Bani Odeh Abed Alr'oof, Wallis Lee, Hamdan Motasem, Stassen Willem
Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.
Faculty of Public Health, Al-Quds University, East Jerusalem, Occupied Palestinian Territory.
PLoS One. 2025 Jan 10;20(1):e0307632. doi: 10.1371/journal.pone.0307632. eCollection 2025.
To validate Palestine's previously derived emergency department quality standards (EDQS) using an e-Delphi survey. A two-round e-Delphi survey validated the EDQS, developed in an earlier study through a literature review and consensus-building among Palestinian emergency medicine and healthcare quality experts. The study purposively sampled 53 emergency department and healthcare quality experts with over 5 years of experience. A Likert scale was used to rate the standards on readability, clarity, and comprehensiveness in the initial round to reach consensus on the EDQS, with detailed feedback. An expanded expert group refined the shortlisted standards in the next phase. Lime Survey collected data anonymously. A set of 100 EDQS was validated through a two-round e-Delphi survey. In the initial round, 103 standards were presented, and consensus was achieved, resulting in a refined list of 100 standards. Among these, 39 standards fell under the clinical pathway domain, and 61 under the administrative pathway domain. In the second round, the validity of these standards was affirmed, with 96.4% consensus for clinical standards and 97.3% for administrative standards. Additionally, seven subdomains of EDQS were associated with the clinical pathway domain: triage, treatment, transportation, medication safety, patient flow, and medical diagnostic services, and nine subdomains were linked to the administration pathway domain: 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 programs. The study validated context emergency department quality standards in Palestine, with over 97% consensus indicating a commitment to quality care. Experts suggest further research on implementation feasibility. Validated standards can aid healthcare leaders in resource allocation, staff training, and enhancing patient care, potentially leading to significant improvements in emergency healthcare in Palestine.
使用电子德尔菲调查法验证巴勒斯坦先前制定的急诊科质量标准（EDQS）。两轮电子德尔菲调查对EDQS进行了验证，该标准是在早期一项研究中通过文献综述以及巴勒斯坦急诊医学和医疗质量专家达成共识而制定的。该研究有目的地抽取了53名具有5年以上经验的急诊科和医疗质量专家。在第一轮中，使用李克特量表对标准的可读性、清晰度和全面性进行评分，以就EDQS达成共识，并提供详细反馈。在下一阶段，一个扩大的专家组对入围标准进行了完善。Lime调查以匿名方式收集数据。通过两轮电子德尔菲调查验证了一套100项的EDQS。在第一轮中，提出了103项标准并达成了共识，最终形成了一份精简后的100项标准清单。其中，39项标准属于临床路径领域，61项属于管理路径领域。在第二轮中，这些标准的有效性得到了确认，临床标准的共识率为96.4%，管理标准的共识率为97.3%。此外，EDQS的七个子领域与临床路径领域相关：分诊、治疗、转运、用药安全、患者流程和医疗诊断服务，九个子领域与管理路径领域相关：文档、信息管理系统、接入地点、设计、领导、管理、劳动力配备、培训、设备、供应、容量复苏室、安全工作环境资源、绩效指标以及患者安全——感染预防与控制计划。该研究验证了巴勒斯坦的情境急诊科质量标准，超过97%的共识表明对优质护理的承诺。专家建议进一步研究实施可行性。经过验证的标准可帮助医疗保健领导者进行资源分配、员工培训并改善患者护理，可能会使巴勒斯坦的急诊医疗服务得到显著改善。
