Smart Triage: Environmental Scan Data

Background

Children under-5 years of age account for both the greatest burden of Sepsis/Severe infection cases (41.5%) and Sepsis/Severe infection-related deaths (26.4%) word-wide. For children recovering from Sepsis/Severe infection, post discharge and in-hospital mortality have been shown to be equal from studies in Western Uganda. Many of these deaths are related to poor quality of care, including delays in care.

Currently, there is an imminent need to improve the existing processes and procedures in Ugandan health facilities for prioritizing children in need of urgent care upon admission (i.e., triaging), or facilitating the hospital to home transition following discharge. As such, each facility conducts its pediatric care basing on procedures determined either through experience or what is convenient to the pediatric clinician.

Methods

This study seeks to evaluate the typical pediatric care process in Ugandan hospitals using the UCMB hospital network as our sample. A cross-sectional quantitative study was conducted at hospitals within the UCMB network. Each site underwent a facility environmental scan comprised of 4 modules: 1) survey of the hospital infrastructure and resources; 2) observation of care processes; 3) health worker perspectives questionnaire; and 4) caregiver perspectives questionnaire.

Due to several factors including resource constraints and the timeline provided by funders, the full Environmental Scan was limited to 4 facilities. Based on the preliminary Environmental Scan results, the Smart Triage + QI program was implemented at 2 facilities in 2022: Uganda Martyrs Ibanda Hospital and St. Joseph’s Kitovu Hospital.

The Environmental Scan was repeated after the implementation of the Smart Triage + QI program at these two facilities. Ethics Declaration: This study was approved by the Makerere School of Public Health in Uganda (902) and the Uganda National Institute of Science and Technology (HS1227ES). Associated datasets: Tools for Data Collection to Determine Facility Readiness to Treat Sepsis~Pediatric Sepsis Data CoLab Environmental Scan An Evaluation of the Pediatric Care Process in Uganda for Improvement of Quality of Care