Emergency Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
Emergency Medicince, University of Cape Town, Cape Town, Western Cape, South Africa.
BMJ Open Qual. 2024 Mar 22;13(1):e002598. doi: 10.1136/bmjoq-2023-002598.
The present study aimed to establish appropriate quality standards for emergency departments (EDQS) in Palestine.
The study comprised four phases. First, a comprehensive literature review was conducted to develop a framework for assessing healthcare services in EDs. Second, the initial set of EDQS was developed based on the review findings. Third, local experts provided feedback on the EDQS, suggesting additional standards, and giving recommendations. This feedback was analysed to create a preliminary set of EDQS. Finally, an expanded group of local emergency care experts evaluated the preliminary set, providing feedback on content and structure to contribute to the final set of EDQS.
We identified quality domains in EDs and categorised them into clinical and administrative pathways. The clinical pathway comprises 39 standards across 7 subdomains: triage, treatment, transportation, medication safety, patient flow and medical diagnostic services. Expert consensus was achieved on 87.5% of these standards. The administrative domain includes 64 consensus-based standards across 9 subdomains: documentation, information management systems, access-location, design, leadership, management, workforce staffing, training, equipment, supplies, capacity-resuscitation rooms, resources for a safe working environment, performance indicators and patient safety-infection prevention and control programmes.
This study employed a rigorous approach to identify QS for EDs in Palestine. The multiphase consensus process ensured the appropriateness of the developed EDQS. Inclusion of diverse perspectives enriched the content. Future studies will validate and refine the standards based on feedback. The EDQS has potential to enhance emergency care in Palestine and serve as a model for other regions facing similar challenges.
本研究旨在为巴勒斯坦的急诊科(EDQS)建立适当的质量标准。
该研究包括四个阶段。首先,进行了全面的文献回顾,以制定评估急诊科医疗服务的框架。其次,根据审查结果制定了初始 EDQS 集。第三,当地专家对 EDQS 提出反馈意见,建议增加其他标准并提出建议。对该反馈进行了分析,以创建初步的 EDQS 集。最后,一组扩大的当地紧急护理专家评估了初步的 EDQS 集,对内容和结构提出反馈意见,以促成最终的 EDQS 集。
我们确定了急诊科的质量领域,并将其分为临床和行政途径。临床途径包括 39 个标准,涵盖 7 个子领域:分诊、治疗、转运、用药安全、患者流程和医疗诊断服务。这些标准中有 87.5%达成了专家共识。行政领域包括 64 个基于共识的标准,涵盖 9 个子领域:文件、信息管理系统、访问位置、设计、领导、管理、劳动力人员配备、培训、设备、用品、容量-复苏室、安全工作环境资源、绩效指标和患者安全-感染预防和控制计划。
本研究采用严格的方法来确定巴勒斯坦急诊科的 QS。多阶段共识过程确保了制定的 EDQS 的适当性。纳入不同的观点丰富了内容。未来的研究将根据反馈意见验证和完善这些标准。EDQS 有可能提高巴勒斯坦的紧急护理水平,并为其他面临类似挑战的地区提供模型。