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Quality Improvement EffortBlack Lion Hospital Emergency Services

Roman Aydiko, MPH Candidate 2011

+Overview

Introduction & Background

Methods

Findings

Discussion

Conclusion

Next steps

Map from http://data.un.org/CountryProfile.aspx?crName=Ethiopia

+Background

A Twinning project between UW and Black Lion Hospital has created a new Emergency Medicine Services in Ethiopia.

Ethiopian Fellows are trained in emergency medicine at UW-Madison for 4-10weeks.

Quality Improvement Training, part of the fellowship headed by Lori DiPrete Brown of Center for Global Health.

+ Quality Improvement Projects(by Ethiopian Fellows at UW)

Increase the quality of triage (AW)

Increase the availability of drugs (TZ)

Improve and automate patient registry system (TB)

Reduce time interval between decision and operation for trauma surgery (ST)

Optimize output of new training Center at BLH/AAU (NS)

Improve compliance with IPP guidelines (AA)

Improve response time for lab and x-ray results (BM)

Double the number of emergency surgeries performed daily (AT)

+Quality Improvement Awareness Training-BLH EU Nurses

24 Nurses, 4 hour QI Awareness Workshops

Divided nurses in groups of 6 per shift

Best time identified as 7am by the nurses (after their 3rd shift at EU)

Nurses eager and willing to participate in the QI Workshops.

+Objectives of QI Awareness Training

Quality improvement principles and methods

Introduce EU nurses to proposed QI projects by the fellows

Provide nurses platform to address key issues that affect their performance daily

+Quality Improvement Workshop Findings

Key improvement areas for ED

1 Adequate materials for patients including emergency drugs and other supplies needed for better care

2 Isolation rooms because of high MDR TB case exposures (worried for their wellbeing as well as patients

3 Free/cheap and accessible vaccinations for ED staff such as flu, meningitis, …and Post Exposure Prophylaxis for those pricked by needles that are potentially HIV positive

4 Improved communication with leaders of the ED to address issues of the department that the nurses

5 Refreshment courses/trainings for ED nurses(priority given)

+Increase the Quality of Triage

Redesigned forms

Use of triage form rose dramatically from 10% to 80% at first evaluation

Second Evaluation showed further increase in use to 100%

Quality/completeness ?

+ Methods

+Quality of Triage

+Culture of Quality

Quality care is possible.

Quality care happens here.

Quality care is my job.

“We can do it.”

+Future Activities

Expand QI collaboration to include pediatrics

Develop a monitoring “Report Card”

Develop training materials for use at Black Lion and beyond

Find sustainable means/ways to respond to BL Emergency Nurses, doctors & staff concerns (ACTION)

+Acknowledgements

Lori DiPrete Brown, MSPH

Girma Tefera, MD

Assefu Woldetsadik, MD

BLH ED Staff

Barb Duerst, RN/MPH

UW-Madison MPH Faculty