Evaluating capacity at three government referral hospital emergency units in the kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool

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dc.contributor.authorPigoga, J L
dc.contributor.authorJoiner, A P
dc.contributor.authorChowa, P
dc.contributor.authorLuong, J
dc.contributor.authorMhlanga, M
dc.contributor.authorReynolds, T A
dc.contributor.authorWallis, L A
dc.date.accessioned2020-05-15T10:18:12Z
dc.date.available2020-05-15T10:18:12Z
dc.date.issued2020-05-06
dc.date.updated2020-05-10T06:02:19Z
dc.description.abstractBackground The Kingdom of Eswatini, a lower-middle income nation of 1.45 million in southern Africa, has recently identified emergency care as a key strategy to respond to the national disease burden. We aimed to evaluate the current capacity of hospital emergency care areas using the WHO Hospital Emergency Unit Assessment Tool (HEAT) at government referral hospitals in Eswatini. Methods We conducted a cross-sectional study of three government referral hospital emergency care areas using HEAT in May 2018. This standardised tool assists healthcare facilities to assess the emergency care delivery capacity in facilities and support in identifying gaps and targeting interventions to strengthen care delivery within emergency care areas. Senior-level emergency care area employees, including senior medical officers and nurse matrons, were interviewed using the HEAT. Results All sites provided some level of emergency care 24 h a day, 7 days a week, though most had multiple entry points for emergency care. Only one facility had a dedicated area for receiving emergencies and a dedicated resuscitation area; two had triage areas. Facilities had limited capacity to perform signal functions (life-saving procedures that require both skills and resources). Commonly reported barriers included training deficits and lack of access to supplies, medications, and equipment. Sites also lacked formal clinical management and process protocols (such as triage and clinical protocols). Conclusions The HEAT highlighted strengths and weaknesses of emergency care delivery within hospitals in Eswatini and identified specific causes of these system and service gaps. In order to improve emergency care outcomes, multiple interventions are needed, including training opportunities, improvement in supply chains, and implementation of clinical and process protocols for emergency care areas. We hope that these findings will allow hospital administrators and planners to develop effective change management plans.en_US
dc.identifier.apacitationPigoga, J. L., Joiner, A. P., Chowa, P., Luong, J., Mhlanga, M., Reynolds, T. A., & Wallis, L. A. (2020). Evaluating capacity at three government referral hospital emergency units in the kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool. <i>BMC Emergency Medicine</i>, 20(1), 33. en_ZA
dc.identifier.chicagocitationPigoga, J L, A P Joiner, P Chowa, J Luong, M Mhlanga, T A Reynolds, and L A Wallis "Evaluating capacity at three government referral hospital emergency units in the kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool." <i>BMC Emergency Medicine</i> 20, 1. (2020): 33. en_ZA
dc.identifier.citationPigoga, J.L., Joiner, A.P., Chowa, P., Luong, J., Mhlanga, M., Reynolds, T.A. & Wallis, L.A. 2020. Evaluating capacity at three government referral hospital emergency units in the kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool. <i>BMC Emergency Medicine.</i> 20(1):33. en_ZA
dc.identifier.issn1471-227X
dc.identifier.ris TY - Journal Article AU - Pigoga, J L AU - Joiner, A P AU - Chowa, P AU - Luong, J AU - Mhlanga, M AU - Reynolds, T A AU - Wallis, L A AB - Background The Kingdom of Eswatini, a lower-middle income nation of 1.45 million in southern Africa, has recently identified emergency care as a key strategy to respond to the national disease burden. We aimed to evaluate the current capacity of hospital emergency care areas using the WHO Hospital Emergency Unit Assessment Tool (HEAT) at government referral hospitals in Eswatini. Methods We conducted a cross-sectional study of three government referral hospital emergency care areas using HEAT in May 2018. This standardised tool assists healthcare facilities to assess the emergency care delivery capacity in facilities and support in identifying gaps and targeting interventions to strengthen care delivery within emergency care areas. Senior-level emergency care area employees, including senior medical officers and nurse matrons, were interviewed using the HEAT. Results All sites provided some level of emergency care 24 h a day, 7 days a week, though most had multiple entry points for emergency care. Only one facility had a dedicated area for receiving emergencies and a dedicated resuscitation area; two had triage areas. Facilities had limited capacity to perform signal functions (life-saving procedures that require both skills and resources). Commonly reported barriers included training deficits and lack of access to supplies, medications, and equipment. Sites also lacked formal clinical management and process protocols (such as triage and clinical protocols). Conclusions The HEAT highlighted strengths and weaknesses of emergency care delivery within hospitals in Eswatini and identified specific causes of these system and service gaps. In order to improve emergency care outcomes, multiple interventions are needed, including training opportunities, improvement in supply chains, and implementation of clinical and process protocols for emergency care areas. We hope that these findings will allow hospital administrators and planners to develop effective change management plans. DA - 2020-05-06 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Emergency Medicine KW - Emergency medicine KW - Emergency care KW - Health systems development KW - Global health LK - https://open.uct.ac.za PY - 2020 SM - 1471-227X T1 - Evaluating capacity at three government referral hospital emergency units in the kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool TI - Evaluating capacity at three government referral hospital emergency units in the kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool UR - ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12873-020-00327-w
dc.identifier.urihttps://hdl.handle.net/11427/31886
dc.identifier.vancouvercitationPigoga JL, Joiner AP, Chowa P, Luong J, Mhlanga M, Reynolds TA, et al. Evaluating capacity at three government referral hospital emergency units in the kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool. BMC Emergency Medicine. 2020;20(1):33. .en_ZA
dc.language.rfc3066en
dc.publisher.departmentDivision of Emergency Medicineen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Emergency Medicineen_US
dc.source.journalissue1en_US
dc.source.journalvolume20en_US
dc.source.pagination33en_US
dc.source.urihttps://bmcemergmed.biomedcentral.com/
dc.subjectEmergency medicineen_US
dc.subjectEmergency careen_US
dc.subjectHealth systems developmenten_US
dc.subjectGlobal healthen_US
dc.titleEvaluating capacity at three government referral hospital emergency units in the kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Toolen_US
dc.typeJournal Articleen_US
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