Assessment Moldova

Objective of the assessment

The assessment of medical-technical needs will take place at the Clinical Hospital and the St. Michael Hospital, both situated in Chisinau (also known as Kishinev), Moldova. The assessment will ultimately lead to an extensive report of advice: the Technical Action Plan. Among other things, this report will include a well-founded priority list of the most urgent facility needs according to the Urgenta Foundation.

The assessment will be carried out from May 4th till May 8th by a team of four members of the Urgenta Foundation, three from the Netherlands and one from Romania.

Most likely, the team will exist of Jan Scheerder, Jo de Jong, Cosmin Costea and Arnold van Rijn.

Key subjects of assessment

To realize a targeted Technical Action Plan, it's absolutely necessary to require some insight into the following topics:

• management and organizational structure of both hospitals in Chisinau
• what specialties do the hospitals have to offer?
• where would the hospital like to be in 5 years, medically (and therefore technically) speaking?
• quality and quantity of the Technical Services (technicians)
• need for education to technicians
• quality and availability of medical equipment
• quality and maintenance of buildings and technical infrastructure
• need for technical maintenance equipment and materials
• need for medicines, bandages etc

Preparing for cooperation

Urgenta wishes to inform both hospitals about these topics before the actual assessment takes place. That way the hospitals will have sufficient time to prepare for the arrival of the team. This is very important: since the team will be available in Moldova for a limited amount of time, it's best to use that time as efficiently as possible.
Therefore it's also necessary for the hospitals to prioritize the technical needs as they see fit.

The Technical Action Plan will be based on the assessment and will be presented to the GG&GD Utrecht on May the 20th at the latest. It is absolutely essential the hospitals provide us with a group of employees whose expertise lies in the topics mentioned.
Additionally, the Urgenta Foundation requires help from doctors, nurses, laboratory assistants, Technical Services employees and equipment engineers.

The team members prefer to stay at the hospitals so they can get a first-hand insight of the organization and the way things are being done or managed. Especially in the evenings and at night, the team will wander through the hospital as experience has proven that is the best way to get a good impression of a medical organization. The First Aid outpatient's clinic will be a department of particular interest.

Nature and scope of the assessment

We expect the hospitals are in great need for structural technical support for both the short and long term. The following topics will be covered in the Technical Action Plan:

• the severity of overdue maintenance of buildings
• the severity of overdue maintenance of technical installations like water systems, medical gasses draining systems, electrical systems, ventilation etc. (infrastructure)
• assessment of medical equipment
• assessment of instrumentation
• assessment of sterilization systems (including the transition from contaminated to sterile)
• assess the need for medicines
• assess the need for hygiene support
• assess the need for medical equipment
• assess the need for medical installations
• assess the need for setting up a technical maintenance system
• assess the need for expansion of technicians' knowledge and education

Introduction

We will give a short summary of what to expect from the Technical Action Plan.

Management structure of the hospitals

A description of the organizational structure of the hospitals including an organigram to get a visual picture of each organization.

Quality of the medical departments and the nursing staff

The Urgenta Foundation will write a short summary about this subject, not to judge individual qualities but merely to give an impression of the basic knowledge level. This way, recommendations can be made about possible technical support that is mostly needed.

Quality of buildings, installations, interiors

This chapter will outline the state of the buildings and its installations. The emphasis will be placed on:

• constructions: roofs, inside and outside walls, ceilings, floors, doors, window/door frames and posts
• electrical systems: transformers, fuse boxes, lightings, wiring, switching materials etc
• mechanics: sanitary facilities, cold and warm water system, drains, heating, energy network, ventilation etc.
• medical technical installations: medical gasses systems
• interiors: wards, examination rooms, treatment rooms etc.
• hygienic conditions: kitchen, sterilization, wards etc.

Quality and availability of medical equipment

The Urgenta Foundation will report her findings on this matter.

Need for medicine, bandages etc.

Our experience tells us, we will certainly come across a lack of these basic medical supplies. The Urgenta Foundation will report about the situation in the hospitals in Moldova.

Conclusions and recommendations

Besides conclusions and recommendations, the Urgenta Foundation will take down a priority list.

The Technical Action Plan will be divided into:

• short term: 2005 - 2006
• medium term: 2007 - 2010

All conclusions and recommendations will be discussed with the hospitals' boards at the end of the assessment. This way, the Urgenta Foundation gets a first reaction which will be of influence on the compilation of the priority list.

As far as the assessment permits and if available, the following supplements will be included in the Technical Action Plan:

• drawings of buildings and installations
• specifications of equipment, interiors etc.
• exemplifying photographs and video's