Criteria for emergency care clinical quality indicators in Africa
Inclusion criteria | Explanation |
Represents conditions which: | |
Occur with significant frequency | |
Are epidemiologically significant | The acute condition has high morbidity and mortality if appropriate care is not received in a timely manner. |
Fall within the scope of emergency care | The scope of emergency care includes all acute presentations within cadres of medical specialty across the life-cycle; it does not include longitudinal chronic care for ongoing morbid conditions. Example: While emergency care plays an important role in acute services for psychotic behaviour or suicidal ideation, ongoing mental health provision is best served by longitudinal chronic care. |
Have improved outcomes with optimal emergency care | Some acute presentations are more influenced than others by the emergency care provided. Example: Sepsis mortality is significantly impacted by early appropriate resuscitation.36 |
Represents conditions whose outcomes: | |
Depend on currently available diagnostic test or equipment | The diagnostic study must be readily available in the majority of emergency units. Example: CT scans are unavailable in the majority of emergency units in Africa and even when available at a tertiary referral level, are difficult to access due to cost, maintenance and expertise. |
Depend on currently available therapeutics | The therapeutic must be commonly available on national formularies, often included on the WHO Essential Medications List.37 Example: Tissue plasminogen activator would not be readily available in most African settings for treatment of acute stroke. |
Are feasible to collect | Most charting systems in LMICs are paper-based and documentation varies significantly. |
Are applicable to the current reality of emergency care delivery in Africa | While there is need for ongoing development of emergency care, the proposed quality indicators must address the current status of care delivery. |
LMICs, low-income and middle-income countries.