title: Mapping the process of emergency care at a teaching hospital in Ghana.
abstract: Emergency Department (ED) overcrowding has become a global concern as the number of countries with formalized emergency care systems has expanded, and the burden of trauma and non-communicable diseases in low and middle-income countries increased. In light of this, the international Emergency Medicine literature has outlined the need for operational projects in low and middle income countries which focus on the process of care. Despite this, there is limited published literature describing these types of projects. We share our experience mapping emergency care processes at a teaching hospital in Ghana as a case study of Lean's application in a relatively resource limited setting. From this work, we conclude that process mapping, a critical first step in further process re-design, is a cost effective, low tech activity which can be feasibly used in low resource environments to initiate quality improvement.
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, USA; Lawrence Center for Quality and Safety, Massachusetts General Hospital and Massachusetts General Physicians' Organization, USA. Electronic address: eaaronson@partners.org.
authors.forename: Emily
authors.initials: E
authors.lastname: Aaronson
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Harvard Medical School, USA; Lawrence Center for Quality and Safety, Massachusetts General Hospital and Massachusetts General Physicians' Organization, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mort
authors.affiliation: Department of Emergency Medicine, Bellevue Hospital, New York University, USA; Non Trauma Emergency Care, Korle Bu Teaching Hospital, Ghana.
authors.forename: Samara
authors.initials: S
authors.lastname: Soghoian
mesh_terms: D003441:Crowding; D004632:Emergency Medical Services / Q000379:methods*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005869:Ghana; D006784:Hospitals, Teaching / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D017064:Process Assessment, Health Care / Q000379:methods* / Q000639:trends; D058996:Quality Improvement