Terms of Reference

For International Advisory services

on the development of protocols for dispatchers, ambulance crews and the development of a scoring system for assessing the severity of a case at the pre-hospital stages in the framework of the project “Emergency Medical Services Project”

Premise

In accordance with the Resolution of the Cabinet of Ministers of the Republic of Uzbekistan No. 952 dated November 23, 2018 “On measures to implement the project “Emergency medical services project” with the participation of the International Development Association (IDA) of the World Bank, the project “Emergency medical services project” was launched.

    As part of the project component (Component 1: Creating an enabling environment for the EMA service, EMA system management and quality improvement), a number of interrelated activities will be carried out to reorient the EMA system to provide high-quality emergency medical aid. Funding is planned for technical assistance, training, study visits, surveys and equipment.

This component includes Subcomponent 1.1: Regulation, Management and Operational Management, created to implement the EMA concept, manage the implementation and operation of the system with the development of the regulatory framework of the EMA. The subcomponent will also contribute to capacity building in operational management at all levels of the EMA system, including in human resources management, budget management, and data-based decision making. Protocols for dispatchers and ambulance crews will be developed and updated to guide their activities in accordance with the established concept of the development of the EMA system, as well as in the development of both pre-hospital and in-patient triage and systems for assessing the severity of the condition to ensure the focus of the EMA system, mainly on emergency cases.

According to the approved feasibility study, it is planned to hire an international advisory for the development and/or updating of protocols both for dispatchers and for ambulance crews and the development of a scoring system for assessing the severity of a case at the pre-hospital stages.

Objective and scope of consultants’ service

For the purposes of the Project, the Project Implementation Unit (PIU) invites an experienced specialist to perform the following types of work:

• Based on international experience and best practice, analyze existing protocols for dispatchers and ambulance crews to assess the severity of the condition, if necessary, develop on the basis of evidence-based medicine and / or update them to focus the EMA activity in line with the modern emergency system development strategy .
• Analysis of the existing situation and on the basis of international experience development of a system model for pre-stationary screening of incoming patients, as well as systems for assessing the severity of the patient’s condition, which play an important role in focusing mainly on emergency cases and introducing them into EMA institutions for improvement emergency medical aid to the population of the Republic of Uzbekistan.
• Preparation of proposals for the introduction of new clinical protocols and standards for dispatchers and ambulance crews based on evidence-based medicine, aimed at improving the quality of medical services.
• Based on the Lean manufacturing method together with the six sigma methodology with the participation of an expert working group, the consultant will develop a model of the system for the effective use of domestic resources and reserves (including financial) in EMS institutions aimed at continuous improvement of business processes, improvement of the organization and working conditions.
• Development of monitoring criteria and tools for assessing the results of the work done, as well as the introduction of these criteria and tools into the relevant information system.
• Conduct a review of best practices in this area and provide recommendations for study tours with indication of the country and the specific medical institution in order to learn the best international experience.

Expected results:

The international advisor will work together with a local advisor to provide results and reports.

The estimated perimeter of consulting services implies the following results:

Qualification requirements:

General requirements

The consultant should have relevant international level work experience in ambulance service dispatch and protocol development or related matters, preferably including in Central Asia and / or Eastern European countries. A high level of knowledge of spoken and written English is mandatory, knowledge of Russian will be an advantage. Interpersonal skills are also important. In preparing the complementary aspects of the project “Emergency Medical Services Project”, the consultant should work in close cooperation with other international and national consultants.

Key qualifications and consultant investments

The consultant should have proven experience in the development and implementation of protocols for dispatchers and ambulance crews, as well as creating a system for assessing the severity of the patient’s condition at the stationary stage of the EMA.

The consultant should have:

• Higher education in the relevant field (medicine, health care management or other related field);
• At least 10 years of practical experience in the relevant field (emergency medical aid, health care management or equivalent), including systematic reviews and strategic planning;
• Knowledge of international standards for ambulance dispatch service, taking into account the use of modern information management systems, as well as standards for ambulance crews, including a system for assessing the severity of a patient’s condition at the pre-hospital stage
• Experience in projects funded by the World Bank, the European Commission or other donor organizations is welcomed
• Fluent English and Russian, skills in text editing programs, spreadsheets, e-mail, graphic programs.

Deliverable:

The consultant must submit all reports in English and Russian:

• The consultant is accountable to the Republican Center for Emergency Medical Aid (RSCEMP) and the PIU of the project “Emergency Medical Services Project”. The consultant should base his report and take into account all aspects of the TOR, noting the key issues.
• The consultant must provide the following summary reports:
• Preliminary report on the planned work with a description of the mechanism for performing tasks (2-4 weeks after the start of work)
• Final activity report - within 10 business days after work is completed.
• Reports must be submitted to the Executive Director of the PIU “Emergency Medical Services Project” (e-version + hard copy) in Russian and English. The PIU must approve all reports within 10 business days.
• All correspondence with the Government and other departments related to the Project should be sent through the Executive Director of the project. The Final Report and other documents prepared by the consultant should be submitted to the Executive Director of the project (e-version + hard copy) in Russian and English. The PIU must approve the reports within 10 working days after the report is agreed with the expert committee of the Ministry of Health.

Organizational measures:

Executive agency and client

The consultant works at the Republican Scientific Center for Emergency Medical Aid and the PIU of the project “Emergency Medical Services Project”, working closely with national specialists and partners, both at the ministerial level and beyond. This will ensure active involvement in the development and implementation of the project for local stakeholders. To the extent possible, the consultant should ensure the strengthening of the institutional capacity of the RSCEMA in the process of project implementation. An expert working group has been set up by the order of the Ministry of Health of the Republic of Uzbekistan to work with foreign and local consultants.

The duration of the provision of services:

The advisor will provide its services within _____ days from July 2019 to December 2019 according to a schedule agreed with the consultant. The remaining ____ working days will be performed at home (if necessary).

Client’s inputs:

The PIU will provide the consultant with furnished office space, access to equipment for reproduction of documents and local communication services, including the Internet. The consultant must have his own laptop for use during the service period. In addition, the PIU will provide relevant materials and reports through the expert working group, help establish contact with various interested organizations / institutions and organize meetings with representatives of interested groups and other interested parties.