Skip to main content

Table 5 Key findings and recommendations from needs analyses in Timor – Leste and Kiribati

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

Country and ContextKey findingsPriority Recommendations
Timor-Leste (2009)
(national referral hospital)
 • Post-conflict
 • Many different service providers
 • Cuban doctor training program
 • New ED building
 • Limited understanding of EC
 • Strong sense of unity
 • Change occurs through mentoring and modelling
Lack of triage impacting on quality of care
Entrance overcrowding and assessment area bottleneck
Poor information management and communication across language/culture
Very limited staff training, precarious leadership, sustainability challenges
Quality of care limitations
Insufficient use of space
Substantial investment in local staff
• Identify potential leaders
• Provision of ED career structure
• Long and short term training
• Provide mentors
• Short and long term technical assistance
Development and implementation of a triage system
Clinical guidelines and regular audits
Improved formal communication; handover, referral, documentation
Basic equipment provision
ED re-design suggestions
Kiribati (2011)
(national referral hospital)
 • Small atoll nation
 • Very close community
 • Strong nurse training and nurse culture
 • Few doctors, some Cuban medical training
 • Old ED building
 • Change occurs through senior leadership and consensus collaboration
Inadequate nurse numbers and insufficient EC training
Absent medical leadership
Very poor environment; not fit for purpose, limited renovation potential, no amenity
No triage system
Overcrowding and bottlenecks
Minimal clinical guidelines or quality standards
Minimal equipment and information management resources
Short term
• Build ED nursing knowledge and leadership
• Minor renovation and re-use of existing space, basic amenity repairs
• Development and implementation of a simple triage system
• Patient flow and clinical guideline working groups
Longer term
• Invest in medical ED leadership
• Improve IT and data management systems
• Source funding for more extensive ED renovation