Improving quality of services in pediatric intensive care units through the development and implementation of a training program

The current project is proposed within the framework for the Swiss-Romanian Cooperation Programme defined by the Memorandum of Understanding between Switzerland and the European Union (EU) dated 27 February 2006 and the Addendum of 25 June 2008 for Bulgaria and Romania, as well as the Romanian-Swiss Framework Agreement on the Swiss Contribution, signed on 7 September 2010.

The overall goal of the Swiss contribution is to reduce economic and social disparities within the enlarged European Union. Therein, Switzerland is committed to support the European Integration process in Romania through implementing several Thematic Funds. On 19th December 2011, Switzerland and Romania signed the Thematic Fund Agreement for the Thematic Fund “Reform linked to Health Issues” (Health Fund). The objectives of the Health Fund are to support Romania in widening access to the health and social services, as well as to improve the quality of health services with a focus on community integrated health and social services, improving pediatric intensive care units, pre-hospital and hospital emergency services and air rescue and will make good use of knowledge and experiences gained during the long-lasting cooperation of Romania and Switzerland between 1992-2008.

The current project proposal is based on the experience and expertise gained by the Centre for Health Policies and Services as the EA for the phases 3 and 4 of the REMSSy project implemented in Romania (2003-2008) as well as the implementation of the REPEMOL project in the Republic of Moldova (2009-present). The current project proposal addressed to pediatric intensive care units personnel will contribute to further capacity building in the hospital, beyond the pre-hospital and hospital emergency care, contributing as such at a continuum of patient care. Also, the current proposal is based on the evaluation visit made by Prof Michel Berner on 24-26 September 2013 at the request of Ministry of Health.

The Emergency Medical Care System in Romania underwent structural changes in the last 6 -7 years with legislation starting with the chapter 4 of the Law 95/2006 and continuing with all the other legal provision such as the hospital classification, transport of critical cases, coordination of emergency departments, triage protocol, regionalization of emergency care, organization of emergency medicine residency, creation of advance supervision and advance treatment of critical cardiac patients (USTACC) and so on. However, paediatric intensive care units in Romania are variably organized. We can find Paediatric hospitals (usually in university centres) that have intensive care units (like Sf Maria Hospital in Iasi, Paediatric Hospital in Cluj, Sf Ioan Hospital in Galati, Paediatric Hospital in Brasov and Sibiu,  Louis Turcanu Hospital in Timisoara, Grigore Alexandrescu Hospital, Marie Currie Hospital and Mother and Child Institute in Bucharest). We can also find general hospitals in which children needing intensive care are admitted in adult’s intensive care units although in some of these hospitals there are also compartments for child intensive care (like in County hospital Constanta, Craiova, Botosani, Children Hospital Pitesti, Municipal Hospital Barlad and Oradea). There is a strong need to rethink the organizational and functioning of such units and compartments in order to offer the proper quality of care for all the children needing intensive care. Such reorganisation will not be possible if properly trained staff will not be available to offer pediatric intensive care services to children in need. The current project answers to a great need of training of paediatric intensive care units’ personnel. Usually the pediatric intensive care unit physicians are intensive care specialists that had –during their residency training- short rotations on children intensive care. As mentioned earlier in very few hospitals in the intensive care units there are also pediatricians.

Overall objective: Romanian children benefit from improved health outcomes following pediatric intensive care services

Objective:     Pediatricians, who passed the "Atestat" program on pediatric intensive care, deliver high quality PICU services based on international standards.

Intermediate outcome 1:             Regional training centers deliver a two year pediatric intensive care program with “Atestat” according to Romanian regulations and adapted to EU standards (ESPNIC);

Intermediate outcome 2:             PICU patients benefit from high quality services provided according to locally implemented Clinical Practice Guidelines (CPG), which correspond to international standards.


Final beneficiaries of the project will be Romanian children with a focus on high risk populations (e.g. accidents, chronic disease and high risk patients etc.). 

Direct beneficiaries are Romanian pediatric and intensive care health professionals, professional associations, training institutions, and government bodies as public health administration, Ministry of Health, Health Insurance House.

Project budget: 574.883 CHF

The project will have a duration of 24 months starting in May 2014.