Getting prepared: Emergency care provision requires adequate skills and human resource capacity

Emergency preparedness is an important pillar of the Health Authority – Abu Dhabi’s (HAAD)’s midterm strategy, which entails expanding both emergency service provision and emergency medicine, in addition to formulating new disaster response plans aimed at containing potential disease outbreaks and effectively managing a mass-casualty incident (MCI).

Accidental Deaths

According to HAAD, injuries were the second leading cause of death in the emirate in 2013, accounting for 19.6% of all fatalities in 2013. Fatal injuries are primarily caused by road traffic accidents, which account for 62% of all injury deaths, followed by falls and falling objects (11%), and suicide (8%). Occupational injuries and childhood injuries account for 18.4% and 12.2% of total deaths, respectively. With the incidence of injuries and accidents relatively high, emergency preparedness and response is now a critical issue for health care stakeholders, as evidenced by its inclusion as one of seven pillars under HAAD’s new mid-term health care strategy, which runs until 2020. During 2016, the authority will be implementing a major initiative to improve emergency and pre-hospital care.

Ambulance Service Expansion

Ambulance services in Abu Dhabi are controlled by the Abu Dhabi Police (ADP), while National Ambulance, which was established to serve government and private clients in partnership with Australia’s Aspen Medical in 2010, acts as the Northern Emirate’s primary emergency responder. National Ambulance has expanded rapidly since 2010. Today, it offers a fleet of 50 vehicles and handles an average of 35,000 calls annually.

HAAD is currently working at a strategic level through a formal committee, the Public Sector Integration Committee, to better align the ambulance service network with health care needs and expand the service to better meet the needs of rural populations. Etihad Airways announced in August 2014 that it had launched a National Ambulance-operated ambulance service for its employees, while the newly opened Cleveland Clinic Abu Dhabi signed a partnership with the company in July 2015 to provide ambulatory care 24 hours a day.

Quarantine & MCIS

The company also offers emergency services to the Abu Dhabi International Airport, including quarantine services in the case of highly-infectious diseases such as Ebola and Middle East respiratory syndrome. This further supports the emirate’s emergency preparedness priorities, although there is still room for improvement. “National Ambulance works in conjunction with key government agencies and authorities to ensure the best patient care is available. This also extends to any mass casualty events, including motor vehicle accidents or extreme weather,” Robert Ball, executive officer at National Ambulance, told OBG.

HR Challenges

Ball identified continued inter-agency cooperation, including continued regular training exercises to create a more efficient chain of command in the event of an MCI, as critical to improving emergency preparedness.

A study in the International Journal of Emergency Medicine in January 2014 highlighted a limited number of specialists as being the most significant challenge to emergency care in the country, with existing shortages caused, in part, by emergency medicine as having only been recognised as a specialty in the UAE for a decade. The study found that fewer than 10% of practising emergency physicians in the UAE are residency trained, with just 50 of an estimated 1000 emergency physicians in the emirate holding Western qualifications or board certifications. That said, numbers of qualified physicians in Abu Dhabi have risen by 20% since 2013, according to HAAD. “Development of the appropriately trained human resources, be it emergency medical technicians or paramedics, remains absolutely critical to National Ambulance’s long-term patient care strategy,” Ball told OBG.