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

Published online by Cambridge University Press:  28 June 2012

M. James Eliades ,
Julian Lis ,
Joilo Barbosa  and
Michael J. VanRooyen
M. James Eliades
Affiliation:
The Center for International Emergency, Disaster and Refugee Studies, Department of Emergency Medicine,Johns Hopkins University School of Medicine, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
Julian Lis
Affiliation:
The Center for International Emergency, Disaster and Refugee Studies, Department of Emergency Medicine,Johns Hopkins University School of Medicine, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
Joilo Barbosa
Affiliation:
Emergency Medicine Research Center, Department of Emergency Medicine, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA
Michael J. VanRooyen*
Affiliation:
The Center for International Emergency, Disaster and Refugee Studies, Department of Emergency Medicine,Johns Hopkins University School of Medicine, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
*
Center for International Emergency, Disaster and Refugee Studies, Department of Emergency Medicine, The Johns Hopkins University, 1830 E. Monument St., Suite 6-100 Baltimore, MD 21205USA E-mail: mvanrooy@jhmi.edu
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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.

Keywords

emergency medical systemsemergency medicine, internationalfactor analysisKosovoprehospital medicineQ-analysisQ-methodologysubjective research
Type
Part II: Complex Emergencies: Research Initiatives
Information
Prehospital and Disaster Medicine , Volume 16 , Special Issue 4: Complex Emergencies , December 2001 , pp. 268 - 274
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2001

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References

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