Asamoah Kofi Tekyi, Beasley Michael Harry
National Cardiothoracic Centre, Korle-Bu Teaching Hospital, Accra, Ghana.
Department of Medicine, Korle-Bu Teaching Hospital, Accra, Ghana.
Glob Heart. 2024 Sep 13;19(1):75. doi: 10.5334/gh.1357. eCollection 2024.
The Ghana Physicians and Surgeons Foundation (GPSF) of North America sponsors Ghanaian clinical fellows to undertake an eight-weeklong clinical observation with the Yale University School of Medicine and Yale-New Haven Health (YNHH) annually, through the Residents in Training Educational Stipend (RITES) programme. This offers the opportunity to appreciate new perspectives in clinical care to improve Ghana's healthcare standard. The cardiovascular medicine workforce at the YNHH is heterogenous, with significant reliance on non-doctor cadres of health workers who demonstrate competence. This is contrasted from the Ghanaian system which despite having a poorer physician-patient ratio, is heavily dependent on doctors. Technological advancements are minimal in Ghana, posing diagnostic and therapeutic challenges which are otherwise minimised at the YNHH. A strong patient-centred culture, coupled with a coordinated emergency response system that ensures appropriate timely transfers, culminate in good care and outcomes. Ideas on how the experience can be translated to Ghanaian clinical practise in cardiovascular medicine, after participating in the RITES programme, are shared in this paper with an emphasis on task sharing, strengthening emergency response systems and improving technological sophistication through capacity building, mentorship and improved health financing.
北美加纳医师与外科医生基金会(GPSF)每年通过住院医师培训教育津贴(RITES)项目,赞助加纳临床研究员到耶鲁大学医学院和耶鲁 - 纽黑文医疗集团(YNHH)进行为期八周的临床观察。这为了解临床护理的新视角提供了机会,以提高加纳的医疗保健水平。YNHH的心血管医学工作队伍构成多样,很大程度上依赖表现出专业能力的非医生卫生工作者干部。这与加纳的系统形成对比,加纳尽管医患比例更低,但严重依赖医生。加纳的技术进步极少,带来了诊断和治疗方面的挑战,而在YNHH这些挑战则被降至最低。以患者为中心的浓厚文化,加上确保适当及时转诊的协调应急系统,最终实现了良好的护理和治疗效果。本文分享了关于在参加RITES项目后如何将这种经验转化为加纳心血管医学临床实践的想法,重点是任务分担、加强应急系统以及通过能力建设、指导和改善卫生筹资来提高技术复杂性。