Updated framework on quality and safety in emergency medicine

ObjectivesQuality and safety of emergency care is critical. Patients rely on emergency medicine (EM) for accessible, timely and high-quality care in addition to providing a ‘safety-net’ function. Demand is increasing, creating resource challenges in all settings. Where EM is well established, this is recognised through the implementation of quality standards and staff training for patient safety. In settings where EM is developing, immense system and patient pressures exist, thereby necessitating the availability of tiered standards appropriate to the local context.MethodsThe original quality framework arose from expert consensus at the International Federation of Emergency Medicine (IFEM) Symposium for Quality and Safety in Emergency Care (UK, 2011). The IFEM Quality and Safety Special Interest Group members have subsequently refined it to achieve a consensus in 2018.ResultsPatients should expect EDs to provide effective acute care. To do this, trained emergency personnel should make patient-centred, timely and expert decisions to provide care, supported by systems, processes, diagnostics, appropriate equipment and facilities. Enablers to high-quality care include appropriate staff, access to care (including financial), coordinated emergency care through the whole patient journey and monitoring of outcomes. Crowding directly impacts on patient quality of care, morbidity and mortality. Quality indicators should be pragmatic, measurable and prioritised as components of an improvement strategy which should be developed, tailored and implemented in each setting.ConclusionEDs globally have a remit to deliver the best care possible. IFEM has defined and updated an international consensus framework for quality and safety.

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Mobile Health in Emergency Care

Encyclopedia of Mobile Phone Behavior ◽

10.4018/978-1-4666-8239-9.ch068 ◽

2015 ◽

pp. 825-838 ◽

Cited By ~ 2

Author(s):

Waddaa Redha ◽

Kirsten Hartwick ◽

Neal Sikka

Keyword(s):

Emergency Medicine ◽

Healthcare System ◽

Mobile Health ◽

Emergency Care ◽

Wound Care ◽

Prehospital Care ◽

Quality Care ◽

Healthcare Providers ◽

Stroke Care ◽

High Quality

With the passage of the Affordable Care Act (ACA) in 2010, significant changes are occurring within the healthcare system. It is imperative that ways to both reduce cost and improve health are found. Since emergency medicine is often considered the gateway to the healthcare system, healthcare providers need to determine the best way to provide high quality care in the emergency department while also curbing costs. Mobile health, or mHealth, utilizes technology to increase the mobility of patients and their providers and provides a medium to transfer data and information efficiently. In emergency medicine, this technology can be applied in various treatments including wound care, stroke care, and prehospital care. In this article, the authors discuss the current uses of mHealth within emergency care and potential areas for future growth.

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Bridging existing governance gaps: five evidence-based actions that boards can take to pursue high quality care

Australian Health Review ◽

10.1071/ah17042 ◽

2019 ◽

Vol 43 (2) ◽

pp. 126

Author(s):

Sandra G. Leggat ◽

Cathy Balding

Keyword(s):

Health Service ◽

Health Services ◽

Care Delivery ◽

Quality Care ◽

Successful Implementation ◽

Evidence Based ◽

Quality And Safety ◽

Quality Systems ◽

High Quality ◽

High Quality Care

Objective To explore the impact of the organisational quality systems on quality of care in Victorian health services. Methods During 2015 a total of 55 focus groups were conducted with more than 350 managers, clinical staff and board members in eight Victorian health services to explore the effectiveness of health service quality systems. A review of the quality and safety goals and strategies outlined in the strategic and operating plans of the participating health services was also undertaken. Results This paper focuses on the data related to the leadership role of health service boards in ensuring safe, high-quality care. The findings suggest that health service boards are not fully meeting their governance accountability to ensure consistently high-quality care. The data uncovered major clinical governance gaps between stated board and executive aspirations for quality and safety and the implementation of these expectations at point of care. These gaps were further compounded by quality system confusion, over-reliance on compliance, and inadequate staff engagement. Conclusion Based on the existing evidence we propose five specific actions boards can take to close the gaps, thereby supporting improved care for all consumers. What is known about this topic? Effective governance is essential for high-quality healthcare delivery. Boards are required to play an active role in their organisation’s pursuit of high quality care. What does this paper add? Recent government reports suggest that Australian health service boards are not fully meeting their governance requirements for high quality, safe care delivery, and our research pinpoints key governance gaps. What are the implications for practitioners? Based on our research findings we outline five evidence-based actions for boards to improve their governance of quality care delivery. These actions focus on an organisational strategy for high-quality care, with the chief executive officer held accountable for successful implementation, which is actively guided and monitored by the board.

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Collective leadership for cultures of high quality health care

Journal of Organizational Effectiveness People and Performance ◽

10.1108/joepp-07-2014-0039 ◽

2014 ◽

Vol 1 (3) ◽

pp. 240-260 ◽

Cited By ~ 23

Author(s):

Michael A. West ◽

Joanne Lyubovnikova ◽

Regina Eckert ◽

Jean-Louis Denis

Keyword(s):

Health Care ◽

Health Care Organizations ◽

Quality Care ◽

Quality And Safety ◽

Healthcare Organizations ◽

Collective Leadership ◽

High Quality ◽

Quality Health Care ◽

Content Type ◽

High Quality Care

Purpose – The purpose of this paper is to examine the challenges that health care organizations face in nurturing and sustaining cultures that ensure the delivery of continually improving, high quality and compassionate care for patients and other service users. Design/methodology/approach – Based on an extensive review of the literature, the authors examine the current and very challenging context of health care and highlight the core cultural elements needed to enable health care organizations to respond effectively to the challenges identified. Findings – The role of leadership is found to be critical for nurturing high-quality care cultures. In particular, the authors focus on the construct of collective leadership and examine how this type of leadership style ensures that all staff take responsibility for ensuring high-quality care for patients. Practical implications – Climates for quality and safety can be accomplished by the development of strategies that ensure leaders, leadership skills and leadership cultures are appropriate to meet the challenges health care organizations face in delivering continually improving, high quality, safe and compassionate patient care. Originality/value – This paper provides a comprehensive integration of research findings on how to foster quality and safety climates in healthcare organizations, synthesizing insights from academic literature, practitioner reports and policy documents to propose clear, timely and much needed practical guidelines for healthcare organizations both nationally and internationally.

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