Challenges of Directing CCU in Egypt Hossam Kandil, MD Professor of Cardiology Cairo University Hossam Kandil, MD Professor of Cardiology Cairo University

Challenges of Directing CCU in Egypt

Challenges of Directing CCU in Egypt

Hossam Kandil, MD

Professor of Cardiology

Cairo University

Hossam Kandil, MD

Professor of Cardiology

Cairo University

Challenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptChallenges of Directing CCU in Egypt

• EnvironmentEnvironment

• PersonnelPersonnel

• Doctors, Nursing staffDoctors, Nursing staff

• Equipments Equipments

• Hospital administrationHospital administration

• Patients and their familiesPatients and their families

• Communication and ArchivingCommunication and Archiving























• Quiet and cleanQuiet and clean

• Climate controlClimate control

• Frequent disinfectionFrequent disinfection

• Area to patientsArea to patients

• Facilities for staffFacilities for staff

• Natural Light Natural Light

• Quiet and cleanQuiet and clean

• Climate controlClimate control

• Frequent disinfectionFrequent disinfection

• Area to patientsArea to patients

• Facilities for staffFacilities for staff

• Natural Light Natural Light

Challenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptEnvironmentEnvironment

Challenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptEnvironmentEnvironment




• Doctors, Nursing staff, nurse assistants Doctors, Nursing staff, nurse assistants and physician assistants and techniciansand physician assistants and technicians







• Doctors, Nursing staff, nurse assistants Doctors, Nursing staff, nurse assistants and physician assistants and techniciansand physician assistants and technicians






– DoctorsDoctors

– Nursing staff, nurse assistant and Nursing staff, nurse assistant and physician assistantsphysician assistants

– TechniciansTechnicians

– Biomedical engineersBiomedical engineers

– PharmacistPharmacist

– Medical secretarial staffMedical secretarial staff


– DoctorsDoctors

– Nursing staff, nurse assistant and Nursing staff, nurse assistant and physician assistantsphysician assistants

– TechniciansTechnicians

– Biomedical engineersBiomedical engineers

– PharmacistPharmacist

– Medical secretarial staffMedical secretarial staff



– Doctors:Doctors:

– Level of trainingLevel of training

– Working at several places at the same timeWorking at several places at the same time

– Taking repeated uninterrupted shifts, taking Taking repeated uninterrupted shifts, taking care of average of 5 patients/shiftcare of average of 5 patients/shift

– CertificationCertification

– ReportingReporting

– Well trained staff, leave hospital for better Well trained staff, leave hospital for better offersoffers


– Doctors:Doctors:









– Nursing staff:Nursing staff:








– Nursing staff:Nursing staff:








• Other PersonnelOther Personnel

– Technicians, nurse assistant and physician Technicians, nurse assistant and physician assistants:assistants:

– Do not exist in EgyptDo not exist in Egypt

• Biomedical engineersBiomedical engineers

• PharmacistPharmacist

• Medical secretarial staffMedical secretarial staff

• Other PersonnelOther Personnel

– Technicians, nurse assistant and physician Technicians, nurse assistant and physician assistants:assistants:

– Do not exist in EgyptDo not exist in Egypt

• Biomedical engineersBiomedical engineers

• PharmacistPharmacist

• Medical secretarial staffMedical secretarial staff

















• Old models with no spare partsOld models with no spare parts

• Poor maintenancePoor maintenance

• ExpensiveExpensive

• No pre-specified budgetNo pre-specified budget

• Poor handling of equipment by CCU Poor handling of equipment by CCU staffstaff

• Working machine with no consumablesWorking machine with no consumables

• Old models with no spare partsOld models with no spare parts

• Poor maintenancePoor maintenance

• ExpensiveExpensive

• No pre-specified budgetNo pre-specified budget

• Poor handling of equipment by CCU Poor handling of equipment by CCU staffstaff

• Working machine with no consumablesWorking machine with no consumables

Challenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptEquipmentsEquipments

Challenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptEquipmentsEquipments
















• Burdened with other hospital problemsBurdened with other hospital problems

• No regular meetings with CCU staffNo regular meetings with CCU staff

• Care more about income than qualityCare more about income than quality

• Difficult to convince to update servicesDifficult to convince to update services

• Burdened with other hospital problemsBurdened with other hospital problems

• No regular meetings with CCU staffNo regular meetings with CCU staff

• Care more about income than qualityCare more about income than quality

• Difficult to convince to update servicesDifficult to convince to update services

Challenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptHospital AdministrationHospital Administration

Challenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptHospital AdministrationHospital Administration
















• Always demanding reassuranceAlways demanding reassurance

• Patients usually come late with Patients usually come late with advanced diseaseadvanced disease

• Most patients are sponsored by a third Most patients are sponsored by a third party, paying reduced fees with very party, paying reduced fees with very delayed payments if anydelayed payments if any

• Claims Suits are getting more frequentClaims Suits are getting more frequent

• Always demanding reassuranceAlways demanding reassurance

• Patients usually come late with Patients usually come late with advanced diseaseadvanced disease

• Most patients are sponsored by a third Most patients are sponsored by a third party, paying reduced fees with very party, paying reduced fees with very delayed payments if anydelayed payments if any

• Claims Suits are getting more frequentClaims Suits are getting more frequent

Challenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptPatients and their familiesPatients and their families

Challenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptPatients and their familiesPatients and their families
















• Poor communication between supportive Poor communication between supportive departments and CCUdepartments and CCU

• Renal dialysis, imaging, nerology etcRenal dialysis, imaging, nerology etc

• No networks for information and Lab results No networks for information and Lab results in most CCUsin most CCUs

• No digital archiving in most hospitals, no No digital archiving in most hospitals, no reporting, most previous information are reporting, most previous information are usually not available, not even on Major usually not available, not even on Major surgeriessurgeries

• Poor communication between supportive Poor communication between supportive departments and CCUdepartments and CCU

• Renal dialysis, imaging, nerology etcRenal dialysis, imaging, nerology etc

• No networks for information and Lab results No networks for information and Lab results in most CCUsin most CCUs

• No digital archiving in most hospitals, no No digital archiving in most hospitals, no reporting, most previous information are reporting, most previous information are usually not available, not even on Major usually not available, not even on Major surgeriessurgeries

Challenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptCommunication and ArchivingCommunication and Archiving

Challenges of Directing CCU in EgyptChallenges of Directing CCU in EgyptCommunication and ArchivingCommunication and Archiving

ConclusionsConclusionsConclusionsConclusions

• Great differences exist between concepts and standards of care between western and most third world countries

• Focus should be on establishment of minimal levels of care in CCUs applicable to economics of third world countries

• Concepts of prevention should be of prime interest of those directing resources to minimize burdens on already disadvantageous acute cardiac care in third world countries

• Great differences exist between concepts and standards of care between western and most third world countries

• Focus should be on establishment of minimal levels of care in CCUs applicable to economics of third world countries

• Concepts of prevention should be of prime interest of those directing resources to minimize burdens on already disadvantageous acute cardiac care in third world countries

Thank You

Documents

Challenges of Directing CCU in Egypt Hossam Kandil, MD Professor of Cardiology Cairo University Hossam Kandil, MD Professor of Cardiology Cairo University