Post-War Kosovo: Part 2. Assessment of Emergency Medicine Leadership Development Strategy

Abstract

Since the return of the refugee population to Kosovo, attempts at development of an emergency medical system in Kosovo have met with varied success, and have been hampered by unforeseen barriers. These barriers have been exacerbated by the lack of detailed health system assessments. A multimodal approach of data collection and analysis was used to identify potential barriers, and determine the appropriate level of intervention for emergency medicine (EM) development in Kosovo. The four step, multi-modal, data collection tool utilized: 1) demographic and health systems data; 2) focus group discussions with health-care workers; 3) individual interviews with key individuals in EM development; and 4) Q-Analysis of the attitudes and opinions of EM leaders.Results indicated that Emergency Medicine in Kosovo is under-developed. This method of combined quantitative and qualitative analysis identified a number of developmental needs in the Kosovar health system. There has been litde formal training, the EMS system lacks organization, equipment, and a reliable communication system, and centralized emergency centers, other than the center at Prishtina Hospital, are inadequate. Group discussions and interviews support the desire by Kosovar health-care workers to establish EM, and highlight a number of concerns. A Q-methodology analysis of the attitudes of potential leaders in the field, supported these concerns and identified two attitudinal groups with deeper insights into their opinions on the development of such a system.This study suggests that a multi-modal assessment of health systems can provide important information about the need for emergency health system improvements in Kosovo. This methodology may serve as a model for future, system-wide assessments in post-conflict health system reconstruction.

Integrating quantitative and qualitative methodologies for the assessment of health care systems: emergency medicine in post-conflict Serbia

“…As a result of studies on emergency services in Kosovo, developmental programs similar to those suggested here have been successfully implemented to improve the training in and provision of Kosovo's emergency medical services [13]. Visiting experts currently travel to the province to provide didactic and bed-side training to physicians and other health care providers on the latest advances in emergency medicine, internal medicine, pediatrics, and several other fields of medicine.…”

An International Fellowship Training Program in Pediatric Emergency Medicine

“…7 The EM system in Kosovo, Federal Republic of Yugoslavia, after a civil war was found to be underdeveloped. 8 Little formal training, lack of organization, equipment, and a reliable communication system and lack of centralized emergency centers were identified early on as barriers to ideal health care. 9 A group from the United States suggested that limited specialized training, lack of coordination between departments, and failure to establish a medical records system were some of the barriers to provision of care in the highvolume and high-acuity PEM system in Kosovo.…”

Post-war development of emergency medicine in Kosovo

“…2 The application of assessment methods complementing humanitarian assistance in Kosovo have been explored previously in emergency medicine and public health efforts by Johns Hopkins and the International Rescue Committee. [3][4][5][6] From a broader perspective, in an era of increasing humanitarian and post-crisis intervention throughout the world, assessments before intervention and evaluations post intervention become increasingly important to donors, academicians, politicians and administrators.…”