Gage Caleb H, Gwyther Liz, Ambler Julia, Burke Jan, Evans Katya, Holmes Linley, Krause René, Lachenicht Kaleb, Lincoln Danielle, Payne Kerene, Ratshikana-Moloko Mpho, Stander Charnelle, Stassen Willem
Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town.
Afr J Prim Health Care Fam Med. 2025 Jun 24;17(1):e1-e10. doi: 10.4102/phcfm.v17i1.4891.
The need for integrated healthcare has been increasingly recognised because of mounting challenges associated with the proliferation of injuries and noncommunicable diseases. A developing example of integration is between Emergency Medical Services (EMS) and palliative care. Despite recommendations for integration in South Africa (SA), these services remain segregated.
This study aimed to develop and prioritise approaches facilitating EMS and palliative care system integration within SA.
An online meeting was held with SA EMS and palliative care experts.
A nominal group technique was employed to answer the question, 'What do you think should be done to most effectively integrate EMS and palliative care services in SA?' Answers were categorised, awarded scores by participants, and ranked according to impact and feasibility.
The following categories were generated: Awareness, Education, Community Engagement, Communication and Information Sharing, Stakeholder Collaborations, Alternative Pathways and Approaches, Research, Funding, Policy Development and Governance. The top five individual approaches were: (1) enable EMS to administer already prescribed medications, (2) Emergency Medical Services undergraduate training in palliative care, (3) improve EMS recognition of signs of dying at the end-of-life, (4) palliative care awareness for the EMS community, and (5) palliative care awareness for in-hospital healthcare providers, particularly those in emergency medicine.
The categories developed in this study should be used to guide EMS and palliative care integration in SA. Future research should aim at establishing the safety and efficacy of these interventions.Contribution: This study provides a structured approach to integrating EMS and palliative care in SA, enhancing holistic care for patients with palliative needs.
由于与伤害和非传染性疾病激增相关的挑战日益严峻，综合医疗保健的需求已得到越来越多的认可。一个正在发展的整合范例是紧急医疗服务（EMS）与姑息治疗之间的整合。尽管南非（SA）有整合的建议，但这些服务仍然是分开的。
本研究旨在制定并确定促进南非EMS与姑息治疗系统整合的方法的优先次序。
与南非EMS和姑息治疗专家举行了一次在线会议。
采用名义群体技术来回答问题：“你认为应该采取什么措施来最有效地整合南非的EMS和姑息治疗服务？”答案被分类，由参与者打分，并根据影响和可行性进行排名。
产生了以下类别：意识、教育、社区参与、沟通与信息共享、利益相关者合作、替代途径和方法、研究、资金、政策制定和治理。排名前五的个人方法是：（1）使EMS能够管理已开处方的药物，（2）EMS本科姑息治疗培训，（3）提高EMS对临终死亡迹象的识别能力，（4）提高EMS社区对姑息治疗的认识，（5）提高医院内医疗服务提供者，特别是急诊医学领域人员对姑息治疗的认识。
本研究中确定的类别应被用于指导南非EMS与姑息治疗的整合。未来的研究应旨在确定这些干预措施的安全性和有效性。贡献：本研究提供了一种在南非整合EMS与姑息治疗的结构化方法，增强了对有姑息治疗需求患者的整体护理。
