WIP 61 - Concordance with Clinical Practice Guidelines for Diagnosis and Management of Common Pediatric Conditions in the John F. Kennedy Medical Center’s Emergency Department in Monrovia, Liberia

Poster Number: WIP 61
Publication Number: WIP 61.964

Background: Clinical practice guidelines (CPGs) are designed to improve the quality, affordability, and efficiency of healthcare delivery by synthesizing available evidence into practical clinical recommendations. They are particularly useful in the emergency department (ED), where the scope of practice is broad and they can help streamline the practice of evidence-based medicine. In low- and middle-income countries (LMICs) access to online clinical resources and subspecialty services is more limited. Despite their value, there are a dearth of CPGs for clinicians working in Pediatric EDs in LMICs. Existing CPGs are further limited by their lack of local contextualization. This is a concern in Liberia, where few pediatric-specific CPGs exist, and where health workforce shortages and underdeveloped emergency care systems necessitate a closer examination of the utilization patterns and utility of CPGs in clinical practice for pediatric illnesses. The ultimate goal of this study is to contribute to the development of regionally tailored, pediatric emergency specific CPGs for Liberia.

Objective: To compare how medical providers in Monrovia, Liberia evaluate and manage common pediatric emergency conditions when compared to pre-existing national (Liberian Ministry of Health) and international (World Health Organization) CPGs.

Design/Methods: This is a retrospective cross-sectional analysis of data from the pediatric registry at John F. Kennedy Medical Center (JFKMC) in Monrovia. Registry entries for any previously healthy pediatric patient ( < 14yo) who presented to the ED at JFKMC between November 2019 and October 2022 with pneumonia, meningitis, neonatal sepsis, malaria or gastroenteritis as a primary or secondary diagnosis will be included (n=3440). Diagnostic evaluation and treatment will be compared for concordance with national and international guidelines, and assessed for variability based on patient demographic factors and outcomes. IRB approvals were obtained through JFKMC and Boston Children’s Hospital. Data cleaning is underway with the plan to complete analyses by January 2024.