Purpose: To describe the anaesthesia services in Barbados: to present
the major challenges confronting the Anaesthesia Department of the gov
ernment-owned Queen Elizabeth Hospital (QEH): and to describe the Depa
rtment's approaches to optimise safety and cost-effectiveness of anaes
thesia at QEH. Source of Information: Authors (KBS, HSLM, RAH), who co
llectively provided more than 50 yr of anaesthesia at QEH; the Dean (E
RW) of the University of West indies Medical School (Barbados campus);
archives of Barbados; and records of QEH. Principal findings: The gov
ernment oi Barbados provides modern health care services to all of its
citizens, primarily at QEH, Barbados, however, has tight financial co
nstraints, intrastructural limitations, and a bureaucratic administrat
ion that predispose QEH's Anaesthesia Department to unexpected depleti
ons of drugs and disposable supplies, sporadic shortages of personnel
and functioning equipment, and occasional quality assurance problems.
To deal with such problems, the Anaesthesia Department has implemented
several pro-active measures: establishing an audit system to prevent
depletion of imported drugs and supplies: training local personnel to
maintain; equipment: purchasing an oxygen concentrator to reduce oxyge
n costs: decreasing nitrous oxide use (expensive in Barbados): and ini
tiating its own quality and safety standards. Conclusion: Continuous d
elivery of high quality cost-effective anaesthesia care requires thoug
htful planning by administrators and judicious resource allocations He
alth care administrators and clinical departments need to work togethe
r closely to establish a framework that enables departments to play a
major role in determining how the institution's limited financial reso
urces are best allocated to meet the departmental priorities.