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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

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Improving emergency attendance and mortality--the case for unit separation.

E Asumanu¹, R Richardson

¹Post Graduate Unit, 37 Military Hospital, Accra, Ghana. easumanu@yahoo.com

West African Journal of Medicine

|August 11, 2009

Summary

The Unit Separation Model (USM) significantly increased emergency attendance and reduced mortality rates in Ghana. This specialty-based emergency care model improved patient outcomes compared to the Single Emergency Model (SEM).

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Area of Science:

Healthcare Management
Emergency Medicine
Public Health

Background:

Emergency attendance and mortality are key indicators of healthcare quality.
Global health institutions are exploring new models to enhance emergency care outcomes.
Ghana implemented a Unit Separation Model (USM) to restructure its emergency unit.

Purpose of the Study:

To evaluate the impact of the Unit Separation Model (USM) on emergency care quality in a developing country.
To compare the effectiveness of USM against the traditional Single Emergency Model (SEM).

Main Methods:

A comparative study analyzing patient attendance and mortality data over two years.
Two phases were studied: Single Emergency Model (SEM) with 809 patients and Unit Separation Model (USM) with 3,505 patients.
Statistical analysis of attendance and mortality rates between SEM and USM phases.

Main Results:

Emergency attendance increased fourfold with USM compared to SEM.
Significant increases in medical, surgical, gynecological, and pediatric emergencies were observed.
Emergency mortality rates decreased substantially across all specialties, with an overall reduction from 36.7% to 10.9% (p < 0.001).

Conclusions:

The Unit Separation Model (USM) positively impacts emergency care by increasing admissions and reducing mortality.
Specialty-based emergency care within the USM framework improves patient outcomes without compromising quality.
The findings suggest that the Single Emergency Model (SEM) may lead to avoidable mortalities.