Merits and challenges in the development of a dedicated burn service at a regional hospital in South Africa

Abstract

IntroductionThe 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. MethodologyThe burn admission records were retrospectively interrogated for the years 2012–2013. ResultsThis 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. ConclusionWe 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.