Building Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations

Background: Surgical capacity building has gained substantial momentum. However, care at the hospital level depends on improved access to emergency services. There is no established model for facilitating trauma and EMS system capacity in LMIC settings. This manuscript describes our model for multi-...

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Autores principales:	Sudha Jayaraman, Faustin Ntirenganya, Menelas Nkeshimana, Ashley Rosenberg, Theophile Dushime, Ignace Kabagema, Jean Marie Uwitonze, Eric Uwitonize, Jeanne d’Arc Nyinawankusi, Robert Riviello, Irene Bagahirwa, Kenneth L. Williams, Elizabeth Krebs, Rebecca Maine, Paulin Banguti, Stephen Rulisa, Patrick Kyamanywa, Jean Claude Byiringiro
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2021
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/d546d3acf2574ce3835976764bd3e272
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spelling	oai:doaj.org-article:d546d3acf2574ce3835976764bd3e2722021-11-08T08:04:52ZBuilding Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations2214-999610.5334/aogh.3324https://doaj.org/article/d546d3acf2574ce3835976764bd3e2722021-10-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/3324https://doaj.org/toc/2214-9996Background: Surgical capacity building has gained substantial momentum. However, care at the hospital level depends on improved access to emergency services. There is no established model for facilitating trauma and EMS system capacity in LMIC settings. This manuscript describes our model for multi-disciplinary collaboration to advance trauma and EMS capacity in Rwanda, along with our lessons and recommendations. Methods: After high-level meetings at the Ministry of Health in Rwanda (MOH), in 2016, a capacity building plan focusing on improved clinical services, quality improvement/research and leadership capacity across prehospital and emergency settings. The main themes for the collaborative model included for empowerment of staff, improving clinical service delivery, and investing in systems and infrastructure. Funding was sought and incorporated into the Sector Wide Approaches to Planning process at the Ministry of Health of Rwanda. Findings: A shared mental model was created through a fully funded immersion program for Rwandese leaders from emergency medicine, nursing, prehospital care, and injury policy. Prehospital care delivery was standardized within Kigali through a train-the-trainers program with four new context-appropriate short courses in trauma, medical, obstetric/neonatal, and pediatric emergencies and expanded across the country to reach >600 staff at district and provincial hospitals. Forty-two protocols and checklists were implemented to standardize prehospital care across specialties. The WHO Trauma Registry was instituted across four major referral centers in the country capturing over 5,000 injured patients. Long-term research capacity development included Masters’ Degree support for 11 staff. Conclusions and Recommendations: This collaboration was highly productive in empowering staff and leadership, standardizing clinical service delivery in EMS, and investing in systems and infrastructure. This can be a useful model for trauma and EMS system capacity development in other LMICs.Sudha JayaramanFaustin NtirenganyaMenelas NkeshimanaAshley RosenbergTheophile DushimeIgnace KabagemaJean Marie UwitonzeEric UwitonizeJeanne d’Arc NyinawankusiRobert RivielloIrene BagahirwaKenneth L. WilliamsElizabeth KrebsRebecca MainePaulin BangutiStephen RulisaPatrick KyamanywaJean Claude ByiringiroUbiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 87, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Sudha Jayaraman Faustin Ntirenganya Menelas Nkeshimana Ashley Rosenberg Theophile Dushime Ignace Kabagema Jean Marie Uwitonze Eric Uwitonize Jeanne d’Arc Nyinawankusi Robert Riviello Irene Bagahirwa Kenneth L. Williams Elizabeth Krebs Rebecca Maine Paulin Banguti Stephen Rulisa Patrick Kyamanywa Jean Claude Byiringiro Building Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations
description	Background: Surgical capacity building has gained substantial momentum. However, care at the hospital level depends on improved access to emergency services. There is no established model for facilitating trauma and EMS system capacity in LMIC settings. This manuscript describes our model for multi-disciplinary collaboration to advance trauma and EMS capacity in Rwanda, along with our lessons and recommendations. Methods: After high-level meetings at the Ministry of Health in Rwanda (MOH), in 2016, a capacity building plan focusing on improved clinical services, quality improvement/research and leadership capacity across prehospital and emergency settings. The main themes for the collaborative model included for empowerment of staff, improving clinical service delivery, and investing in systems and infrastructure. Funding was sought and incorporated into the Sector Wide Approaches to Planning process at the Ministry of Health of Rwanda. Findings: A shared mental model was created through a fully funded immersion program for Rwandese leaders from emergency medicine, nursing, prehospital care, and injury policy. Prehospital care delivery was standardized within Kigali through a train-the-trainers program with four new context-appropriate short courses in trauma, medical, obstetric/neonatal, and pediatric emergencies and expanded across the country to reach >600 staff at district and provincial hospitals. Forty-two protocols and checklists were implemented to standardize prehospital care across specialties. The WHO Trauma Registry was instituted across four major referral centers in the country capturing over 5,000 injured patients. Long-term research capacity development included Masters’ Degree support for 11 staff. Conclusions and Recommendations: This collaboration was highly productive in empowering staff and leadership, standardizing clinical service delivery in EMS, and investing in systems and infrastructure. This can be a useful model for trauma and EMS system capacity development in other LMICs.
format	article
author	Sudha Jayaraman Faustin Ntirenganya Menelas Nkeshimana Ashley Rosenberg Theophile Dushime Ignace Kabagema Jean Marie Uwitonze Eric Uwitonize Jeanne d’Arc Nyinawankusi Robert Riviello Irene Bagahirwa Kenneth L. Williams Elizabeth Krebs Rebecca Maine Paulin Banguti Stephen Rulisa Patrick Kyamanywa Jean Claude Byiringiro
author_facet	Sudha Jayaraman Faustin Ntirenganya Menelas Nkeshimana Ashley Rosenberg Theophile Dushime Ignace Kabagema Jean Marie Uwitonze Eric Uwitonize Jeanne d’Arc Nyinawankusi Robert Riviello Irene Bagahirwa Kenneth L. Williams Elizabeth Krebs Rebecca Maine Paulin Banguti Stephen Rulisa Patrick Kyamanywa Jean Claude Byiringiro
author_sort	Sudha Jayaraman
title	Building Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations
title_short	Building Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations
title_full	Building Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations
title_fullStr	Building Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations
title_full_unstemmed	Building Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations
title_sort	building trauma and ems systems capacity in rwanda: lessons and recommendations
publisher	Ubiquity Press
publishDate	2021
url	https://doaj.org/article/d546d3acf2574ce3835976764bd3e272
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Building Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations

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