The goal of the fellowship
My journey started in September 2017, when my colleagues and I in Pakistan sought to understand the provision of existing critical care services and identify priorities for improving care. To do this we used a methodology designed and successfully implemented in Sri Lanka, by a research collaboration of Network for Improving Critical Care Systems and Training (NICST) and Mahidol Oxford Tropical Medicine Research Unit (MORU), Thailand. The aim of the fellowship was to support implementation of PRICE - an electronic real time surveillance platform which uses routine information to enable evaluation of critical care services and enables clinicians and policy makers to harness the information to identify opportunities for quality improvement, research and capacity building within the international critical care community.
Rising pressures on critical care in Pakistan
Pakistan is a developing country with a population of nearly 200 million people with rising demands for critical care services. Increasing incidence of trauma following road traffic and construction incidents, infectious diseases resulting in organ dysfunction and a growing epidemic of non-communicable diseases and their related complications, all place considerable burden on the limited and disparate critical care services that currently exist nationally.
Why we need to provide a mechanism to benchmark and evaluate existing care and plan for the future
Having trained in Anaesthesia (1991-1996) and Intensive care (2005), I returned to Pakistan with a desire to build capacity for education and research in the region. My role, first as an anaesthetist and later as a full time intensivist has seen me help to establish a dedicated burns critical care service in a densely populated area of Karachi and help to establish critical care as an independent speciality through a dedicated speciality training programme.
With a growing interest in acute and critical care, Pakistan’s doctors and allied healthcare professionals now have the opportunity to practice critical care in Pakistan, with postgraduate training opportunities established nationally. With rising demand on critical care services, increasing demands for resource investment and growing interest from professional bodies in how to strengthen the quality of critical care systems, the next natural step seemed to be to help provide a mechanism through which existing care could be benchmarked, quality of care evaluated and priorities for future investment in infrastructure, human resource and training be identified.