TY - JOUR
T1 - The Pakistan National Emergency Department Surveillance Study (Pak-NEDS)
T2 - Introducing a pilot surveillance
AU - Mir, Mohammed Umer
AU - Bachani, Abdulgafoor M.
AU - Khawaja, Haseeb
AU - Afridi, Shiraz Qayoom
AU - Ali, Sabir
AU - Khan, Muhammad Mujeeb
AU - Jamali, Seemin
AU - Sumalani, Fareed Ahmed
AU - Hyder, Adnan A.
AU - Razzak, Junaid A.
N1 - Funding Information:
The Pak-NEDS study was supported through the “Johns Hopkins International Collaborative Trauma and Injury Research Training Program” [Grant No. D43TW007292] by Fogarty International Center of the United States National Institutes of Health. The content is solely the responsibility of the authors and does not represent the views of Fogarty or NIH. The authors are grateful to local collaborators and data collection teams and also Ms. Leann Rosenberg for providing language edits of the paper. This article has been published as part of BMC Emergency Medicine Volume 15 Supplement 2, 2015: Articles from the Pakistan National Emergency Departments Surveillance Study (Pak-NEDS). The full contents of the supplement are available online at http://www.biomedcentral.com/ bmcemergmed/supplements/15/S2. Publication of this supplement was funded by the Johns Hopkins School of Public Health.
Publisher Copyright:
© 2015 Mir et al.
PY - 2015/12/11
Y1 - 2015/12/11
N2 - Background: Evidence-based decision making is essential for appropriate prioritization and service provision by healthcare systems. Despite higher demands, data needs for this practice are not met in many cases in low- and middle-income countries because of underdeveloped sources, among other reasons. Emergency departments (EDs) provide an important channel for such information because of their strategic position within healthcare systems. This paper describes the design and pilot test of a national ED based surveillance system suitable for the Pakistani context. Methods: The Pakistan National Emergency Department Surveillance Study (Pak-NEDS) was pilot tested in the emergency departments of seven major tertiary healthcare centres across the country. The Aga Khan University, Karachi, served as the coordinating centre. Key stakeholders and experts from all study institutes were involved in outlining data needs, development of the study questionnaire, and identification of appropriate surveillance mechanisms such as methods for data collection, monitoring, and quality assurance procedures. The surveillance system was operational between November 2010 and March 2011. Active surveillance was done 24 hours a day by data collectors hired and trained specifically for the study. All patients presenting to the study EDs were eligible participants. Over 270,000 cases were registered in the surveillance system over a period of four months. Coverage levels in the final month ranged from 91-100% and were highest in centres with the least volume of patients. Overall the coverage for the four months was 79% and crude operational costs were less than $0.20 per patient. Conclusions: Pak-NEDS is the first multi-centre ED based surveillance system successfully piloted in a sample of major EDs having some of the highest patient volumes in Pakistan. Despite the challenges identified, our pilot shows that the system is flexible and scalable, and could potentially be adapted for many other low- and middle-income settings.
AB - Background: Evidence-based decision making is essential for appropriate prioritization and service provision by healthcare systems. Despite higher demands, data needs for this practice are not met in many cases in low- and middle-income countries because of underdeveloped sources, among other reasons. Emergency departments (EDs) provide an important channel for such information because of their strategic position within healthcare systems. This paper describes the design and pilot test of a national ED based surveillance system suitable for the Pakistani context. Methods: The Pakistan National Emergency Department Surveillance Study (Pak-NEDS) was pilot tested in the emergency departments of seven major tertiary healthcare centres across the country. The Aga Khan University, Karachi, served as the coordinating centre. Key stakeholders and experts from all study institutes were involved in outlining data needs, development of the study questionnaire, and identification of appropriate surveillance mechanisms such as methods for data collection, monitoring, and quality assurance procedures. The surveillance system was operational between November 2010 and March 2011. Active surveillance was done 24 hours a day by data collectors hired and trained specifically for the study. All patients presenting to the study EDs were eligible participants. Over 270,000 cases were registered in the surveillance system over a period of four months. Coverage levels in the final month ranged from 91-100% and were highest in centres with the least volume of patients. Overall the coverage for the four months was 79% and crude operational costs were less than $0.20 per patient. Conclusions: Pak-NEDS is the first multi-centre ED based surveillance system successfully piloted in a sample of major EDs having some of the highest patient volumes in Pakistan. Despite the challenges identified, our pilot shows that the system is flexible and scalable, and could potentially be adapted for many other low- and middle-income settings.
KW - Emergency department
KW - Methodology
KW - Mulit-center
KW - Pakistan
KW - Surveillance
UR - http://www.scopus.com/inward/record.url?scp=84977608951&partnerID=8YFLogxK
U2 - 10.1186/1471-227X-15-S2-S1
DO - 10.1186/1471-227X-15-S2-S1
M3 - Article
C2 - 26690669
AN - SCOPUS:84977608951
SN - 1471-227X
VL - 15
JO - BMC Emergency Medicine
JF - BMC Emergency Medicine
IS - 2
M1 - S1
ER -