Published Paper Details:

Introduction: The lack of integrated, organized emergency care leads to millions of preventable deaths and creates wide discrepancies in outcomes across the range of emergency conditions. Objective: To identify the selected aspects in gaps of emergency care services in all health care institutions in the Western Province. Methodology: It was a descriptive cross sectional study which evaluated the emergency care services in all Health Care Institutions in the Western Province. The sample was all 39 Health Care Institutions which are at different levels of care. Emergency services were assessed through a validated questionnaire. It was focused on the case load, infrastructure, diagnostic facilities, human resource and quality. Results: The gaps identified were: o Lack of triage categorization, triage documentation and knowledge of ED case-mix by triage category o Lack of documentation of critical timings for patient care in the ED with resulting lack of knowledge of status of patient flow through the ED. There is also resulting lack of data on time based operational quality indices in EDs in Sri Lanka. o Relative lack of appropriate physical infrastructural facilities at most EDs in the Western province that are not commensurate with patient load and national guidelines on A&E services. o Significant shortage of critical professional staff, especially doctors and nurses in most EDs compromises the speed and quality of care EDs are able to provide o Lack of uniformity in availability of imaging and laboratory facilities to the different levels of EDs o Significant variability in quality of documentation in ED medical records Conclusion: This study identifies many gaps in different aspects in the Emergency care. Recommendations: An emergency care model should be developed which appropriate for Sri Lanka