Proposal for Funding/Charitable Contribution for the

Acquisition of an Electroconvulsive Therapy (ECT)

Machine for Sabian General Hospital Psychiatry and
Substance Rehabilitation Ward

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Contents
1. INTRODUCTION ................................................................................................................................ 1
1.1 Background ....................................................................................................................................... 2
2. Goals and Objectives of the Project ........................................................................................................ 2
2.1 Project Goals ..................................................................................................................................... 2
2.2 Project Objectives ............................................................................................................................. 2
2.3. Specific objectives ............................................................................................................................ 2
Project Outcome...................................................................................................................................... 2
3. Activities................................................................................................................................................... 3
4. Strategies.................................................................................................................................................. 3
5. Indicators:................................................................................................................................................ 3
6. Beneficiaries......................................................................................................................................... 3
✓ Direct beneficiaries: .......................................................................................................................... 3
✓ Indirect beneficiaries:........................................................................................................................ 3
7. Methods/Procedures ........................................................................................................................... 4
Target Population: .................................................................................................................................. 4
Formation of ECT Case Team: ................................................................................................................. 4
8. Staff management ............................................................................................................................... 4
9. IDENTIFIED PROGRAM KEY STAKEHOLDERS .......................................................................... 4
10. SWOT Analysis ................................................................................................................................ 5
11. Problem Analysis ............................................................................................................................ 6
12. objective analysis ............................................................................................................................. 7
13. Project design matrix ............................................................................................................................ 8
13. Work plan.......................................................................................................................................... 9
15. Important Assumptions of the project .............................................................................................. 10
16. Potential Risks for the project implementation................................................................................ 10
17. Intended Impacts of the establishment of the unit ........................................................................... 10
18. Budget .................................................................................................................................................. 11
19. Monitoring and Evaluation Framework for ECT Implementation: .............................................. 12
Monitoring:............................................................................................................................................ 12
Evaluation:............................................................................................................................................. 12
20. Action Plan .......................................................................................................................................... 13

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 1. INTRODUCTION

Electroconvulsive Therapy (ECT), also known as electroshock therapy, is a medical procedure that
has been used for several decades to treat various mental health conditions. Despite its long history,
ECT remains a highly controversial treatment modality, eliciting strong emotions and opinions in
both the medical community and the general public.

The origins of ECT can be traced back to the late 1930s when it was first introduced as a treatment
for severe mental illnesses, particularly schizophrenia. Since then, ECT has evolved significantly,
with advancements in anesthesia and the use of muscle relaxants to minimize potential risks and
side effects. Today, it is primarily utilized in cases of treatment-resistant depression, bipolar
disorder, and certain forms of schizophrenia.

The ECT procedure involves the administration of a controlled electrical current to the brain,
typically inducing a generalized seizure lasting for a short duration. This process is carried out
under general anesthesia to ensure the patient's comfort and safety. The exact mechanism of action
of ECT remains unclear, but it is believed to involve the modulation of neurotransmitters and
neuroplasticity within the brain, leading to therapeutic effects.

ECT has shown remarkable efficacy in cases of severe depression, particularly when other
treatment options have failed. It is often considered when patients are at high risk for suicide or
are unable to respond to medications due to various factors such as treatment resistance or
intolerance to side effects. Moreover, ECT is known for its rapid onset of action, with some
individuals experiencing improvements after just a few sessions.

ECT can be used in various populations, including elderly patients, pregnant women, and
adolescents. However, special considerations and precautions must be taken into account for each
group due to their unique physiological and developmental characteristics.

As a patient-centric healthcare facility, Sabian General Hospital has been at the forefront of
providing exceptional healthcare services to the community, particularly in the field of mental
health and substance abuse treatment. making ECT an essential addition to our existing treatment
modalities. The availability of ECT services will enable us to offer a comprehensive range of
treatment options to patients with severe psychiatric disorders, leading to improved clinical
outcomes and a reduction in patient suffering.

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1.1 Background
Sabian General Hospital Psychiatry and Rehabilitation Center, located in Dire Dawa, provides
high-quality mental health care and rehabilitation services to the community. As part of our
commitment to offering comprehensive treatment options, we recognize the need to acquire an
Electroconvulsive Therapy (ECT) machine. ECT is a highly effective treatment method for certain
mental health conditions, and its availability will significantly enhance our ability to provide
optimal care to our patients.

2. Goals and Objectives of the Project

2.1 Project Goals
✓ To introduce Electroconvulsive Therapy (ECT) as a treatment modality at the Sabian General
Hospital Psychiatry and Rehabilitation Center.

