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Broccoli MC, Moresky R, Dixon J, et al. Defining quality indicators for emergency care delivery: findings of an expert consensus process by emergency care practitioners in Africa. BMJ Glob Health. 2018;3(1):e000479doi: 10.1136/bmjgh-2017-000479.
Broccoli, M. C., Moresky, R., Dixon, J., Muya, I., Taubman, C., Wallis, L. A., & Calvello Hynes, E. J. (2018). Defining quality indicators for emergency care delivery: findings of an expert consensus process by emergency care practitioners in Africa. BMJ global health, 3(1), e000479. https://doi.org/10.1136/bmjgh-2017-000479
Broccoli, Morgan C, et al. "Defining quality indicators for emergency care delivery: findings of an expert consensus process by emergency care practitioners in Africa." BMJ global health vol. 3,1 (2018): e000479. doi: https://doi.org/10.1136/bmjgh-2017-000479
Broccoli MC, Moresky R, Dixon J, Muya I, Taubman C, Wallis LA, Calvello Hynes EJ. Defining quality indicators for emergency care delivery: findings of an expert consensus process by emergency care practitioners in Africa. BMJ Glob Health. 2018 Feb 15;3(1):e000479. doi: 10.1136/bmjgh-2017-000479. eCollection 2018. PMID: 29527337; PMCID: PMC5841514.
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BMJ Glob Health. 2018 Feb 15;3(1):e000479. doi: 10.1136/bmjgh-2017-000479. eCollection 2018.

Defining quality indicators for emergency care delivery: findings of an expert consensus process by emergency care practitioners in Africa.

BMJ global health

Morgan C Broccoli, Rachel Moresky, Julia Dixon, Ivy Muya, Cara Taubman, Lee A Wallis, Emilie J Calvello Hynes

Affiliations

  1. Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts, USA.
  2. sidHARTe Program, Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, USA.
  3. Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
  4. Nursing Committee Chair and Executive Committee Secretary, African Federation for Emergency Medicine, Cape Town, South Africa.
  5. Department of Emergency Medicine, Harlem Hospital, New York, USA.
  6. Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.

PMID: 29527337 PMCID: PMC5841514 DOI: 10.1136/bmjgh-2017-000479

Abstract

Facility-based emergency care delivery in low-income and middle- income countries is expanding rapidly, particularly in Africa. Unfortunately, these efforts rarely include measurement of the quality or the impact of care provided, which is essential for improvement of care provision. Our aim was to determine context-appropriate quality indicators that will allow uniform and objective data collection to enhance emergency care delivery throughout Africa. We undertook a multiphase expert consensus process to identify, rank and refine quality indicators. A comprehensive review of the literature identified existing indicators; those associated with a substantial burden of disease in Africa were categorised and presented to consensus conference delegates. Participants selected indicators based on inclusion criteria and priority clinical conditions. The indicators were then presented to a group of expert clinicians via on-line survey; all meeting agreements were refined in-person by a separate panel and ranked according to validity, feasibility and value. The consensus working group selected seven conditions addressing nearly 75% of mortality in the African region to prioritise during indicator development, and the final product at the end of the multiphase study was a list of 76 indicators. This comprehensive process produced a robust set of quality indicators for emergency care that are appropriate for use in the African setting. The adaptation of a standardised set of indicators will enhance the quality of care provided and allow for comparison of system strengthening efforts and resource distribution.

Keywords: health services research; health systems; health systems evaluation

Conflict of interest statement

Competing interests: None declared.

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