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Table 3 The Solomon Islands needs assessment case example

From: A Pacific needs analysis model: a proposed methodology for assessing the needs of facility-based emergency care in the Pacific region

FindingsPriority RecommendationsOutcomes
Staff
 • Lack of leadership
 • Insufficient numbers
 • Minimal training
 • Poor morale
Leadership investment
Staff recruitment
Staff training and development
Two local Emergency Medicine Physicians in leadership roles
Australian EM physician and ED Nurse as in-country technical assistance and support
24-h ED medical rostering
Local leaders running
• regular daily education sessions
• annual compulsory competency training to ensure minimum standard of care
• rotating overseas professional development opportunities for all staff
• new EM Diploma degree
• annual ED staff medical checks
• junior staff portfolios
Systems
 • Quality and safety
 • Poor communication
 • Limited information systems
 • Triage
  o No system
  o Unsafe practice
 • Patient Flow
  o Overcrowding, bottlenecks
  o Absent management system
Patient flow management systems
Patient tracking systems
Triage system
Quality improvements
• Clinical guidelines
• Audits
• Minimum standards
Paediatric care focus
24 h Security staff
Recruitment of cleaners
Hospital-wide ED Access Block policy and procedures
Development of local patient tracking system
Development and implementation of the Solomon Islands Triage Scale (SITS)
ED clinical guidelines
Point-of-care testing
Weekly audits
Team meetings: ED and external
Disaster training
Space (environment)
 • Limited space
 • Unsafe space
 • Inadequate equipment
Redesign suggestions
• Paediatric area
Improve amenity
Basic equipment procurement & maintenance
Separate Paediatric ED care space
New triage and registration room
Air-conditioners, amenity block renovation
Individual staff basic equipment packs
Facilitators
 • Strong nurses
 • Desire for change
 • Future potential
 Overall outcomes
• Good morale
• High engagement
• ‘Best Department’ award
• Future positivity
Barriers
 • Exhaustion
 • After-hours issues
 • Administrative challenges
 Risks
• Burnout