Studies focus on the quality of hospital emergency care

Abstract Background Emergency care services in low-and middle-income countries (LMICs) have traditionally received less attention in the dominant culture favouring vertical health programs. The unmet needs of pre-hospital and hospital-based emergency services are high but the barriers to accessing safe and quality emergency medical services (EMS) remain largely unaddressed. Few studies in Sub-Saharan Africa have qualitatively investigated barriers to EMS use, and quality of pre-hospital services from the providers and community perspective. We conducted a qualitative study to describe the patient-centred approach to emergency care in Kampala, Uganda, with specific attention to access to EMS.Methods The data collection was comprised of Key Informant Interviews (KII) and Focus Group Discussions (FGDs) with the community members. KII participants were selected using maximum purposive sampling based on expert knowledge of emergency care systems, and service delivery. FGDs were conducted to understand perceptions and experiences towards access to pre-hospital care, and to explore barriers to utilization of EMS. The respondents of ten KII and seven FGDs included pre-hospital EMS (PEMS) administrators, policy makers, police, health workers and community members. We conducted a directed content analysis to identify key themes and triangulate findings across different informant groups.Results Key themes emerged across interviews and discussions concerning: (1) lack of funds, (2) lack of standards, (3) need for upfront payments for emergency transport and care, 4) corruption, 5) poor quality pre-hospital emergency service, 6) poor quality hospital emergency care, and 7) delay in seeking treatment.Conclusions Patient-centred emergency care should be an integral part of comprehensive health care services. As Uganda and other LMICs continue to strive for universal health coverage, it is critical to prioritize and integrate emergency care within health systems owing to its cross-cutting nature. Community perceptions around access and quality of PEMS should be addressed in national policies covering affordable and safe EMS.

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The Quality of Pre-Hospital Emergency Care for Children with Acute Abdominal Pain: The Prospective Cohort Study Results

Педиатрическая фармакология ◽

10.15690/pf.v15i3.1908 ◽

2018 ◽

Vol 15 (3) ◽

pp. 264-269

Author(s):

Ekaterina A. Romanova ◽

Leyla S. Namazova-Baranova ◽

Elena Yu. Dyakonova ◽

Aleksey Yu. Romanov

Keyword(s):

Cohort Study ◽

Abdominal Pain ◽

Prospective Cohort Study ◽

Emergency Care ◽

Prospective Cohort ◽

Acute Abdominal Pain ◽

Hospital Emergency ◽

Study Results

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Problems of pathology related to the dermatovenerology field in the emergency hospital

Vrač skoroj pomoŝi (Emergency Doctor) ◽

10.33920/med-02-2001-06 ◽

2020 ◽

pp. 45-52

Author(s):

I. Barsukova ◽

I. Bagretsova

Keyword(s):

Health Care ◽

Quality Of Care ◽

Emergency Care ◽

Diagnostic Process ◽

Emergency Hospital ◽

New Models ◽

Hospital Development

Development of a system for the delivery of emergency care in a hospital inevitably raises questions of its availability and quality. And, if the leading pathological syndrome which is a reason for hospitalization and posing a threat to the patient's life deserves priority attention, then the accompanying pathology often stays in the background. At the same time the accompanying pathology related to the field of dermatovenerology poses epidemiological threat. The aim of the study was to improve the organization of health care for patients with concomitant pathology related to dermatovenerology in an emergency hospital. Development of new models and principles of the organization of medical and diagnostic process, introduction of methods of express diagnostics is required; importance of a dermatovenerologist becomes obvious, it will increase the availability and quality of care for patients with dermatovenereological pathology in an emergency hospital.

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Advanced paramedics and nurses can deliver safe and effective pre‐hospital and in‐hospital emergency care: An integrative review

Nursing Open ◽

10.1002/nop2.866 ◽

2021 ◽

Author(s):

Jörgen Jansson ◽

Maria Larsson ◽

Jan Nilsson

Keyword(s):

Emergency Care ◽

Integrative Review ◽

Hospital Emergency ◽

Advanced Paramedics

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Assessing the quality of care by house staff in a municipal hospital emergency department

Journal of the American College of Emergency Physicians ◽

10.1016/s0361-1124(76)80004-4 ◽

1976 ◽

Vol 5 (4) ◽

pp. 257-261 ◽

Cited By ~ 3

Author(s):

