Establishing Core elements for a Prehospital Emergency Care Systems Evaluation Tool (PECSET) for systems in early stages of development: A Delphi consensus.

Autor:	Nadarajan GD; Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore., Pek PP; Prehospital & Emergency Research Centre, Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore, Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore., Blewer AL; Department of Family Medicine and Community Health, Department of Population Health Sciences, Duke University School of Medicine, USA, Prehospital & Emergency Research Centre, Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore., Haedar A; Saiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Indonesia., Staton C; Global Emergency Medicine Innovation and Implementation Research Center, Department of Emergency Medicine, Duke University School of Medicine, Duke Global Health Institute, USA., Wong KD; Emergency and Trauma Department, Penang General Hospital, Malaysia., Mesa-Gaerlan FJ; University of the Philippines, Philippine General Hospital, Philippines., Karim S; Prehospital Care Services Unit, Hospital Sungai Buloh, Malaysia., Riyapan S; Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand., Østbye T; Department of Family Medicine and Community Health, Duke University School of Medicine, USA., Ong MEH; Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore, Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore., Joiner A; Department of Emergency Medicine, Duke University School of Medicine, USA, Prehospital & Emergency Research Centre, Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore.
Jazyk:	angličtina
Zdroj:	Prehospital emergency care [Prehosp Emerg Care] 2024 Dec 19, pp. 1-17. Date of Electronic Publication: 2024 Dec 19.
DOI:	10.1080/10903127.2024.2443472
Abstrakt:	Objectives: International Prehospital Emergency Care (PEC) standards have been primarily developed by and for high resource settings. Most PEC systems in Asia, which are still in the early stages of development, struggle to achieve these standards. There is a need for an evaluation tool which can define achievable basic building blocks for PEC systems in low resource settings to improve quality of PEC. We aimed to identify the core, basic elements (building blocks of a PEC system) for a Prehospital Emergency Care Systems Evaluation Tool (PECSET) for low resource settings in Asia. Methods: A 4-stage modified Delphi consensus method was used to engage 32 PEC experts from 12 Asian countries. Participants voted on 32 elements identified from a prior scoping review, focus group discussions, and survey. Each round of voting was conducted through an anonymous, web-based application and followed by face-to-face group discussions. The first two rounds aimed to answer, "Is the element important and feasible in a low resource setting?" The last two stages aimed to answer "Should this element be prioritized as core in the tool?" A thematic analysis of the recorded and transcribed discussions was used to identify participants' rationale for prioritization. Results: After four rounds of voting, 12 elements were identified as core elements: 1) dispatch assisted instructions, 2) protocols for screening, triage and destination, (3) medical direction, 4) standardized training programs, 5) minimum ambulance standards, 6) operational metrics, 7) quality assurance, 8) operational safety protools, 9) essential patient care documentation, 10) medical records management, 11) layperson awareness and education and 12) universal access emergency number. However, the participants decided to include all 32 elements in the tool grouped into broader categories by percent agreement for a tiered approach for early, intermediate, and advanced PEC systems. Rationales for prioritization included a need for focus on basic infrastructure and building resilience in resource-stretched systems. Conclusions: Through a Delphi consensus process, stakeholders identified core elements for PEC systems in low resource settings. These findings will inform the development of a tool for quality assurance and monitoring in low resource settings in South and Southeast Asian countries.
Databáze:	MEDLINE
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