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Improving Safety in Pediatric Anesthesia in Moldova

Improving Safety in Pediatric Anesthesia in Moldova. Markus Schily Biel, Switzerland. Is more safety in anesthesia in Eastern Europe needed ? Who is responsible for it ? Who is going to do it ?. Moldova. 3.3 mill . people. Anesthesia safety differs in Europe.

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Improving Safety in Pediatric Anesthesia in Moldova

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  1. Improving Safety in Pediatric Anesthesiain Moldova Markus Schily Biel, Switzerland

  2. Is moresafety in anesthesia in Eastern Europe needed? Who isresponsibleforit? Who isgoingto do it?

  3. Moldova 3.3 mill. people Anesthesiasafetydiffers in Europe

  4. Different Standards: Example1: ChildrenshouldhaveanesthesiaforTE Example2: Childrenshouldhavepainfree CC Example3: Most ped.anesthesiashouldbecombined with a regional block Motivation, technologies, knowledge Interculturallearning Progress

  5. A projecttoimproveanesthesiasafety 2007: firstactivitieswithMoldovandoctors 2008: foundationof IATC

  6. I = Information • A = Assistance • T= Technologies • C = Communication

  7. Driving on theleftside? KEEP LEFT!

  8. Wikipedia: Promote empathy, role-play . Supports students in making the shift in perspective: own culture becomes a strange, looked at from the outside, target culture becomes familiar.

  9. Inter Cultural Learning • Gradual approach: • Identification and understanding of the fundamental values • of the host country • Acquisition of the keys needed to decode new situations • Adaptation of behaviour

  10. ImprovingSafety - Projects obstacles Funding? Language & culturebarrier MinistryofHealth: decisionmaker

  11. Understanding - teaching in 2007 by IATC

  12. Sterile surgerydrapes

  13. 2012: MoldovanAnesthesia Machines

  14. Who isgoingto listen tous? German MinistryofHealth Z31 International Cooperation

  15. Lawrence ofArabia: united theBeduintribes…

  16. Strategy: Target governmental funding introduction of modern drugs and technologies

  17. Anesthesiaequipmentupgrade Ministries of Health Annual meetings in Moldova AnesthesiaSafety

  18. Strategy: Improvecommunication • Involving societies, find a name of activities • improved anesthesia training

  19. Fundraising strategy Private fundraising improving means of teaching, humanitarian aid

  20. Initial IATC project in Moldova: Upgrade ofanesthesiaequipment

  21. 2007: First donatedanesthesiamachine

  22. Bern 2008 – usedanesthesiamachinesforMoldova

  23. These machineswentfrom Luzern toMoldova

  24. IATC aidtoMoldovaincluded: Budget ofabout 2 Mill. EUR More than 80 anesthesiaworkingstations 3 ultrasoundmachines, 55 syringepumps 150 hospitalbeds Ambulancecar

  25. All threechildrenhospitals fullyequipedwithnew anesthesiamachines

  26. First result Reducedpediatricanesthesiamortalitycomparedto 2007 ref: MoHMoldova, 2012

  27. Improvingcommunicationbetweensocieties WFSA SARM

  28. ESPA delegatefromMoldova 2011 -2013, sponsoredandsupportedby IATC

  29. Commission SARM, MoH, ESA: Reform ofanesthesiaresidency 2010 – 2011, sponsoredandsupportedby IATC

  30. Situation ahead of Anesthesia Reform (before 2011) • Pediatric Anesthesia Residency 4 years • (separate Residency) • 2. Anesthesia Residency: 4 years • 3. Moldovan Syllabus • 4. Moldovan oral Exam

  31. Plan of Reform , Anesthesia Residency Moldova, Nov. 2011: • Pediatric Anesthesia Residency integrated • Residency: 5 years • European Syllabus • EDAIC exam

  32. Whatiswrong? Moldovan anesthesia exam result 2012: 100% candidates passing EDAIC exam Chisinau exam result 2012: 0 % candidates passing

  33. Corruption Extra feestodoctors MC questions: knownaheadofexam Everythingcanbebought

  34. 2012: last 35 anesthesiamachines / monitorsdelivered New Teaching Concept: Mobile Simulation based & clinicalteaching OLA

  35. Mobile Anesthesia Simulation Unit Curriculum: Recommendations, guidelines Crisismanagement, crewresourcemanagement Rare casemanagement, patienttransfer Simulation cannotreplaceclinicalteaching!

  36. German GiZfundingtill end of 2013 Sim baby, Sim 3G man, Sim junior Ambulancecar, transportcar Anesthesiaworkingplace

  37. Simulation in Switzerland, 2013 No ECG leads! Cardiacarrest after aspiration

  38. ESPA SafetyCommitteeand Simulation: Joint venture: spreadguidelinesandrecommendations PediatricAnesthesia Simulation Course: ESimPA

  39. ESimPA: • European network • Small mobile teachingteams • Inclusionof Eastern Europe • CoordinatingsimulationactivitieswithESPA • Certificationofattendance (ESPA

  40. First steps: Moldovanproject ESPA safetyproject TTC forESimPAtutors ESimPAtutors: Simulation stage in Swiss and German hospitals Learning fromothers: Visitations

  41. Conclusion: 6 yrs.IATCprojectprovedthatanesthesiasafetydifferssignificantly in Europe Technical upgrade must befollowedbyteachingactivities ESPA: keyfactor in making European pediatricanesthesiamoresafe

  42. IATC supports ESPA… It‘s all aboutanesthesiasafetyin Europe 2010 2011

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