Assessing the burns service in Mongolia

Working closely with staff from Mongolia’s National Trauma and Orthopaedic Centre (NTOC) in Ulaanbaatar, Interburns recently supported the burn team in carrying out an in depth assessment of burn services using the digital Delivery Assessment Tool (DAT). Funded by the NIHR, the project has resulted in a colour coded score card highlighting strength and gaps as well as recommendations for a comprehensive quality improvement programme.

Local facilitators Mandukhai Batmunkh and Khulan Ganbat were key to the process which used resources available at www.dat4burns.org. Guided by the DAT Facilitator Guide translated into Mongolian, the burn team held a three hour discussion group in May 2021. Based on the notes from this discussion, key strengths and areas for improvement were highlighted, aligned to 10 key service areas in Interburns Operational Standards.

Sian Falder, clinical lead, and Charlie Leach, nursing faculty, reviewed the notes and videos and developed concrete quality improvement recommendations against each service area. Many of these are relatively simple to implement and do not require excess funding, meaning that steps towards improvement can be taken immediately based on evidence.

Dr Narantunggalag, Head of the Burns Unit, agreed with all the report’s findings and said it was now clear where to start in order to achieve progress. Priorities are:

·      Develop treatment guidelines adapted to Mongolia.

·      Improve the capacity of NTOC staff.

·      Advocate for increased numbers of nurses to relieve work pressure.

·      Expand training at aimag (district) and soum (village) level.

Interburns aims to support these improvements including: sharing guidelines tailored for LMICs and convening Interburn’s faculty to help further develop these for Mongolia; developing proposals for Essential and Basic Burn Care ToT for delivery across this vast country. The two sides agreed to work together to secure funding to support these initiatives.

Dr Galbadrakh Erdenstesteg Head of the NTOC said ‘this is the right assessment at the right time’ and thanked Interburns for providing the architecture for improving the burns service. We look forward to working together, raising funds, and planning for continued work in Mongolia. With thanks to all the participating staff at NTOC:

Dr. Galbdrakh Erdentsetseg - Head of Mongolia’s NTOC

Dr. Tumen-Ulzii Badarch - Head of Statistical and Surveillance Unit.

Dr. Narantungalag Tsedendamba - Head of Burns unit 

Dr. Tuya Khuvkhuu - Surgeon 

Dr. Uuganbayar Gombosuren - Head of rehabilitation unit 

Suvd-Erdene Orshikh - Chief nurse of Burns unit

Khulan Ganbat – DAT Notetaker 

Mandukhai Batmunkh - DAT Facilitator