Performance Analysis for the
Emergency Medical Service Dhulikhel, Nepal
The ambulance service in the catchment area of Dhulikhel Hospital is still in its infancy. A network of now 8 ambulance guards is based on the vision of a committed Nepalese doctor who wanted to do the same with emergency medical care in Germany and has implemented a control center in the Dhulikhel Hospital. For seven years now, this has been coordinating 8 rescue guards, some of which are operated with the support of the Nepalese Red Cross.
A pre-hospital emergency system created by a handful of dedicated individuals.
What the Dhulikhel ambulance service lacks, despite its overwhelming commitment, is a quality check of the current system. Emergency data have been collected in the Dhulikhel control center for seven years now, but have not been subjected to any standardized evaluation due to a lack of know-how. The actual performance of the system is not known and potential process optimizations are also hidden.
In Germany, the standardized evaluation of the control center data is part of day-to-day business in order to ensure compliance with the legal requirements for rescue services. There are no such requirements in Nepal because the rescue service in Nepal is not organized centrally.
The lack of knowledge about one's own performance makes it difficult to expand the system in a targeted manner and to close potential supply gaps.
Also, there is no way to attract potential supporters until the system's performance can be demonstrated.
What have we done?
In February 2020 we traveled to Nepal to have a look at the control center and the ambulance service at Dhulikhel Hospital. Particular attention was paid to data entry, which at that time was still quite uncoordinated by people with little training. Accordingly, the data quality could be improved. In February, the creation of an input mask was already in progress, so we neglected to optimize the data input.
We have merged and cleaned up the Excel files that were loose at the time.
We are currently working on the creation of several MS Power BI dashboards in which the emergency services are presented in detail. Supply bottlenecks and optimizations in medical care are to be uncovered so that they can be targeted.
The Nepalese rescue service team is to receive a tool that can be shown to potential donors and from which it can be seen how many people could actually be looked after by the Dhulikhel rescue service. An overview of the complaints and the overall health of the emergency patients should show the necessity of the emergency services. The deployment development over the years and per province should make visible if the capacity of the rescue service network should be expanded in a targeted manner in favor of an even larger number of patients.
The analyzes should be adapted to the new database as soon as the standardized data entry is in operation.
Threshold values should then show where the capacity needs to be increased or where it makes sense to reserve rescue service personnel at other rescue stations. The performance of the system should be made visible and weak points can be eliminated in a targeted manner.