Dear CHIFA members,
I would like to draw your attention to an unfortunate incident, which has serious policy implications.
A 5-month-old, was admitted in the paediatric ward of a large hospital on 16/07/22. The child’s condition deteriorated rapidly on 23/07/22 around 12 pm, with severe abdominal swelling and hematemesis. The patient was referred to the nearby Medical University and dispatched in an ambulance, with oxygen, at 3.15 pm.
However, upon reaching the University, we found that there were no PICU beds available, which the doctors advised would likely be necessary; they instead referred us to another large Hospital in another part of the city. We requested the doctor in paediatric emergency to phone ahead of time to enquire whether a PICU bed was available, but she declined, advising me to just google the numbers. We were able to contact the new hospital, but the operator advised me that he was not in a position to say whether or not a PICU bed was available and that we needed to come directly to inquire.
Upon reaching this new hospital at 5.30 pm, we were again told that there were no PICU beds available. At this point, the desperate parents of the patient decided to take the child to a private hospital. Sadly, the baby passed away en-route to the hospital at 6.15pm – having been in an ambulance without receiving specialist medical attention for the last three hours.
Death of this baby – and thousands of other patients – may have been averted by greater coordination between different government hospitals, to ensure that patients are only referred to hospitals which have the required facilities immediately available. We wish to offer two policy recommendations which could fix this problem.
In the immediate term, primary and secondary health centres should be given a list of numbers for key tertiary care hospitals, It should be the responsibility of a referring doctor to call the hospital they are referring to ahead of time to confirm the availability of the required facility, before sending the patient.
In the longer term, there could be a portal set up, similar to the current ORS websites display of blood availability by group type, in which key hospitals give live updates on the availability of general and ICU beds. Referring doctors, or patients themselves, could easily check the information rather than making an unnecessary trip.While working with the concerned provincial government we would like provide them as many options, models from other parts of the world.
If you have ideas, experience, practices, apps or other tools please do share.Suggestions wanted for Greater Coordination among Hospitals.
CHIFA profile :
Augustine Veliath is a Health Communication Specialist and an independent
Consultant in India. Professional interests: Child Survival, Advocacy, Environment
Building, Behavior Change communication, Entertainment education.
email :augustinevjATgmail.com
