Conference Material > Poster
Iscla M, Alamba PP, Pesqueria R, Nggilari J, Danjuma M
MSF Paediatric Days 2022. 2022 November 30; DOI:10.57740/bzw2-w143
Journal Article > ResearchFull Text
Emerg Infect Dis. 2013 February 1; Volume 19 (Issue 2); DOI:10.3201/eid1902.120301
Minetti A, Kagoli M, Katsulukuta A, Huerga H, Featherstone A, et al.
Emerg Infect Dis. 2013 February 1; Volume 19 (Issue 2); DOI:10.3201/eid1902.120301
Despite high reported coverage for routine and supplementary immunization, in 2010 in Malawi, a large measles outbreak occurred that comprised 134,000 cases and 304 deaths. Although the highest attack rates were for young children (2.3%, 7.6%, and 4.5% for children <6, 6-8, and 9-11 months, respectively), persons >15 years of age were highly affected (1.0% and 0.4% for persons 15-19 and >19 years, respectively; 28% of all cases). A survey in 8 districts showed routine coverage of 95.0% for children 12-23 months; 57.9% for children 9-11 months; and 60.7% for children covered during the last supplementary immunization activities in 2008. Vaccine effectiveness was 83.9% for 1 dose and 90.5% for 2 doses. A continuous accumulation of susceptible persons during the past decade probably accounts for this outbreak. Countries en route to measles elimination, such as Malawi, should improve outbreak preparedness. Timeliness and the population chosen are crucial elements for reactive campaigns.
Conference Material > Video
Iscla M
MSF Paediatric Days 2022. 2022 November 29; DOI:10.57740/7g0s-ye58
English
Français
Conference Material > Abstract
Iscla M, Kilbride C, Ishaya A, Pesqueria R, Nggilari J, et al.
MSF Paediatric Days 2022. 2022 November 26; DOI:10.57740/pn92-5p50
BACKGROUND AND AIMS
Simulation in healthcare education is well known, but the role of simulation in quality improvement (QI) processes is less recognised. MSF Field Simulation developed a pilot using simulation to understand and address the problem of late detection of critically ill paediatric and adult patients presenting to a hospital-level OPD, in Pulka, Nigeria, after staff raised concerns that ‘red’ cases were frequently missed at triage. We aimed to show the value of incorporating simulation into the Plan-Do-Study-Act (PDSA) cycle in the analysis and redesign of the existing triage system.
METHODS
Simulation was incorporated into each stage of the PDSA-cycle. PLAN: a tabletop simulation exercise was used to identify areas for improvement and potential solutions, completing the cause-and-effect diagram. DO: 6 practical simulations were carried out for 21 staff on a new triage protocol, the Interagency Integrated Triage tool. STUDY: a tally sheet and observation checklist were implemented, and 2 structured debriefings took place. ACT: The new triage system was established and tested using a walk-through simulation.
RESULTS
Simulation deepened the problem analysis and helped define improvement plans in: space design; processes; team composition; task distribution; material; and staff competencies. Although no baseline data was available, post-intervention data showed a highly functional triage system: from 4331 OPD-triaged patients over 30 days there were 59 red cases, 96.6% of whom were identified at triage. From a 25-point observation checklist, staff completed 96-100% of all steps in repeated observations. The team chose to use the same methodology to adapt the triage process for the upcoming malaria peak, even including the community for walk-through simulations and feedback..
CONCLUSIONS
Simulation is a powerful tool that can be used to drive QI processes. Incorporating simulation into the Plan-Do-Study-Act (PDSA) cycle allowed greater participation and depth of analysis by staff and helped to redesign, test and adapt a new triage system.
Simulation in healthcare education is well known, but the role of simulation in quality improvement (QI) processes is less recognised. MSF Field Simulation developed a pilot using simulation to understand and address the problem of late detection of critically ill paediatric and adult patients presenting to a hospital-level OPD, in Pulka, Nigeria, after staff raised concerns that ‘red’ cases were frequently missed at triage. We aimed to show the value of incorporating simulation into the Plan-Do-Study-Act (PDSA) cycle in the analysis and redesign of the existing triage system.
METHODS
Simulation was incorporated into each stage of the PDSA-cycle. PLAN: a tabletop simulation exercise was used to identify areas for improvement and potential solutions, completing the cause-and-effect diagram. DO: 6 practical simulations were carried out for 21 staff on a new triage protocol, the Interagency Integrated Triage tool. STUDY: a tally sheet and observation checklist were implemented, and 2 structured debriefings took place. ACT: The new triage system was established and tested using a walk-through simulation.
RESULTS
Simulation deepened the problem analysis and helped define improvement plans in: space design; processes; team composition; task distribution; material; and staff competencies. Although no baseline data was available, post-intervention data showed a highly functional triage system: from 4331 OPD-triaged patients over 30 days there were 59 red cases, 96.6% of whom were identified at triage. From a 25-point observation checklist, staff completed 96-100% of all steps in repeated observations. The team chose to use the same methodology to adapt the triage process for the upcoming malaria peak, even including the community for walk-through simulations and feedback..
CONCLUSIONS
Simulation is a powerful tool that can be used to drive QI processes. Incorporating simulation into the Plan-Do-Study-Act (PDSA) cycle allowed greater participation and depth of analysis by staff and helped to redesign, test and adapt a new triage system.
Conference Material > Slide Presentation
Iscla M, Kilbride C, Ishaya A, Pesqueria R, Nggilari J, et al.
MSF Paediatric Days 2022. 2022 December 1; DOI:10.57740/75a6-w616