John J. McNamara ◽

Aziz Gourji ◽

Michele Green

Keyword(s):

Emergency Department ◽

Quality Of Care ◽

House Staff ◽

Hospital Emergency Department ◽

Municipal Hospital ◽

Hospital Emergency

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Knowledge-Based System supported by Chatbot to assist the Risk Classification Process of Patients in Hospital Emergency care (Preprint)

10.2196/preprints.33665 ◽

2021 ◽

Author(s):

Marciane Mueller ◽

Rejane Frozza ◽

Liane Mählmann Kipper ◽

Ana Carolina Kessler

Keyword(s):

Medical Care ◽

Knowledge Base ◽

Language Processing ◽

Emergency Care ◽

Risk Classification ◽

Conversational Agent ◽

Conversational Agents ◽

Hospital Emergency ◽

Knowledge Based System ◽

Knowledge Based

BACKGROUND This article presents the modeling and development of a Knowledge Based System, supported by the use of a virtual conversational agent called Dóris. Using natural language processing resources, Dóris collects the clinical data of patients in care in the context of urgency and hospital emergency. OBJECTIVE The main objective is to validate the use of virtual conversational agents to properly and accurately collect the data necessary to perform the evaluation flowcharts used to classify the degree of urgency of patients and determine the priority for medical care. METHODS The agent's knowledge base was modeled using the rules provided for in the evaluation flowcharts comprised by the Manchester Triage System. It also allows the establishment of a simple, objective and complete communication, through dialogues to assess signs and symptoms that obey the criteria established by a standardized, validated and internationally recognized system. RESULTS Thus, in addition to verifying the applicability of Artificial Intelligence techniques in a complex domain of health care, a tool is presented that helps not only in the perspective of improving organizational processes, but also in improving human relationships, bringing professionals and patients closer. The system's knowledge base was modeled on the IBM Watson platform. CONCLUSIONS The results obtained from simulations carried out by the human specialist allowed us to verify that a knowledge-based system supported by a virtual conversational agent is feasible for the domain of risk classification and priority determination of medical care for patients in the context of emergency care and hospital emergency.

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Telemedicine in paediatric emergency care: A systematic review

Journal of Telemedicine and Telecare ◽

10.1177/1357633x211010106 ◽

2021 ◽

pp. 1357633X2110101

Author(s):

Aditi Mitra ◽

Rubina Veerakone ◽

Kathleen Li ◽

Tyler Nix ◽

Andrew Hashikawa ◽

...

Keyword(s):

Systematic Review ◽

Patient Satisfaction ◽

Emergency Care ◽

Cost Savings ◽

Process Measures ◽

Paediatric Emergency ◽

Paediatric Emergency Care ◽

Therapeutic Decision Making ◽

The Impact

Introduction The impact of telemedicine on the access and quality of paediatric emergency care remains largely unexplored because most studies to date are focused on adult emergency care. We performed a systematic review of the literature to determine if telemedicine is effective in improving quality of paediatric emergency care with regards to access, process measures of care, appropriate disposition, patient-centred outcomes and cost-related outcomes. Methods We developed a systematic review protocol in accordance with PRISMA (Preferred Reporting Items for Systematic Review) guidelines. We included studies that evaluated the impact of synchronous and asynchronous forms of telemedicine on patient outcomes and process measures in the paediatric emergency care setting. Inclusion criteria were study setting, study design, intervention type, age, outcome measures, publication year and language. Results Overall, 1.9% (28/1434) studies met study inclusion and exclusion criteria. These studies revealed that telemedicine increased accuracy of patient assessment in the pre-clinical setting, improved time-to disposition, guided referring emergency department (ED) physicians in performing appropriate life-saving procedures and led to cost savings when compared to regular care. Studies focused on telepsychiatry demonstrated decreased length of stay (LOS), transfer rates and improved patient satisfaction scores. Discussion Our comprehensive review revealed that telemedicine enhances paediatric emergency care, enhances therapeutic decision-making and improves diagnostic accuracy, and reduces costs. Specifically, telemedicine has its most significant impact on LOS, access to specialized care, cost savings and patient satisfaction. However, there was a relative lack of randomized control trials, and more studies are needed to substantiate its impact on morbidity and mortality.

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