Evidence-Based Decision Making: A Hospital Executive’s Call to Action

As someone who has dedicated my career to advancing healthcare systems across both the Caribbean and the United States, my decision to return to the Virgin Islands was both a homecoming and a call to service. I returned with the intention of helping to shape a future in which healthcare across our region is not only sustainable but also driven by precision, integrity, and evidence.

Now, as the permanent CEO of the Juan F. Luis Hospital, I stand at a pivotal moment—not only for our institution, but for healthcare delivery across the Caribbean region. Our shared reality is one of urgent financial constraints, workforce challenges, and growing patient demands. In this pressing environment, leadership cannot rely solely on instinct or tradition. It must be guided by data, sharpened by evidence, and executed with accountability. The time for action is now.

Why Evidence-Based Leadership Matters

Healthcare is an industry where every decision carries significant weight—on outcomes, costs, and lives. In regions with underdeveloped or fragmented data infrastructure, the absence of evidence leads to decisions made in the dark. This is a risk we cannot afford to take. Our patients deserve care built on the best available knowledge—not on anecdotes, habit, or guesswork. The advantages of evidence-based leadership are clear: it leads to improved patient outcomes, optimized costs, and a more efficient healthcare system.

Our patients deserve care built on the best available knowledge—not on anecdotes, habit, or guesswork.

For example, staffing decisions—which are often among the most costly and complex—must be more than routine. Through even modest investments in analytics, hospitals can begin to forecast patient volumes, identify chronic staff shortages, and track trends in service demand. In our work at the Governor Juan F. Luis Hospital and Medical Center, we’re harnessing these tools to ensure staff are deployed where and when they’re needed most—resulting in better patient outcomes, improved morale, and more innovative use of public funds.

Tools for Evidence-Based Leadership—Even in Low-Data Environments

A lack of historical data doesn’t mean we’re powerless. Here are some of the tools that Caribbean healthcare leaders can begin using right now, even with minimal baseline infrastructure:

Rapid Cycle Evaluation: Test and measure new strategies—like triage protocols or outpatient scheduling—in small pilots to generate evidence quickly and scale what works.

Data Dashboards (e.g., Power BI, Tableau, Metabase): These tools allow for real-time tracking of hospital metrics, even when sourced from spreadsheets or manual logs.

Basic Predictive Modeling: Using current data on admissions and discharges, we can project near-term staffing needs or anticipate surges in service demand.

Regional Data-Sharing Agreements: Partnering with community clinics, ministries of health, and NGOs helps fill gaps in historical data and creates a richer, shared ecosystem for care delivery.

Electronic Health Records with Analytics Modules: Even basic EHR systems can provide insight into patient trends, utilization rates, and service needs.

Collaboration is Key

No hospital operates in isolation. Our healthcare systems are part of a broader continuum that includes outpatient providers, public health agencies, long-term care facilities, and—crucially—our communities. Data-driven collaboration among these partners is not just beneficial, it’s essential. It enables smoother care transitions, reduces duplicative services, and ensures patients don’t fall through the cracks.

Consider the emergence of an infectious disease outbreak. Timely and coordinated action between hospitals and public health agencies can only occur if information is shared swiftly and accurately. Integrated data systems, even simple ones, help detect patterns earlier, target interventions better, and reduce the burden on our already stretched hospital systems.

Making the Case to Policymakers

With consistent and accurate data, we build trust—with our staff, with our communities, and with the policymakers who shape the future of healthcare in our region. It is through this foundation of trust and transparency that we can advocate effectively, plan responsibly, and lead courageously. The time has come for hospital executives and healthcare leaders across the Caribbean to move beyond tradition and toward transformation—grounded in evidence, driven by purpose, and committed to delivering the highest standard of care for every patient we serve.