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Improving The Care of Critically Ill Patients: Lessons Learned from The Promotion of Essential Emergency and Critical Care In Tanzania: A Qualitative Study.

Kaliza, A. C.; Mlunde, L. B.; Schell, C. O.; Khalid, K.; Sawe, H.; Mkumbo, E.; Kigombola, A.; Mwandalima, I.; Sylvanus, E.; Kilindimo, S.; Lugazia, E.; Masuma, J. S.; Baker, T.

2024-05-24 health systems and quality improvement
10.1101/2024.05.24.24307887 medRxiv
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ObjectiveTo describe the lessons learned during the promotion of a new approach to the care of critically ill patients in Tanzania - Essential Emergency and Critical Care (EECC) DesignA descriptive qualitative study using thematic analysis of structured interviews Setting and ParticipantsThe study was conducted in Tanzania, involving eleven policy makers, researchers and senior clinicians who participated in the promotion of EECC in the country. ResultsThe five thematic lessons that emerged from the promotion of EECC in Tanzania were: (i) ensure early and close collaboration with the government and stakeholders; (ii) conduct research and utilize evidence; (iii) prioritize advocacy and address misconceptions about EECC; (iv) leverage events and embed activities in other health system interventions and (v) employ a multifaceted implementation strategy. ConclusionThe results from this study show the efficacy of a holistic, comprehensive approach in promoting EECC as each strategy reinforces the others. This approach led the to the successful promotion of EECC and the development of a National Strategic Plan for EECC by the government of Tanzania. Article SummaryStrengths and Limitations of this study: StrengthsO_LIHigh credibility of findings due to the in-depth qualitative data collection process and the inclusion of diverse participants, which continued until data saturation was reached. C_LIO_LIMitigation of personal biases by iterative sharing of findings with participants and key stakeholders C_LI WeaknessesO_LIThe purposeful selection of participants may have missed some stakeholders with alternative viewpoints and experiences. C_LIO_LIWe were unable to transcribe the interviews, instead, a codebook and audio recordings were used for cross-referencing which may have led some relevant information being missed. C_LI

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