This project aims to fill a needed gap in POCUS (point of care ultrasound) utilization at Hospital Infantil Robert Reid Cabral (RRC), a large pediatric referral center in Santo Domingo, Dominican Republic. This project will sustainably build local capacity, improve care delivery, and advance collective understanding of how best to implement similar initiatives across low resource settings. The initial site visits have demonstrated an immense need for POCUS to allow for timely diagnoses and interventions in acutely ill and injured children. This team consists of an expert, interdisciplinary, multicultural group that will be well equipped to aid in implementing a POCUS curriculum to educate physicians in Santo Domingo for improved patient outcomes.
Hospital Infantil Robert Reid Cabral (RRC) is the largest children’s hospital in the Dominican Republic, where UNICEF reports an under-5 mortality rate of 33/1000 live births. Located in the capital city of Santo Domingo, it consists of a busy emergency department (ED) seeing approximately 125 children daily, several inpatient general pediatrics and subspecialty units (including a dialysis unit, a dengue unit, and a full array of medical and surgical subspecialties), a neonatal intensive care unit (NICU) and nursery, and a 12-bed pediatric intensive care unit (PICU). As a public hospital, it serves a diverse cohort of some of the most at-risk children in Santo Domingo, across the country, and in many cases from Haiti. It also is a major teaching hospital. Medical students from several different medical schools, pediatric residents, surgery residents, pediatric emergency medicine fellows, and pediatric critical care fellows all train at RRC. Both trainees and patients will benefit immensely from the implementation of this program and POCUS-based training. Given the volume/magnitude of RRC and its location as a main medical center for underserved patient populations, we hope to successfully improve patient outcomes through implementation of this project.
We strongly believe this study will significantly improve the care of children at RRC due to the high volume and acuity of pediatric patients, demonstrated clearly in the initial pilot visits. The evident enthusiasm from both senior leadership and trainees at RRC will also serve to broaden the impact of this implementation, as local champions will be a key to sustainability, and early introduction of POCUS skills for trainees will increase POCUS adoption and integration into their clinical care practices. We hope lessons learned from this project will further inform implementation of POCUS in other similar settings, again broadening the projected impact of this partnership.
The Emergency Department and the Intensive Care Unit of the Robert Reid Hospital in the Dominican Republic were able to attend courses to learn POCUS skills with hands-on practice to utilize in their facilities. We were able to educate on indications and procedures and provided practical skills teaching. Through this trip, we were able to provide them with donations of supplies to begin to build an ultrasound program.
