Essentials for emergency care: Lessons from an inventory assessment of an emergency centre in Sub-Saharan Africa

Abstract

Introduction:The World Health Organization (WHO) has published lists of essential equipment and supplies for delivering emergency care in resource-limited settings. The objective of this study was to assess material resources available for adult emergency care at a major academic tertiary care referral centre in Accra, Ghana, to determine quality improvement needs. Methods: A spot inventory of emergency centre equipment and supplies was conducted in Korle-Bu Teaching Hospital (KBTH) and compared to the WHO essential emergency equipment list released in 2006. Results: Most items considered essential were available at the time of inventory. Notable exceptions included: equipment and supplies for healthcare provider safety and infection control, advanced airway management, and ophthalmologic or gynaecological examinations. Several additional items, such as glucometers and pulse oximeters, were available and often used for patient care. Conclusion: Beyond pointing out specific material resource deficiencies at the Surgical Medical Emergency (SME) centre, our inventory assessment indicated a need to develop better implementation strategies for infection control policies, to collaborate with other departments on coordination of patient care, and to set a research agenda to develop emergency and acute care protocols that are both effective and sustainable in our setting. Equipment and supplies are essential elements of emergency preparedness that must be both available and 'ready-to-hand'. Consequently, key factors in determining readiness to provide quality emergency care include supplychain, healthcare financing, functionality of systems, and a coordinated institutional vision. Lessons learnt may be useful for others facing similar challenges to emergency medicine development.

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“…Previous studies have shown that educational interventions for paramedics are less effective if equipment availability limits their ability to implement their knowledge [19]. Financial and supply‐chain barriers often hinder the ability to adopt intervention strategies and provide quality emergency care [20].…”

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