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Impact of the Use of a WhatsApp-based Group Chat for Sharing Emergency Department Access-Block Data on Overcrowding and Census in a Low-Resource Emergency Department in Kigali, Rwanda

Nkeshimana, M.; Uwineza, C.; Pousson, A. Y.; Cattermole, G. N.

2020-06-26 health systems and quality improvement
10.1101/2020.06.25.20139790 medRxiv
Show abstract

In Low & Middle Income Countries (LMICs), hospitals often face serious communication issues that threaten to paralyze the process of healthcare provision. The Centre Hospitalier Universitaire de Kigali (CHUK) is located in the middle of a vibrant city of Kigali, and is often overwhelmed by a high number of referred patients from its catchment area, and those brought in by emergency evacuation ambulance system (SAMU). The facility has no interdepartmental landline communication network, which would be ideal to connect the inpatient services to the emergency room in order to fasten the care process. Using WhatsApp-based Group Chat for sharing the real-time caseloads, the number of patients boarding the emergency room has significantly improved (dropping from 38.1 +-7.1 to 28 +-6.5, p<0.001), although the overall length of stay in the emergency room has remained high (3.37 +-0.61 days), mainly due to other co-factors such as the availability of specialized staff (i.e. neurosurgeon) and uninterrupted imaging services (i.e. computer tomography scans).

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