The Strengthening Emergency Systems Program conducted a study at Columbia University's Mailman School of Public Health in collaboration with the African Federation of Emergency Medicine fills this gap, identifying 76 quality indicators for emergency care for use in critical care facilities in Africa. The study was published in the British Medical Journal.
The need for emergency care in low-income and middle-income countries has never been greater, but until now, measurable indicators for providing this care have been lacking. "Access to emergency care systems in low – and middle – income countries (LMICs) is expanding, particularly in Africa," said Rachel T.
She is also the founding director of the sidHARTe Program, which for the last decade has collaborated with local partners and international stakeholders in LMICs to improve acute care systems to save lives. "Until now, these efforts rarely included measurements for the quality or the impact of care provided, which is essential for improvement of care provision."
A research team of 32 physicians, clinical officers, nurses and administrators from 21 countries worked to create the list of context-appropriate quality indicators that were established and agreed on by providers and policymakers. Their goal: allow for uniform and objective data collection to enhance emergency care delivery throughout Africa.
The researchers searched peer-reviewed publications such as PubMed, MEDLINE, and EMBASE. Through consensus, they identified seven emergency clinical conditions, including trauma, sepsis, acute respiratory problems, shock, altered mental state, pain, and obstetric bleeding, which together account for nearly 75% of deaths in Africa.
In addition to enhancing the quality of care, processes for system strengthening efforts and resource distribution can now be directly compared, noted the authors. It also provides a common language for comparisons between different facilities within a single country and between countries.
They expect that with proper implementation of these performance indicators it will lead to enhanced understanding of disparities in care quality and resource distribution analysis that can redirect resources to improve patient outcomes. Local adaptation specific to the burden of disease and feasibility of measurement will be a crucial next step.