Impact of the implementation of an observation unit in the emergency department of a district hospital in Sierra Leone
María Belén Italia Cenere 1,&, Sáez Matías Ignacio1, Wambua Gerald1
1Médecins Sans Frontière, OCBA, Koinadugu Project, Sierra Leone Mission, Koinadugu, Sierra Leone
María Belén Italia Cenere, Médecins Sans Frontière, OCBA, Koinadugu Project, Sierra Leone Mission, Koinadugu, Sierra Leone
observation units are dedicated areas in a hospital that provide medical evaluation and management for patients with illnesses that are potentially managed within 24 hours, allowing for prompt discharge. In June 2016, MSF started supporting the emergency department of Kabala government hospital, a district hospital in the Northern Province of Sierra Leone, which includes a 12-bedded observation unit (OU). The aim of this analysis is to determine the impact of the implementation of an OU on overall paediatric inpatient admissions and management.
admission and discharge criteria for the OU was put into practice in March 2017 with the agreement and collaboration of the managers of all departments involved. Data on the number of patients attending the OU and number of inpatient admissions was collected for the months of January and May 2017, before and after the intervention. These months were chosen due to the comparable numbers of patients attending through the general hospital triage.
after the introduction of the OU, there was a decrease in the paediatric ward admissions of 45.4% (220 in January compared with 120 in May), and an almost 10-fold increase in the number of patients managed in the OU (24 in January while 233 in May).
as a result of the introduction of the OU, unnecessary paediatric inpatient admissions decreased. There was also a much higher proportion of patients who were managed in OU. These patients would otherwise have been reviewed in the outpatient department, revealing the need for more comprehensive assessment and allowing for a period of observation for patients who did not require inpatient admission. In addition, it highlights the need to strengthen the capacity of triage and outpatient departments, in terms of equipment, staff and training.
Dates: 15 Dec 17 - 16 Dec 17
Venue: Hotel Ngor Diarama
Contact person: Dr. Laurent Hiffler (firstname.lastname@example.org)