The hospital is suppose to be the safety net of the system. To be there to provide medical care for all in the community. And if people don't have access to a regular medical practitioner, then the ER becomes the ultimate safety net. But I don't understand, yet, how the safety net here fails to catch people. Are there holes in the net, or are people (kids) just too far out of reach of the net?
We had a monthly review meeting yesterday. A review of the stats from the previous month. This review is only for the 4 general pediatric ward teams. The stats don't reflect newborns/NICU/hemeatology-oncology/pedi ED, pedi surgery or the metabolic/refeading units.
We had a monthly review meeting yesterday. A review of the stats from the previous month. This review is only for the 4 general pediatric ward teams. The stats don't reflect newborns/NICU/hemeatology-oncology/pedi ED, pedi surgery or the metabolic/refeading units.
In July there were 507 admissions, and 37 deaths. Each team reviewed the overall picture of the kids who had died. And it was quite interesting to note that more than a few of these kids died the same day they were admitted, or even within a few hours of coming into the hospital. What is keeping these kids from showing up earlier, and therefore, maybe having a better chance of making it?
Certainly, many of these kids had gone to local healers (aka sangoma) as a first option. This is culturally related. But also there is a delay because as far as I understand, one must go to the local clinic first to be seen (likely a wait there) and then be referred to the pedi ED (more wait) and then eventually seen, and eventually admitted.
Some of these deaths were not completely unexpected. A few, well-known, kids with chronic medical conditions died during the month, having exhausted medical therapy. But it seemed that so many of the deaths were related to poor nutrition and living standards. It's always been one thing to read statistics of child mortality and know that diarrheal diseases and respiratory infections are big offenders, but there has always been a disconnect in reading this information. But having seen these kids the past few weeks, it's really, really appalling to know that many of these deaths have been preventable!
I was kind of tuning out thinking about how many preventable deaths occur over the year when something caught my attention.
"Baby S, and 8 month old discharged from ward 18 2 week prior. . ." And so now I'm really curious to know who this kid is. . . "had been admitted initially w/ dehydration and severe malnutrition. . ." This is beginning to sound familiar. . . "Was readmitted for -blank- and died the next day."
-blank-
-blank-
Blank isn't some mysterious medical condition or something that I'm too worried to share, but blank is exactly what happened in my mind as I realized who this kids was.
My Baby S! The one I wrote about last month.
Shit!
And I think this sucks. He had follow up in place, but somehow something happened, and he either fell through the safety net, or missed it completely on his way down.
