Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112762

Elizabeth Molyneux, FRCPCH¹, Ajib Phiri, MD¹, Anna Gregory, MRCPCH¹, Stephen Kinoti, MD², Mary Drake, RN, MPH³, and Mandy Rose, MBBS, MPH, MRCP⁴. (1) Pediatric Department, College of Medicine, PO Box 360, Blantyre, Malawi, (2) The Quality Assurance Project, University Research Co/LLC, 7200 Wisconsin Avenue, Suite 600, Bethesda, MD 20814, (3) Quality Assurance Project, University Research Co., LLC, 7200 Wisconsin Avenue, Bethesda, MD 20814, 301-941-8517, mdrake@urc-chs.com, (4) The Quality Assurance Project, University Research Co, /LLC, 7200 Wisconsin Avenue, Suite 600, Bethesda, MD 20814

It is recognized widely that emergency care saves lives, but evidence of this in resource-constrained settings is limited. The residents in pediatrics of the central teaching hospital in Malawi, with support from the Ministry of Health (MOH), the College of Medicine (CoM) and the Quality Assurance Project (QAP), in June 2004 initiated a program to introduce emergency, triage, assessment and treatment (ETAT) in eight district hospitals, and to monitor its impact on reducing facility-based under-five mortality. The MOH selected the 8 facilities in which pediatric emergency care systems were assessed. Findings showed that facilities had no formal triage system and no emergency care space, equipment or supplies; providers were not trained in triage or emergency care, and reporting of deaths was inconsistent.

Given these findings, the CoM conducted an ETAT training of trainers, who subsequently trained district teams in using the World Health Organization ETAT guidelines. This training was coupled with collaborative learning in quality improvement mechanisms to monitor ETAT process and outcome indicators. Facility teams then began implementing activities to improve ETAT. Mentorship and coaching, ongoing supervision and support for data collection were given by the CoM pediatric residents. Support from district and facility management included allocation of space, equipment and supplies. This paper will review an innovative model for coaching and mentorship in building capacity to improve emergency care, present process and outcome results, and discuss challenges and lessons learned from implementing ETAT in 8 district hospitals in Malawi.

Learning Objectives:

• List a range of problems commonly identified in pediatric emergency care.
• Describe the pediatric emergency care improvements implemented by facility teams.
• Articulate the advantages and achievements of an innovative model for coaching and mentorship.

Keywords: Emergency Department/Room, Pediatrics

Related Web page: www.qaproject.org

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.