Smart QI: A Digital Platform and Quality Improvement (QI) Bundle to Save the Lives of Critically Ill Children

In resource-limited countries, poor-quality care at district hospitals results in death and disability. One reason for this poor care is a lack of systems that enable healthcare workers to judge the severity of illness, especially within emergency departments. Rather than treating critically ill patients as a priority, patients are treated in the order in which they arrive at hospital. The resulting delays in treatment disproportionately affect young children under five with severe infections, particularly if these infections lead to sepsis – the number one cause of death in this age group. In children with sepsis, every hour of delay in treatment is associated with greater organ damage, persistent poor health, and death. Our innovation enables earlier diagnosis of severely ill children with infection by identifying them on arrival (a process called triage), leading to earlier treatment with life-saving antibiotics from the healthcare team. Sepsis is more common in the under-fives and therefore these children will benefit the most from our project. To achieve this goal we have partnered with the Uganda Catholic Medical Bureau (UCMB) and developed, implemented, and evaluated a digital platform (mobile app and dashboard) that reduces the time from arrival in the facility to treatment of critically ill children with suspected infection. This platform is currently in one hospital within the UCMB, and we propose to extend the program to two additional district hospitals during Phase 2 of the Grand Challenges Canada Transition to Scale (TTS2). We will further develop a scalable package of services that any hospital or health system can use to implement Smart QI in a low-resource facility.