Table 3 The Solomon Islands needs assessment case example
Findings | Priority Recommendations | Outcomes |
|---|---|---|
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 |