目的:本研究旨在为巴勒斯坦的急诊科(EDQS)建立适当的质量标准。
方法:本研究包括四个阶段。首先,进行了全面的文献综述,以制定评估ED医疗服务的框架.第二,EDQS的初始集是根据审查结果制定的.第三,当地专家对EDQS提供了反馈,建议额外的标准,并给出建议。对这些反馈进行了分析,以创建一套初步的EDQS。最后,一个扩大的当地急救专家小组评估了初步的一套,提供有关内容和结构的反馈,以有助于最终的EDQS集。
结果:我们确定了ED的质量领域,并将其分为临床和管理途径。临床路径包括7个子域的39个标准:分诊,治疗,交通运输,用药安全,患者流量和医疗诊断服务。专家对这些标准的87.5%达成了共识。管理域包括跨9个子域的64个基于共识的标准:文档,信息管理系统,access-location,设计,领导力,管理,劳动力配置,培训,设备,用品,容量复苏室,安全工作环境的资源,绩效指标和患者安全-感染预防和控制计划。
结论:这项研究采用了严格的方法来确定巴勒斯坦ED的QS。多阶段共识过程确保了已开发的EDQS的适当性。包含不同的观点丰富了内容。未来的研究将基于反馈来验证和完善标准。EDQS有可能加强巴勒斯坦的紧急护理,并成为面临类似挑战的其他地区的典范。
OBJECTIVE: The present study aimed to establish appropriate quality standards for emergency departments (EDQS) in Palestine.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.