Improving care systems involves four key processes:
- Performing an accurate assessment of the current status of integrated ECO care
- Identifying and defining gaps so that local stakeholders can prioritize the reduction of the gaps and create a “road-map” for improvement
- Identifying and implementing resources to fill those gaps (including from the WHO toolkit)
- Collecting baseline data and then monitoring both the implementation of the tools and the outcomes from the implementation to ensure that the desired effect is achieved
The UCSF WHO Collaborating Centre for Emergency, Critical and Operative Care assists WHO as needed with these processes and, in particular, processes 3 and 4.
WHO Tool Development
Integrated ECO care is, by definition, care to avert death and disability from potentially life-threatening conditions under time pressure. Often, a small intervention can mean the difference between a life lost and a person who goes on to live a long life as a contributing member of society. These interventions can be as simple as implementing a checklist or sharing the knowledge to perform life-saving procedures at just the right time. As dramatic as it may sound, the difference between life and death can be a matter of minutes, so it’s essential to have tools to help organize and standardize care.
While well-developed ECO systems have already implemented many, if not all these tools, newer systems may find developing the tools to be incredibly time- and labor-intensive. To alleviate some of that burden, WHO has tapped into expert opinion from around the world to develop practical tools. As a WHO Collaborating Centre, we join in providing that expertise, and in developing the tools themselves.
Tools that we have contributed to or are in the process of contributing to include:
- Interagency Integrated Triage Tool
- Resuscitation Area Designation
- WHO Medical Emergency Checklist
- WHO Trauma Care Checklist
- Basic Critical Care Course (in pilot)
- Basic Ambulance Provider Course (in development)
- Basic Operative Course (in development)
Implementation Projects
Implementation of the Basic Emergency Care Course
Through partnerships with local hospitals and governments in Uganda, Tanzania and Liberia, we have been able to pilot the Basic Emergency Care (BEC) Course in these regions, generating evidence for the course’s impact on the timely delivery of quality ECO care.
The broad success and popularity of the BEC has also led to the creation of additional, more advanced emergency care modules which we have helped to develop. These will be integrated into a second edition of the course.
Following a similar model, the Basic Critical Care Course is being piloted and evaluated across multiple settings, and our team is contributing to those efforts. We plan to do the same with the Basic Ambulance Provider Course and the Basic Operative Care course once they are ready.