Pakistan Registry of Intensive CarE (PRICE): Expanding a lower middle-income, clinician-designed critical care registry in South Asia

Hashmi, Madiha; Beane, Abi; Taqi, Arshad; Memon, Muhammad Iqbal; Athapattu, Priyantha Lakmini; Khan, Zahid; Dondorp, Arjen M.; Haniffa, Rashan

doi:10.1177/1751143718814126

Cited by 30 publications

(43 citation statements)

References 18 publications

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“…A number of high-quality ICU databases [39][40][41] , while not primarily developed for research, have proved valuable to answering research questions. Moreover, ICU databases have recently been developed in several lower and middle-income counties [42][43][44] . However, these databases are rarely linked to each other or to other data sources.…”

Section: Shorter-term Priority 1: Harmonizing and Linking Existing Icmentioning

confidence: 99%

Understanding and Enhancing Sepsis Survivorship. Priorities for Research and Practice

Prescott

Iwashyna

Blackwood

et al. 2019

Am J Respir Crit Care Med

111

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An estimated 14.1 million patients survive sepsis hospitalization each year. Many survivors experience poor long-term outcomes, including new or exacerbated neuropsychological impairment, functional disability, and heightened vulnerability to further health deterioration, including recurrent infection, cardiovascular events, and acute renal failure. However, current guidelines and interventional trials have focused on shorter-term survival, so there is little data on how to best promote longer-term recovery. To address this unmet need, a Colloquium on "Understanding and Enhancing Sepsis Survivorship" was held in February 2018, sponsored by the International Sepsis Forum. The goals of the Colloquium were to identify (1) gaps and limitations of current research, (2) shorter-term research priorities, and (3) longer-term research priorities for understanding and enhancing sepsis survivorship, informed by review of the literature and expert opinion. A total of 26 experts from 8 countries participated. The top three short-term priorities were to better leverage existing databases for research, to develop and disseminate educational resources on post-sepsis morbidity, and to build deep connections with sepsis survivors to define and achieve research priorities. The top longer-term priorities were to link mechanisms to long-term outcomes through large cohort studies with deep phenotyping, build a harmonized global sepsis registry from which patients could be enrolled into cohort studies or interventional trials, and to complete detailed longitudinal follow-up to characterize the heterogeneity of recovery experiences across sepsis survivors. This Perspective reports on the Colloquium discussions, the rationale for the research priorities, and current initiatives addressing these priorities.

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Section: Shorter-term Priority 1: Harmonizing and Linking Existing Icmentioning

confidence: 99%

Understanding and Enhancing Sepsis Survivorship. Priorities for Research and Practice

Prescott

Iwashyna

Blackwood

et al. 2019

Am J Respir Crit Care Med

111

View full text Add to dashboard Cite

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“…Timely analysis and feedback of results to clinical staff can reduce these barriers as staff begin to see the impact of data collection and surveillance on their daily work. Examples could include monitoring, coordination and reporting of intensive care unit bed availability or medication stockouts in a region to help plan emergency care 31. It is important to consider what conditions are of critical importance to the emergency system in order to prioritise data collection for those cases.…”

Section: Challenges and Opportunities For Lmic Emergency Care Surveilmentioning

confidence: 99%

Emergency care surveillance and emergency care registries in low-income and middle-income countries: conceptual challenges and future directions for research

et al. 2019

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Despite the fact that the 15 leading causes of global deaths and disability-adjusted life years are from conditions amenable to emergency care, and that this burden is highest in low-income and middle-income countries (LMICs), there is a paucity of research on LMIC emergency care to guide policy making, resource allocation and service provision. A literature review of the 550 articles on LMIC emergency care published in the 10-year period from 2007 to 2016 yielded 106 articles for LMIC emergency care surveillance and registry research. Few articles were from established longitudinal surveillance or registries and primarily composed of short-term data collection. Using these articles, a working group was convened by the US National Institutes of Health Fogarty International Center to discuss challenges and potential solutions for established systems to better understand global emergency care in LMICs. The working group focused on potential uses for emergency care surveillance and registry data to improve the quality of services provided to patients. Challenges included a lack of dedicated resources for such research in LMIC settings as well as over-reliance on facility-based data collection without known correlation to the overall burden of emergency conditions in the broader community. The group outlined potential solutions including incorporating data from sources beyond traditional health records, use of standard clinical forms that embed data needed for research and policy making and structured population-based research to establish clear linkages between what is seen in emergency units and the wider community. The group then identified current gaps in LMIC emergency care surveillance and registry research to form a research agenda for the future.

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“…The platform is being implemented across 18 intensive care units in four provinces in Pakistan; the collaboration has shared technology, approach to implementation and solutions to the barriers to adoption in a South-to-South partnership 32. While Sri Lanka has a predominantly centralised government-led health system, governance in Pakistan is devolved to regional organisations with a higher proportion of privately funded facilities.…”

Section: Discussionmentioning

confidence: 99%

Addressing the information deficit in global health: lessons from a digital acute care platform in Sri Lanka

Beane¹,

Silva²,

Athapattu

et al. 2019

BMJ Glob Health

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Lack of investment in low-income and middle-income countries (LMICs) in systems capturing continuous information regarding care of the acutely unwell patient is hindering global efforts to address inequalities, both at facility and national level. Furthermore, this of lack of data is disempowering frontline staff and those seeking to support them, from progressing setting-relevant research and quality improvement. In contrast to high-income country (HIC) settings, where electronic surveillance has boosted the capability of governments, clinicians and researchers to engage in service-wide healthcare evaluation, healthcare information in resource-limited settings remains almost exclusively paper based. In this practice paper, we describe the efforts of a collaboration of clinicians, administrators, researchers and healthcare informaticians working in South Asia, in addressing the inequality in access to patient information in acute care. Harnessing a clinician-led collaborative approach to design and evaluation, we have implemented a national acute care information platform in Sri Lanka that is tailored to priorities of frontline staff. Iterative adaptation has ensured the platform has the flexibility to integrate with legacy paper systems, support junior team members in advocating for acutely unwell patients and has made information captured accessible to diverse stakeholders to improve service delivery. The same platform is now empowering clinicians to participate in international research and drive forwards improvements in care. During this journey, we have also gained insights on how to overcome well-described barriers to implementation of digital information tools in LMIC. We anticipate that this north–south collaborative approach to addressing the challenges of health system implementation in acute care may provide learning and inspiration to other partnerships seeking to engage in similar work.

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Pakistan Registry of Intensive CarE (PRICE): Expanding a lower middle-income, clinician-designed critical care registry in South Asia

Cited by 30 publications

References 18 publications

Understanding and Enhancing Sepsis Survivorship. Priorities for Research and Practice

Understanding and Enhancing Sepsis Survivorship. Priorities for Research and Practice

Emergency care surveillance and emergency care registries in low-income and middle-income countries: conceptual challenges and future directions for research

Addressing the information deficit in global health: lessons from a digital acute care platform in Sri Lanka

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