Development of emergency medicine and critical care masters program for nurses at Addis Ababa University, School of Medicine.

BACKGROUND: In Ethiopia, though all health care facilities have rooms available for ill and injured patients, emergency care has always remained suboptimal. Poor organization, lack of properly trained staff and lack of timely identification of the critically sick are the reasons. The role of nurses in the emergency rooms is very vital to im- prove patient survival. To address this pressing health care need and improve the emergency rooms (ER) nursing care, Addis Ababa University School of Medicine (AAU-SM) prioritized Emergency Medicine and Critical Care Nursing Training Program. The initial training began in September 2010 with a class of 20 students. Of these, 18 nurses successfully completed the Emergency Medicine and Critical Care Masters of Nursing program and graduated in 2012. OBJECTIVES: To review the Emergency medicine and Critical Care Masters training program for nurses developed and implemented at AAU-SM in partnership with the University of Wisconsin (UW) and the University of Toronto (UT) and to evaluate the progress and challenges to date. METHODS: An Emergency Medicine Task Force (EMTF) organized at AAU-SM developed a two years modular type of EM and Critical Care masters program curriculum for nurses that is co-implemented by faculty teachers from AAU-SM, UT and UW. In this article both the curriculum and other relevant materials are used as a resource. RESULTS: Thirty eight nurses have already graduated with Masters in Emergency Medicine and Critical Care. Equal number of trainees are currently in full-time training. Their skill and competency log book is going according to the curriculum expectation. CONCLUSION: This EM and Critical Care masters training program for nurses is successfully implemented. This program has also shown that the number and qualification of trained personnel capacity in low resource setting health care system can be effectively improved by partnership with developed training institutions.

Enhancing emergency medicine initiatives with a quality improvement program: lessons learned in the emergency department of Tikur Anbessa Hospital, Addis Ababa Ethiopia.

INTRODUCTION: A Twinning Partnership between the University of Wisconsin-Madison (UW) and Addis Ababa University (AAU) in Addis Ababa, Ethiopia was formed to strengthen the development of emergency medical services at AAU's Tikur Anbessa Specialized Hospital (TASHI) through medical education and exchanges. The Twinning philosophy which emphasizes collaboration and joint learning was an ideal program in which QI program was incorporated to maximize success, promote sustainability, and reinforce basic principles for effective healthcare service delivery. This article describes the QI methodology, capacity building strategy, implementation approach, and lessons learned. METHODOLOGY: QI initiative at TASH ED started during EM fellowship in 2010 when Priority problems in the department were identified, and root cause analysis and possible strategies for improvement were devised. Then Baseline and sensitization was undertaken which was followed by Quality Improvement Projects cycles. The Federal Ministry of health key performance indicators (KPI) were used as standard and measurement tool when it was relevant. The findings were analyzed and trends presented to the ED staff and other stakeholders. RESULTS: In the past four years Since QI initiatives started in TASH EM department different achievements have been registered. The main developments were capacity building with QI training of EM fellows, EM residents and EM and critical care nurses. QI Training was also conducted to Tikur Anbessa Hospital and college of health sciences leadership. In addition, various QI projects have been designed and started, while some are finalized and the rest are on implementation. DISCUSSION: The QI experience in the department suggests that a QI program can effectively support, complement, and enhance health system strengthening partnerships, and that establishment of a QI program at the department level is feasible and beneficial, enhancing the adoption and sustainability of health care improvements such as marked improvements in triage, improved infection control and other critical improvements. Therefore, program leaders have determined that scale-up to a hospital-wide QI program is needed to fully realize the potential for increased quality, efficiency and system strengthening.