFMU increased by 7% from financial year 2020–2021 to year 2021–2022.

INNOVATION AND ENTREPRENEURSHIP PROJECTS

There first floor has been renovated and repurposed into a 10-bed post-surgical operative suite to accommodate inpatient stay. Additionally, the second operating theatre on the ground floor was commissioned.

STAFF ACCOMPLISHMENTS

Walters, Yvonne. The National Family Planning Board (NFPB), Provider Initiated Training and Counselling Programme, September 20–23, 2021. Kingston, Jamaica. Certificate of Participation

ONLINE PROMOTION

The HWFMU’s digital media space has been gaining traction and generating interest and clients in the assisted conception, family planning and minimally invasive services of the Unit resulting in increased consultation. This has contributed to the improved financial health of the University.