2.2 Project Objectives

To establish Electroconvulsive Therapy (ECT) treatment unit in psychiatry department at Sabian
General Hospital

2.3. Specific objectives

1. Establish a dedicated ECT treatment unit with the necessary infrastructure and equipment.

2. Recruit and train healthcare professionals to administer ECT treatment safely and effectively.

3. To provide ECT services for treatment for certain psychiatric conditions.

4. Develop evidence-based treatment protocols and guidelines for standardized ECT

administration.

5. Educate and inform patients, families, and the community about ECT treatment to promote
understanding and reduce stigma.

Project Outcome
The successful implementation of ECT treatment at the Sabian General Hospital Psychiatry and
Rehabilitation Center will lead to the following outcomes:

✓ Improved treatment outcomes and well-being for patients with severe mental health
conditions.
✓ Expanded access to comprehensive psychiatric care through the availability of ECT treatment.
✓ Prevention and mitigation of relapse in severe mental disorders.
✓ Continued management and treatment of severe mental disorders.
✓ Enhanced collaboration and coordination among healthcare professionals within the ECT
treatment team.
✓ Reduced stigma and increased awareness of ECT treatment among patients, families, and the
community.

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3. Activities
1. Identify and describe the target population in need of ECT treatment.
2. Form a dedicated case team for the ECT unit.
3. Provide comprehensive training to team members prior to the launch of ECT services.
4. Deliver ECT treatment for individuals with severe mental health conditions.
5. Establish a specialized case team to focus on ECT treatment.
6. Continuously manage and treat individuals with comorbid severe mental disorders using
ECT.
7. Develop guidelines for the administration of ECT treatment.
8. Establish admission criteria and adopt new standards of care for patients undergoing ECT
treatment.

4. Strategies
✓ Allocate and mobilize staff members to the newly established ECT unit.
✓ Identify key stakeholders involved in ECT treatment, including healthcare professionals,
administrators, and patient advocacy groups, and involve them in the planning and
implementation process.
✓ Engage and educate the local community about the benefits and safety of ECT treatment,
addressing any misconceptions or stigma associated with the therapy.
✓ Secure necessary resources, including infrastructure, equipment, and funding, to support the
establishment and ongoing operation of the ECT unit.

5. Indicators:
➢ Number of patients admitted and treated at the ECT unit.
➢ Number of team members deployed at the ECT unit.
➢ Number of patients who received inpatient and outpatient ECT care at the unit.
➢ Number of staff members trained in ECT treatment.
➢ Treatment response rate
➢ Length of hospital stay.
➢ Follow-up rates

6. Beneficiaries
✓ Direct beneficiaries:
- Patients with treatment-resistant mental health conditions who will benefit from the availability
of ECT treatment.
- Psychiatry and Rehabilitation Center staff who will gain new skills and expertise in
administering ECT treatment.

✓ Indirect beneficiaries:
- Sabian General Hospital as a whole, as the availability of ECT treatment will contribute to the
hospital's overall reputation and revenue generation.
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- The community of Dire Dawa and surrounding areas, who will have access to a broader range
of specialized mental health treatments.

7. Methods/Procedures

Target Population:
The target population for Electroconvulsive Therapy (ECT) treatment includes individuals
suffering from severe psychiatric illnesses that have not responded to other forms of treatment or
who require urgent intervention due to the severity of their symptoms..

Formation of ECT Case Team:

✓ Psychiatrists, psychiatric professionals, and msc psychiatric professionals form the core
ECT case team.
✓ The team collaboratively manages and coordinates the ECT treatment process.
✓ Responsibilities include patient assessment, treatment planning, administering ECT,
monitoring patient progress, and providing necessary support.

8. Staff management

The ECT case team will be assigned by the department head and ECT unit head. The team will
have a clearly defined structure with assigned roles and duties. The team members, along with
the head of the ECT unit, will actively participate in monitoring and evaluation activities
throughout the implementation process.

By following this staff management strategy, the ECT unit ensures efficient allocation of
responsibilities, clear communication channels, and active involvement of team members and
unit heads in monitoring and evaluating the ECT treatment processes. This approach promotes
effective teamwork, accountability, and continuous quality improvement within the ECT unit.

9. Identified program key stakeholders.

➢ Psychiatrists, msc psychiatric professionals, and psychiatric professionals involved in

providing ECT treatment and patient care.
➢ Sabian General Hospital and Ministry of Health: Provide funding, materials, and support
for the program.
➢ Managers and Supervisors: Monitor and maintain the goals of the ECT unit.
➢ General Public: Affected by substance-related disorders prevention and control
measures.

