Pakistan society of EM has changed hands. My tenure ended and a new cabinet has sworn in. It reflects a very important step in the history of EM in Pakistan. This was the first change that occurred since the inception of the society. It shows that the journey we embarked on in 2018 started maturing. It shows that we are becoming relevant, and that the need for the society is becoming well understood and it has started engaging. This process happened through a defined democratic approach which involved people at all levels. Whether it be at Cabinet level, voters level or at general well-wishers of PSEM level. People expected such a process and continuity to give more relevance to us.
Now the present cabinet needs to continue on all fronts and also create more ways for the people to get the benefit of the society. A few areas of future work could be summarized as follows:
- Membership drive.
It is always good to be all inclusive and give a feel of welcome to all those who are interested in our work. So expansion among the doctors working in emergency department is of prime importance. With same token our nursing and paramedics are same way relevant and need to come share this platform. We also should welcome anyone who is interested in our work and want the emergency care to improve in Pakistan.
- Creating and enhancing understanding of people about Emergency Care.
We are facing a recognition challenge and we need to do everything to explain ourselves to all those who matter. We have a huge challenge of changing mindset of our patients, our colleagues and also the decision makers/ stakeholders of healthcare. People need to know our scope, our relevance and also areas of our competence to get the benefit from us. We have witnessed a change in mind set, yet a lot still needs to be done. We need to educate people about emergency medicine in all respects. As patients, colleagues in other specialties and as decision makers in power corridors. Ultimately resulting in better provision of emergency care through combined work. We want people to utilize emergency department for what it is meant for “Taking care of emergencies”
- Educational aspects.
There is a vast gap in the educational aspects of people working in the emergency departments. The doctors and nurses are mostly fresh and untrained. Any avenue to enhance the knowledge of these people would be greatly appreciated by all. We need to have structured as well as non-structured activities to make ED care providers competent. By structured means a defined and recognized training program, and the non-structured can be sources or workshop to other relevant activities done to enhance the caliber of people working in the emergency department.
- Help in Training.
College of Physicians and Surgeons Pakistan has a great role in enhancing the Emergency Medicine by paving way for the EM to be accredited for training. We need to enhance the role of CPSP as well as increase the number of institution providing the training of EM. The training of EM was recognized in 2011 by the CPSP. It is a 5 years program resulting in an exit degree called FCPS in EM. Besides CPSP we also have worked with other stakeholders, both national and international and we have worked hard on quite a few elements when it comes to training.
- FCPS/MS/MD in EM.
- Generic Courses in Life support competencies.
- Certification Courses with the help of International partners.
We are still in need of short term training in EM either through CPSP or with the help of any other College or University.
Similarly, we also need to create the educational programs for nurses and paramedics. There are a few certification courses for nurses in EM but they are not enough to cater our needs.
- Policy making arena.
Healthcare system works under the guidance and directive of governmental policies and this is the area that has to provide support for the improved delivery of emergency care in Pakistan. We need to create awareness and start a dialogue with stakeholders. The healthcare policy makers need to start meaningful dialogue with people working in ED to create and enhance policies about prehospital care, emergency care, disaster management, toxicology, legal aspects of emergency care and other aspects of emergency care neglected so far presently.
- Quality of Care.
PSEM should bring physician together and work together for the safety and quality of patient care in the emergency department. These standards have already been defined in the developed countries. So it’s logical that we all come together and make our own standards because of resources constraints, social and cultural norms and treatment expectations. This will not only ensure the safety of patients in the hands of healthcare staff but also result in increasing the caliber of staff as well as provision of proper tools in the hands of people who need it.
- Data collection.
When we struggle to improve things, then we need to first establish the status of present situation and this requires collecting data. This data needs to be collected in all institutions and should be combined to get pooled analysis about our population and our practices, as well as outcome. These initiatives are extremely important and society has to make sure that we work on them constantly. Society also can utilize this information to affect the policy making and exert the resources where these will matter the most.
- Training the trainers.
The people involved in the training program on Pakistan are mostly from other specialties and at times feel that they need guidance and education to continue providing teaching services. A constant stream of educational support goes a long way to enhance the EM program in general and would result in better trained doctors and nurses. There are multitude of resources both human as well as educational that is available out there for the benefit of the EM community in Pakistan. The society needs to be collaborative and create this system of improvement and make it available for all trainers and instructors and supervisors in EM.
Being a relatively new discipline, we understand that the emergency doctors have plenty to think about and that the PSEM with limited resources have a lot to do. Yet it is very important to have developed a list of priorities and also have developed understanding of what needs to be done.
I have full trust in the cabinet that has been bestowed with leading the PSEM and will always be available to work with them in future. Our exceptional members of PSEM both in training and also in faculty have worked hard and worked together to reach so far. We feel confident that together the future will be more fruitful for people who trust us for their emergency needs.