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[Preprint]. 2024 Dec 24:rs.3.rs-5640378.
doi: 10.21203/rs.3.rs-5640378/v1.

Developing and integrating a destination decision support algorithm into an innovative electronic communication platform to improve injury care service coordination in Rwanda: The Rwanda912 study protocol

Rwanda RIGHT Group; Aurore Nishimwe  1 , Justine Davies  1 , Jean Claude Byiringiro  1 , Abebe Bekele  2 , Lucia D'Ambruoso  3 , Agnieszka Ignatowicz  1 , Barnabas Tobi Alayande  2 , Jeanne D'Arc Nyinawankusi  4 , Jean Marie Uwitonze  4 , Jean Nepomuscene Sindikubwabo  4 , Irene Bagahirwa  4 , Collins Inkotanyi  2 , Sudha Jayaraman  5 , Antonio Belli  6 , Rob Rickard  7 , Assuman Nuhu  8 , Ephrem Daniel Sheferaw  2 , Laura Quiin  1 , Gilbert Rukundo  4 , Philbert Muhire  9 , Oda Munyura  2 , Fabien Hagenimana  8 , Didier Hagumimana  8
Affiliations

Developing and integrating a destination decision support algorithm into an innovative electronic communication platform to improve injury care service coordination in Rwanda: The Rwanda912 study protocol

Rwanda RIGHT Group et al. Res Sq. .

Update in

Abstract

Introduction: Delays in getting injured patients to hospital in a timely manner can increase avoidable death and disability. Like many low- or middle-income countries (LMICs), Rwanda experiences delays related to lack of efficient prehospital communication and formal guidelines to triage patients for hospital care. This paper describes the protocol to develop, roll out, and evaluate the effectiveness of a Destination Decision Support Algorithm (DDSA) integrated in an electronic communication platform, '912Rwanda'. The DDSA will facilitate the linkage of patients to health facilities able to treat their condition(s). Work will be conducted in three phases: i. development, ii. training and roll-out, and iii. evaluation.

Methods and analysis: Work will be conducted in the pre-hospital emergency service "SAMU - Service d'Aide Medicale Urgente" and health facilities in Kigali City and Musanze District, which serve predominately urban and rural populations, respectively. We will develop interfaces to capture facility and patient-relevant data, which feed into a guideline-based electronic DDSA to match patients to hospitals. We will assess existing trauma care processes using qualitative and quantitative methodologies. This will be followed by a series of consensus workshops to develop at-scene triage guidelines and agree variables to capture in the interfaces. The DDSA will be developed based on outputs from these workshops and tested against historical ambulance data and expert opinion until acceptable thresholds of performance are passed. User interfaces will be developed and tested using human computer interface design principles.

Discussion: The combined collaborative approach of bringing together experts and software developers, and with deep engagement of Rwandan stakeholders, including leadership of Rwanda Ministry of health through its technical arm, the Rwanda Biomedical Center, should lead to an ambulance communication system which is utilized, sustained, and effective.

Keywords: Ambulance; Destination Decision-Support Algorithm (DDSA); Emergency care; Pre-hospital emergency care system; Rwanda; Service d’Aide Medicale Urgente (SAMU).

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Figures

Figure 1
Figure 1
Inefficient communication (red arrows denote multiple mobile telephone calls) between dispatch centre, ambulance crews, and health facilities resulting in avoidable pre-hospital delays.
Figure 2
Figure 2
The Destination Decision Support Algorithm concept and solution
Figure 3
Figure 3
Summary of study flow
Figure 4
Figure 4
Objective 1 - stages and analysis
Figure 5
Figure 5
Objective 2 - stages and analysis
See this image and copyright information in PMC

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