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10.SWOT Analysis
Table 1: SWOT analysis

Strengths (Internal) Weaknesses (Internal)

Highly skilled and experienced psychiatrists and Limited budget for acquisition and maintenance
staff
Well-established Psychiatry and Rehabilitation Insufficient staff training on ECT protocols
Center
Strong reputation in the local healthcare Lack of dedicated ECT facilities or infrastructure
community
Access to a diverse patient population Limitation of experience in working substance
related disorders

Opportunities (External) Threats (External)

Increasing demand for effective mental health Changing healthcare regulations and reimbursement
treatments policies
Collaboration with local healthcare providers Competition from other psychiatric facilities offering
for referrals alternative treatments
Potential partnerships with research institutions Public misconceptions and stigma associated with
for ECT studies ECT

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 11.Problem Analysis

Problem Analysis for Electroconvulsive Therapy (ECT)

Efficacy and Effectiveness: Safety and Side Effects:

effectiveness of ECT across different Modern day ECT is safe and effective. It can
psychiatric conditions and patient populations. relieve symptoms of the most severe forms of
depression more effectively than medication
or therap

Stigma and Misconceptions: Access and Availability:

Need for public education and awareness Inequitable access to ECT, resulting in delayed
campaigns to address misconceptions and reduce or inadequate treatment for individuals who
stigma. could benefit from it

Informed Consent and Ethical Considerations: Training and Competency of Providers:

Ethical considerations in obtaining informed consent Ensuring healthcare providers administering

for ECT, ensuring patients have comprehensive ECT receive appropriate training and
information about the procedure, risks, benefits, and maintain competency.
alternatives.

Cost and Financial Considerations: Integration with Mental Health Services:

Financial implications associated with ECT, Need for better integration of ECT with mental
including equipment, facility requirements, health services to provide comprehensive care
anesthesia, and specialized personnel. for patients with co-occurring mental health
disorders.
Figure 1: Problem Analysis for Electroconvulsive Therapy (ECT)

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 12.objective analysis

To establish ECT unit in psychiatry department at sabian general hospital medical

center

Availability of ECT health services Actively prevent and mitigate relapse

for psychiatry disorders

Educate and inform patients, families, To establish case team for ECT unit
and the community about ECT treatment
to promote understanding and reduce To provide ECT services for treatment of
stigma. certain psychiatric conditions.

Reduce psychological and economic impact of treatment.

figure 2: 12. objective analysis for ECT

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 13. Project design matrix

Narrative summary Performance indicator Means of verification

Overall goal ✓ Number of patients Counting
✓ To establish an ECT unit at Sabian General admitted and treated at
Hospital the unit.
✓ Number of team
members deployed at the
unit.
✓ Number of patients who
received ECT treatment.
Project objective ✓ Number of patients Counting
✓ To provide Electroconvulsive Therapy (ECT) for admitted and treated at
individuals with severe mental disorders the unit.
✓ To establish a specialized ECT treatment team ✓ Number of team
✓ To effectively manage and treat severe mental members deployed at the
disorders using ECT, including comorbid unit.
conditions with substance-related disorders ✓ Number of patients who
received ECT treatment.
Out put. ✓ Number of patients Counting
✓ Effective ECT treatment provided for psychiatric admitted and treated at
disorders. the unit.
✓ Psychological intervention and care provided in ✓ Number of patients who Counting
conjunction with ECT treatment. received ECT treatment.
✓ Actively prevent and mitigate relapse of severe ✓ Satisfaction of patients Feedback surveys or
mental disorders interviews
✓ Adequate remission of Documentation
psychiatric symptoms
Activities Input Preconditions
✓ Establish the ECT unit at Sabian General Hospital ✓ Human resources -Commitment of Sabian
✓ Recruit and train a team of healthcare (Psychiatrists, General Hospital
professionals for the ECT unit. Anesthesiologists, -Cooperation from the
✓ Conduct training programs for the staff on ECT Nurses) Ministry of Health and
procedures and safety protocols. ✓ Education materials other stakeholders
✓ Develop guidelines and protocols for ECT (guidelines, training - Availability of adequate
treatment at the hospital. materials funding and resources for
✓ Ensure the availability of necessary equipment ✓ Facilities (ECT establishing and
and facilities for ECT. machine, anesthesia maintaining the ECT unit
equipment, treatment
rooms)

