Critically ill patients are not just luggage: The experiences of health workers on the transportation of critically ill patients in hospitals in Tanzania.
Maiba J., Mkumbo E., Khalid K., Willows TM., Onyango O., Schell CO., McKnight J., Oliwa J., Baker T.
BackgroundCritical illness is a life-threatening condition impacting millions of patients globally each year. Critically ill patients often need to be transported within the hospital during their care and the safety and efficiency of transportation are key for good health outcomes. There is a lack of knowledge about the processes and safety of intra-hospital patient transport in low-resourced health care settings.ObjectiveThis study aimed to understand health workers' experiences of the process and the safety of intra-hospital transportation of critically ill patients in Tanzania.MethodsQualitative in-depth interviews were conducted with 15 health workers involved in the care and transportation of critically ill patients in five Tanzanian hospitals. Purposive sampling identified participants. Data were analysed using thematic analysis, guided by the Donabedian quality of care framework.ResultsThree themes of health workers' experiences of patient transportation were identified, the first two related to structures and the third to processes: (i) the design and organisation of hospitals did not facilitate the initiation and conduct of quick, short and safe transport for critically ill patients; (ii) hospitals lacked resources for safe, effective transportation of critically ill patients; (iii) there were weaknesses in the preparation for, conduct of, and handover of information concerning the transportation of critically ill patients. Health workers in Tanzania faced substantial challenges in ensuring safe transportation due to hospital infrastructure limitations, resource shortages, and inadequate processes.ConclusionWe conclude that the transport of critically ill patients is overlooked in hospital services in Tanzania, despite the importance of safe intra-hospital transportation in preventing deaths. Feasible solutions to these challenges are necessary for reducing high mortality and morbidity among critically ill patients.