Emergency unit assessment of seven tertiary hospitals in Nepal using the WHO tool: a cross-sectional study

International Journal of Emergency Medicine

Research

Ghan B. Thapa¹  Ajay S. Thapa²  Yagya R. Pokharel³  Adam R. Aluisio⁴  Derek Lubetkin⁴  Timmy Lin⁴  Ramu Kharel⁴  Giovanna Deluca⁴  Achyut R. Karki⁵  Sanu K. Shrestha⁶  Olita Shilpakar⁷  Yogendra M. Shakya⁷  Samriddha R. Pant⁷  Bimal S. Bist⁸  Nishant Dhakal⁹  Samir K. Adhikari^1,10  Santosh Paudel^1,11  Tamara Voor^1,12  Pryanka Relan^1,13 

[1] Department of Emergency Medicine and Prehospital Care, Grande International Hospital, Kathmandu, Nepal;Department of Emergency Medicine, B & B Hospital, Lalitpur, Nepal;Department of Emergency Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal;Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA;Department of General Practice and Emergency Medicine, Bir Hospital, Kathmandu, Nepal;Department of General Practice and Emergency Medicine, Dhulikhel Hospital - Kathmandu University School of Medicine, Dhulikhel, Nepal;Department of General Practice and Emergency Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal;Department of Health, Graduate School of Education, Tribhuvan University, Kathmandu, Nepal;Department of Pre-Hospital and Emergency Medicine, HAMS Hospital, Kathmandu, Nepal;Health Emergency Operation Center, Ministry of Health and Population, Kathmandu, Nepal;National Trauma Center, Kathmandu, Nepal;UT Southwestern Medical Center, Dallas, TX, USA;World Health Organization, Geneva, Switzerland;

关键词: Emergency care;    Nepal;    Global health;    Emergency assessment;    Hospital care;    Acute care;   

DOI  :  10.1186/s12245-023-00484-2

 received in 2022-10-20, accepted in 2023-02-12,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn 2021, the Nepal national emergency care system’s assessment (ECSA) identified 39 activities and 11 facility-specific goals to improve care. To support implementation of the ECSA facility-based goals, this pilot study used the World Health Organization’s (WHO) Hospital Emergency Unit Assessment Tool (HEAT) to evaluate key functions of emergency care at tertiary hospitals in Kathmandu, Nepal.MethodsThis cross-sectional study used the standardized HEAT assessment tool. Data on facility characteristics, human resources, clinical services, and signal functions were gathered via key informant interviews conducted by trained study personnel. Seven tertiary referral centers in the Kathmandu valley were selected for pilot evaluation including governmental, academic, and private hospitals. Descriptive statistics were generated, and comparative analyses were conducted.ResultsAll facilities had continuous emergency care services but differed in the extent of availability of each item surveyed. Academic institutions had the highest rating with greater availability of consulting services and capacity to perform specific signal functions including breathing interventions and sepsis care. Private institutions had the highest infrastructure availability and diagnostic testing capacity. Across all facilities, common barriers included lack of training of key emergency procedures, written protocols, point-of-care testing, and ancillary patient services.ConclusionThis pilot assessment demonstrates that the current emergency care capacity at representative tertiary referral hospitals in Kathmandu, Nepal is variable with some consistent barriers which preclude meeting the ECSA goals. The results can be used to inform emergency care development within Nepal and demonstrate that the WHO HEAT assessment is feasible and may be instructive in systematically advancing emergency care delivery at the national level if implemented more broadly.

【 授权许可】

CC BY   
© The Author(s) 2023

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