Table 2: project design matrix

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 13.Work plan
Activity Detailed Description Key Resources Time
Stakeholders Required (Inputs) fram
e
Objective: To provide Electroconvulsive Therapy (ECT) for individuals with severe mental
disorders.
Activity Identify and describe the • Psychiatrist Assessment tools, data
target population in need of • Mental health collection instruments
ECT professional
Form an ECT treatment Recruitment process,
• Residents
team team selection criteria
Provide short-term training • Nurses Training materials,
for ECT team members Unit head trainers, training
before the launch facilities
Develop guidelines for ECT Expert input, existing
implementation guidelines, stakeholder
inputs
Establish admission criteria Clinical expertise,
and adapt new standards of guideline adaptation
care applicable for ECT
patients
Procure necessary ECT machines,
equipment and facilities for anesthesia equipment,
ECT treatment unit recovery area,
treatment rooms
Collaborate with other Networking,
mental health units for collaboration
referral and coordination agreements
Implement ECT treatment ECT schedule, patient
for eligible patients assessment, treatment
plans
Monitor and evaluate the Monitoring tools, data
effectiveness and safety of collection instruments,
ECT interventions analysis software
Provide ongoing training Training materials,
and supervision for ECT trainers, supervision
team members to ensure framework
quality of care
Ensure compliance with Ethical guidelines,
ethical and legal legal frameworks,
requirements for ECT documentation
procedures procedures
Table 3: work plan

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15. Important Assumptions of the project

The project assumes the following:

➢ Assumed support from relevant authorities for resources and approvals.

➢ Assumed availability and commitment of professionals for ECT implementation.
➢ Assumed effective collaboration and coordination among stakeholders.
➢ Assumed adherence to ethical and legal guidelines for ECT procedures.
➢ Assumed willingness of eligible patients to undergo ECT treatment after counseling.

16. Potential Risks for the project implementation

Potential Risks for ECT Implementation:

➢ Staff unwillingness
➢ Limited trained professionals
➢ Limited resources
➢ Stakeholder resistance
➢ Regulatory and legal considerations
➢ Ethical concerns and public perception
➢ Safety and adverse events

17. Intended Impacts of the establishment of the unit

Intend to produce the following impacts in the psychiatry ward:

➢ Improved treatment outcomes for severe mental health conditions.
➢ Increased access to specialized care.
➢ Enhanced collaboration and multidisciplinary approach.
➢ Reduced hospitalization and healthcare costs.
➢ Improved overall mental health system.

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18. Budget

Summary of Budget

S No Description of costs Total Remarks

1 Human cost

2 Materials cost

3 Transportation cost

Grand total

Table 4: budget summary

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19. Monitoring and Evaluation Framework for ECT Implementation:

Monitoring:
The implementation of the ECT program will be closely monitored by the team members and the
head of the unit. Regular monitoring activities will involve tracking the progress of each activity
assigned to team members, ensuring adherence to timelines, and addressing any implementation
challenges that may arise.

Evaluation:
Evaluation of the ECT implementation project will be conducted at the end of the project period.
The evaluation process will involve the participation of selected team members from the substance
unit and relevant stakeholders. The evaluation will assess the overall achievements and outcomes
of the project based on the following indicators:

✓ Number of patients admitted and treated at the ECT unit.

✓ Number of team members deployed at the ECT unit.
✓ Number of patients receiving inpatient and outpatient care at the unit.
✓ Number of staff trained on substance-related disorders.
✓ Patient satisfaction with ECT treatment.
✓ Reduction in symptom severity scores for patients undergoing ECT.
✓ Cost-effectiveness analysis of the ECT program.
✓ Integration of ECT into existing mental health services.

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20. Action Plan

No Activity Resource Responsible body Time

frame
1 Formation of the ECT team Human resource Project Team
2 Conduct meeting sessions with Human resource Project Team
stakeholders
3 Submit proposal and solicit funds Human resource Project Team

4 Establish cooperation and secure Transportation Letter of

necessary funding cooperation

5 Assignment and deployment of ECT Human Project Team

teams resource,
Budget
6 Establish the ECT unit Human resource Project Team

7 Staff training on ECT procedures and Human resource Project Team

best practices
8 Preparation of guidelines for ECT Human resource Project Team
administration

9 Launch the ECT unit Human resource Project Team

10 Project evaluation and closure Human resource SGH

Table 5: Action plan for ECT Implementation

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REFERENCE
1. DSM-5. Arlington, VA2013.
2. The Journal of ECT (JECT)

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