Clinical emergency care quality indicators in Africa: a scoping review and data summary

Objectives Emergency care services are rapidly expanding in Africa; however, development must focus on quality. The African Federation of Emergency Medicine consensus conference (AFEM-CC)-based quality indicators were published in 2018. This study sought to increase knowledge of quality through iden...

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Main Authors: Corey B Bills, Brian Rice, Ashley E Pickering, Petrus Malherbe, Joan Nambuba, Emilie Calvello Hynes
Format: Article
Language:English
Published: BMJ Publishing Group 2023-05-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/5/e069494.full
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author Corey B Bills
Brian Rice
Ashley E Pickering
Petrus Malherbe
Joan Nambuba
Emilie Calvello Hynes
author_facet Corey B Bills
Brian Rice
Ashley E Pickering
Petrus Malherbe
Joan Nambuba
Emilie Calvello Hynes
author_sort Corey B Bills
collection DOAJ
description Objectives Emergency care services are rapidly expanding in Africa; however, development must focus on quality. The African Federation of Emergency Medicine consensus conference (AFEM-CC)-based quality indicators were published in 2018. This study sought to increase knowledge of quality through identifying all publications from Africa containing data relevant to the AFEM-CC process clinical and outcome quality indicators.Design We conducted searches for general quality of emergency care in Africa and for each of 28 AFEM-CC process clinical and five outcome clinical quality indicators individually in the medical and grey literature.Data sources PubMed (1964—2 January 2022), Embase (1947—2 January 2022) and CINAHL (1982—3 January 2022) and various forms of grey literature were queried.Eligibility criteria Studies published in English, addressing the African emergency care population as a whole or large subsegment of this population (eg, trauma, paediatrics), and matching AFEM-CC process quality indicator parameters exactly were included. Studies with similar, but not exact match, data were collected separately as ‘AFEM-CC quality indicators near match’.Data extraction and synthesis Document screening was done in duplicate by two authors, using Covidence, and conflicts were adjudicated by a third. Simple descriptive statistics were calculated.Results One thousand three hundred and fourteen documents were reviewed, 314 in full text. 41 studies met a priori criteria and were included, yielding 59 unique quality indicator data points. Documentation and assessment quality indicators accounted for 64% of data points identified, clinical care for 25% and outcomes for 10%. An additional 53 ‘AFEM-CC quality indicators near match’ publications were identified (38 new publications and 15 previously identified studies that contained additional ‘near match’ data), yielding 87 data points.Conclusions Data relevant to African emergency care facility-based quality indicators are highly limited. Future publications on emergency care in Africa should be aware of, and conform with, AFEM-CC quality indicators to strengthen understanding of quality.
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spelling doaj.art-28c697f24d464797a8bf7c6e62edba982024-06-21T04:45:16ZengBMJ Publishing GroupBMJ Open2044-60552023-05-0113510.1136/bmjopen-2022-069494Clinical emergency care quality indicators in Africa: a scoping review and data summaryCorey B Bills0Brian Rice1Ashley E Pickering2Petrus Malherbe3Joan Nambuba4Emilie Calvello Hynes5Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA2 Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UKEmergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USAEmergency Medicine, Ochsner Medical Center, New Orleans, Louisiana, USAEmergency Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USAEmergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USAObjectives Emergency care services are rapidly expanding in Africa; however, development must focus on quality. The African Federation of Emergency Medicine consensus conference (AFEM-CC)-based quality indicators were published in 2018. This study sought to increase knowledge of quality through identifying all publications from Africa containing data relevant to the AFEM-CC process clinical and outcome quality indicators.Design We conducted searches for general quality of emergency care in Africa and for each of 28 AFEM-CC process clinical and five outcome clinical quality indicators individually in the medical and grey literature.Data sources PubMed (1964—2 January 2022), Embase (1947—2 January 2022) and CINAHL (1982—3 January 2022) and various forms of grey literature were queried.Eligibility criteria Studies published in English, addressing the African emergency care population as a whole or large subsegment of this population (eg, trauma, paediatrics), and matching AFEM-CC process quality indicator parameters exactly were included. Studies with similar, but not exact match, data were collected separately as ‘AFEM-CC quality indicators near match’.Data extraction and synthesis Document screening was done in duplicate by two authors, using Covidence, and conflicts were adjudicated by a third. Simple descriptive statistics were calculated.Results One thousand three hundred and fourteen documents were reviewed, 314 in full text. 41 studies met a priori criteria and were included, yielding 59 unique quality indicator data points. Documentation and assessment quality indicators accounted for 64% of data points identified, clinical care for 25% and outcomes for 10%. An additional 53 ‘AFEM-CC quality indicators near match’ publications were identified (38 new publications and 15 previously identified studies that contained additional ‘near match’ data), yielding 87 data points.Conclusions Data relevant to African emergency care facility-based quality indicators are highly limited. Future publications on emergency care in Africa should be aware of, and conform with, AFEM-CC quality indicators to strengthen understanding of quality.https://bmjopen.bmj.com/content/13/5/e069494.full
spellingShingle Corey B Bills
Brian Rice
Ashley E Pickering
Petrus Malherbe
Joan Nambuba
Emilie Calvello Hynes
Clinical emergency care quality indicators in Africa: a scoping review and data summary
BMJ Open
title Clinical emergency care quality indicators in Africa: a scoping review and data summary
title_full Clinical emergency care quality indicators in Africa: a scoping review and data summary
title_fullStr Clinical emergency care quality indicators in Africa: a scoping review and data summary
title_full_unstemmed Clinical emergency care quality indicators in Africa: a scoping review and data summary
title_short Clinical emergency care quality indicators in Africa: a scoping review and data summary
title_sort clinical emergency care quality indicators in africa a scoping review and data summary
url https://bmjopen.bmj.com/content/13/5/e069494.full
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