Western Cape Metro Emergency Medical Services (EMS)
Division of Emergency Medicine, University of Cape Town, South Africa [June 2009 to June 2021]
Core Overview:
- Paediatric Emergency Medicine (PEM) senior specialist with a remit to help improve emergency care of children in Emergency Departments (EDs) and Emergency Medical Services (EMS) in Western Cape (WC) province of South Africa (SA).
- Lead clinician for the Specialized Paediatric Retrieval Including Neonatal Transport (SPRINT) team. The SPRINT team is the WC EMS critical care transport service for critically ill newborns and children. The unit transports approximately over 2000 children per year in the state.
DUTIES & RESPONSIBILITIES:
Governance
- State - Appointed to Provincial Clinical Governance Committees (PCGC) of Emergency Medicine (EM) and Child Health – Lead: Emergency medicine services for children - Critical Care & Paediatric Emergencies Task Team and Guidelines/Protocol Development Task Team
- SPRINT - Created and optimized clinical governance structure and functions at SPRINT.
Systems Improvement
- Standards– lead clinician in WC for standard setting for emergency care of children, chaired the technical work group (TWG) that produced The Standards for Paediatric Emergency Care Expert Consensus Report. This led to the implementation of Priority Standards on behalf of EM and Child Health PCGC.
- Continuous Quality Improvement (CQI)– involved actively in surveillance, investigation and analysis of complaints relating to EMS transport of children in WC metropole area. Lessons shared and translated directly in practice and policy change.
- Medical Technology: Advised on specifications procurement of new technologies & equipment for child emergencies in the state
- Data: Collaborated with EMS healthcare information systems providers to produce valid and meaningful data relating to children. Data used to guide strategic and tactical decision making.
Clinical Leadership
- Strategic direction: Provided strategic direction, oversight, assurance and collaboration around improving critical care transport of neonates, children and the most critically unstable adult patients.
- Collaboration & liaison: Engaged and collaborated with clinical specialists in allied specialties (e.g. emergency medicine, paediatrics, neonatology, critical care, anaesthetists) on projects linked with paediatric emergency care.
Clinical Processes
- Guidelines– Editor from inception in 2010 to 2021 of Paediatric Emergency Medicine Guidance (PEMGs) endorsed by UCT and WC Department of Health. Researches and developed patient care protocols, procedures and pathways based on international norms and bestpractice.
- Referrals– Drove processes for improvement of clinical information sharing between referring and receiving facilities. Active consideration of patient safety principles. Encouraged more standardized clinical support from higher levels of care for junior medical staff at referring facilities.
- Research - Led projects from inception to completion with the aim of elucidating valuable clinical information and data pertaining to PEM practices in hospitals and EMS settings.
- Triage - Acknowledged expert in the field of paediatric triage in LMIC settings. Coordinated the World Health Organization (WHO) Emergency Triage Assessment & Treatment (ETAT) program in southern region of Malawi (2005-2007). At request of SA National Department of Health adapted generic WHO ETAT for used in SA to create 'ETAT-SA' as well as modifying Western Cape triage tool to combine it with ETAT-SA. See 'Key Achievements' below. [Reference: Paediatric Triage in South Africa. Cheema B, Stephen C, Westwood A. South African Journal of Child Health 2013;7(2):43-45]
Education
- Undergraduate & Post-graduate– teaching medical students, doctors, nurses and paramedics – broad range of topics including PEM, resuscitation, research methods, patient safety. Created PEM content for Clinical Emergency Care module of Master of Philosophy degree in Emergency Medicine, UCT.
- SPRINT-Ahead– Developed novel multi-modal teaching program for SPRINT team. First of its kind locally. Modular. Incentivized point system – incorporates team work and ‘good practice’ activities.
- Provincial, National & International – Recognized as an international expert in PEM in LMIC settings. Regularly invited as speaker to PEM conferences locally, nationally and internationally (see 'Conference Presentations' for further details).