Where to from here? A quality improvement project investigating burns treatment and rehabilitation practices in India

Abstract

ObjectiveTo describe the capacity of the Indian healthcare system in providing appropriate and effective burns treatment and rehabilitation services.ResultsHealth professionals involved in burns treatment or rehabilitation at seven hospitals from four states in India were invited to participate in consultative meetings. Existing treatment and rehabilitation strategies, barriers and enablers to patient flow across the continuum of care and details on inpatient and outpatient rehabilitation were discussed during the meetings. Seventeen health professionals from various clinical backgrounds were involved in the consultation process. Key themes highlighted (a) a lack of awareness on burn first aid at the community level, (b) a lack of human resource to treat burn injuries in hospital settings, (c) a gap in burn care training for medical staff, (d) poor hospital infrastructure and (e) a variation in treatment practices and rehabilitation services available between hospitals. A number of opportunities exist to improve burns treatment and rehabilitation in India. Improvements would most effectively be achieved through promoting multidisciplinary care across a number of facilities and service providers. Further research is required to develop context-specific burn care models, determining how these can be integrated into the Indian healthcare system.

How the service delivery works in the Iranian specialised burns hospitals? A qualitative approach

“…They showed that implementing prevention strategy results in significant improvement, especially in primary and secondary prevention. Also, some other studies noted that weak performance of burn wards is not due to hospital performance or severity of injuries, but it is mostly due to society’s awareness about burn, primary measures and prevention [13]. A study by Hodgins et al has also emphasized awareness of burns [21].…”

“…Various unplanned visits and ignoring sanitary codes by patients’ families, also increase the secondary infections in hospitalised burn patients. Jagnoor et al showed that lack of society’s awareness on basic burn services can reduce desired consequences [13].…”

“…In line with the findings of the current study, Jagnoor has also found that lack of patients’ follow-up is an important challenge in treating burn patients in India. Many of the identified challenges were related to the patients’ socioeconomic status, their literacy level and lack of facilities [13].…”

“…But, because in India BRSs are available in public hospitals, access limitation to specialised services were lesser. Besides, the authors found that insufficient skills of health staff, including physicians with general surgery skills, is an important obstacle to provide high quality BRSs in all healthcare centres [13]. In the study by Atyieh et al, the researchers emphasized on regionalization of burn care and linkage between primary, secondary and tertiary levels.…”

“…Jagnoor et al (2018) identified a number of barriers to providing burn care services in India. This study showed that the lack of operating standards for burn treatment, different knowledge and skills from health professionals in providing burn care, along with resource shortages, affect the quality of burn care for patients [13]. Jagnoor et al (2017) identified the challenges of burn and recovery care such as poor communication between health care providers and burn victims, limited rehabilitation services, transportation problems to health centres, and high costs of burn treatment and confirmed the need for long-term rehabilitation [14].…”