Date of Award

1-27-2022

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Amna Rehana Siddiqui

Department

Community Health Sciences

Abstract

Background: Optimum service delivery is the key to curbing transmission of acute respiratory infections presented to emergency departments like influenza, SARS[1]CoV-2, and others. Tertiary care hospitals are the first point of contact for most patients and there is need to be well prepared in addressing transmissible and contagious respiratory infections including dealing with surge capacity as well as protection of HCWs and decreasing morbidity in other patients. This study conducted an in-depth analysis of the readiness of emergency departments in dealing with respiratory infections.
Methods: Convergent mixed methods study design is used. Quantitative methods are covered by direct observation of four tertiary care facilities in Karachi, Pakistan using an adapted version of Service Availability and Readiness assessment (SARA) checklist and a cross sectional survey of Health Care Workers (HCWs) of the same facilities. The results obtained were graded using the readiness scores classified as low (< 75%), intermediate (75-99%), ready (>99%). Three eighty-seven responses were recorded. Qualitative method is covered by six in-depth interviews of key informants from the four selected tertiary care hospitals. All findings are triangulated to find the readiness of the facilities in dealing with transmissible respiratory infections under 6 domains of governance and coordination, facility infrastructure, human resources, supplies, communication, and infection control practices (IPC).
Findings: On facility observation out of all six domains there was variability in all except in presence of adequate number of human resources. Observation and HCW survey results were congruent. Overall mean readiness score for governance and coordination was 85.04%, facility infrastructure was 81.99%, human resources was 83.03%, supplies was 90.4%, communication was 85.4% and IPC was 75.1%. The overall mean readiness score of HCW survey was statistically different across all six domains (p value= < 0.05). The highest mean readiness score attained was 90.4% in the domain of supplies and the lowest was 75.1% in the domain of infection prevention and control across the four hospitals. Qualitative findings suggest limited resources and poor coordination among staff members as key to barriers in readiness of emergency departments in dealing with respiratory infections.
Conclusion: The importance of monitoring readiness of emergency facilities in dealing with respiratory infections is crucial element in curbing transmission of infection. With limited resources, lack of implementation of infection control practices and lack of trainings in HCW increases risk of morbidity and mortality that our health system cannot afford.

First Page

1

Last Page

65

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