Public Health Department, University Hospital Centre, Poitiers, France
Emergency Department, University Hospital Centre, Poitiers, France.
BMJ Open Qual. 2021 May;10(2). doi: 10.1136/bmjoq-2020-001176.
Emergency medical regulation is a risky activity. In France, emergency medical societies have proposed activity and performance indicators, but their lists are non-exhaustive, unstructured and used heterogeneously among emergency medical call centres (Centres de Réception et de Régulation des Appels, CRRA). Our objective was to build by means of regional stakeholder consensus an operational quality dashboard for CRRAs.
We conducted an observational step in a French CRRA from June to September 2018 and at the same time listed existing activity and quality indicators through a rapid international literature review. We adapted and classified all indicators identified in a structured table. We prioritised them from April to September 2019 by seeking consensus with one regulator physician and one medical regulation assistant from the 13 CRRAs of the largest French region. We used an adapted Delphi method with a prioritisation scale from 1 to 9.
The rapid review of literature included 33 studies among the 414 identified and, with the first observational step, resulted in a list of 360 quality indicators covering the following areas: material resources, human resources, quality approach, call handling and postcall support. 15 of the 26 members participated in the entire process. Seventy indicators were considered as priorities with strong agreement among participants. We built an operational dashboard of quality indicators deemed high priority and provided 70 descriptive indicator sheets.
Our study allowed to build an operational quality dashboard for CRRAs as a ready-to-use support for an internal audit, for prioritisation of quality approach actions and for national and international benchmarking.
紧急医疗监管是一项高风险的活动。在法国，紧急医疗协会已经提出了活动和绩效指标，但它们的清单并不全面，结构不完整，并且在紧急医疗呼叫中心（Centres de Réception et de Régulation des Appels，CRRA）中使用方式也不一致。我们的目标是通过区域利益相关者的共识，为 CRRA 构建一个操作性的质量仪表板。
我们在 2018 年 6 月至 9 月期间对法国的一个 CRRA 进行了观察性研究，并同时通过快速的国际文献回顾列出了现有的活动和质量指标。我们将所有识别出的指标进行了改编和分类，并在一个结构化的表格中进行了分类。我们在 2019 年 4 月至 9 月期间，通过与 13 个法国最大地区的 CRRA 中的一名监管医生和一名医疗监管助理寻求共识，对所有指标进行了优先级排序。我们使用了一种经过改编的 Delphi 方法，使用 1 到 9 的优先级评分。
文献快速回顾共包括 33 项研究，加上第一个观察性步骤，共列出了 360 项质量指标，涵盖了以下领域：物质资源、人力资源、质量方法、呼叫处理和呼叫后支持。26 名参与者中的 15 名参加了整个过程。70 个指标被认为是具有高度共识的优先指标。我们构建了一个操作性的质量指标仪表板，认为这是内部审计、质量方法行动的优先排序以及国家和国际基准的有用支持。
我们的研究为 CRRA 构建了一个操作性的质量仪表板，可作为内部审计、质量方法行动的优先排序以及国家和国际基准的有用支持。
