title: Merits and challenges in the development of a dedicated burn service at a regional hospital in South Africa.
abstract: BACKGROUND
  The Edendale Hospital Burn Service was initiated in 2011 to improve the quality of burn care at a regional hospital. This audit reviews the merits and challenges in developing such a service and identifies areas on which to focus quality improvement initiatives.
  
  
  METHODS
  The burn admission records were retrospectively interrogated for the years 2012-2013.
  
  
  RESULTS
  This audit covers an 18-month period in which 490 patients were admitted. Admitted days per percentage burn were 2.6 days per percentage total body surface area burnt. The mortality rate was 13%. Fourteen percent of patients met the criteria for referral to the provincial burn centre but for a variety of logistical reasons only 3% were transferred.
  
  
  CONCLUSIONS
  We have redesigned the process of care without alteration of resources. Outcomes of burns less than 30% total body surface area are not acceptable which we believe reflects the lack of infrastructure and systems development. This audit has revealed a number of areas, which are suitable for dedicated quality improvement initiatives.
authors.affiliation: Department of Surgery, Pietermaritzburg Metropolitan Complex, University of Kwa-Zulu Natal, South Africa. Electronic address: nikkiallorto@gmail.com.
authors.forename: Nikki L
authors.initials: NL
authors.lastname: Allorto
authors.affiliation: Department of Surgery, Pietermaritzburg Metropolitan Complex, University of Kwa-Zulu Natal, South Africa.
authors.forename: Damian L
authors.initials: DL
authors.lastname: Clarke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001458:Bandages; D002053:Burn Units / Q000458:organization & administration*; D002056:Burns / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000458:organization & administration*; D003906:Developing Countries; D005260:Female; D006760:Hospitalization; D006767:Hospitals, District; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016038:Skin Transplantation; D013019:South Africa; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Burn; Developing world