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Published in: International Journal of Emergency Medicine 4/2010

Open Access 01-12-2010 | Original Research Article

Identification of performance indicators for emergency centres in South Africa: results of a Delphi study

Authors: David Maritz, Peter Hodkinson, Lee Wallis

Published in: International Journal of Emergency Medicine | Issue 4/2010

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Abstract

Background

Emergency medicine is a rapidly developing field in South Africa (SA) and other developing nations. There is a need to develop performance indicators that are relevant and easy to measure. This will allow identification of areas for improvement, create standards of care and allow inter-institutional comparisons to be made. There is evidence from the international literature that performance measures do lead to performance improvements.

Aims

To develop a broad-based consensus document detailing quality measures for use in SA Emergency Centres (ECs).

Methods

A three-round modified Delphi study was conducted over e-mail. A panel of experts representing the emergency medicine field in SA was formed. Participants were asked to provide potential performance indicators for use in SA, under subheaders of the various disciplines that are seen in emergency patients. These statements were collated and sent out to the panel for scoring on a 9-point Lickert scale. Statements that did not reach a predefined consensus were sent back to the panellist for reconsideration.

Results

Consensus was reached on 99 out of 153 (65%) of the performance indicators proposed. These were further refined, and a synopsis of the statements is presented, classified as to whether the statements were thought to be feasible or not in the current circumstances.

Conclusions

A synopsis of the useful and feasible performance indicators is presented. The majority are structural and performance-based indicators appropriate to the development of the field in SA. Further refinement and research is needed to implement these indicators.
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Literature
1.
go back to reference Ncayiyana DJ (2008) National health insurance on the horizon for South Africa. SAMJ 98:4 Ncayiyana DJ (2008) National health insurance on the horizon for South Africa. SAMJ 98:4
2.
go back to reference Tregunno D, Baker GR, Barnsley J et al (2004) Competing values of emergency department performance: balancing multiple stakeholder perspectives. Health Serv Res 39(4):771–792PubMedPubMedCentralCrossRef Tregunno D, Baker GR, Barnsley J et al (2004) Competing values of emergency department performance: balancing multiple stakeholder perspectives. Health Serv Res 39(4):771–792PubMedPubMedCentralCrossRef
3.
4.
go back to reference Lindsay P, Schull M, Bronskill S et al (2002) The development of indicators to measure the quality of clinical care in emergency departments following a modified-Delphi approach. Acad Emerg Med 9:1131–1139PubMedCrossRef Lindsay P, Schull M, Bronskill S et al (2002) The development of indicators to measure the quality of clinical care in emergency departments following a modified-Delphi approach. Acad Emerg Med 9:1131–1139PubMedCrossRef
7.
go back to reference Ospina MB, Bond K, Schull M et al (2007) Key indicators of overcrowding in Canadian emergency departments: a Delphi study. Can J Emerg Med 9:339–346 Ospina MB, Bond K, Schull M et al (2007) Key indicators of overcrowding in Canadian emergency departments: a Delphi study. Can J Emerg Med 9:339–346
8.
go back to reference Hung G, Chalut D (2008) A consensus-established set of important indicators of pediatric emergency department performance. Ped Emerg Care 24:9–15 Hung G, Chalut D (2008) A consensus-established set of important indicators of pediatric emergency department performance. Ped Emerg Care 24:9–15
9.
go back to reference Thangaratinam S, Redman CWE (2005) The Delphi technique. Obstet Gynaecol 7:120–125CrossRef Thangaratinam S, Redman CWE (2005) The Delphi technique. Obstet Gynaecol 7:120–125CrossRef
10.
go back to reference Likert A (1932) A technique for the measurement of attitudes. Arch Psychol (Frankf) 22:55 Likert A (1932) A technique for the measurement of attitudes. Arch Psychol (Frankf) 22:55
11.
go back to reference Graff L, Stevens C, Spaite D et al (2002) Measuring and improving quality in emergency medicine. Acad Emerg Med 9(11) Graff L, Stevens C, Spaite D et al (2002) Measuring and improving quality in emergency medicine. Acad Emerg Med 9(11)
12.
go back to reference Institute of medicine (2001) Crossing the quality chasm: a new health system for the 21st century. National academy press, Washington; DC Institute of medicine (2001) Crossing the quality chasm: a new health system for the 21st century. National academy press, Washington; DC
13.
go back to reference Initiative for sub-district support: technical report No 3. What really improves the quality of primary health care? A review of local and international experience. Health Systems Trust Initiative for sub-district support: technical report No 3. What really improves the quality of primary health care? A review of local and international experience. Health Systems Trust
14.
go back to reference Williams PL, Webb C (1994) The Delphi technique: a methodological discussion. J Adv Nurs 19:180–186PubMedCrossRef Williams PL, Webb C (1994) The Delphi technique: a methodological discussion. J Adv Nurs 19:180–186PubMedCrossRef
15.
go back to reference Hasson F, Keeney S, McKenna H (2000) Research guidelines for the Delphi survey technique. J Adv Nurs 32:1008–1015PubMed Hasson F, Keeney S, McKenna H (2000) Research guidelines for the Delphi survey technique. J Adv Nurs 32:1008–1015PubMed
16.
go back to reference Sheldon T (1998) Promoting health care quality: what role performance indicators? Qual Health Care 7(Suppl):S45–S50PubMed Sheldon T (1998) Promoting health care quality: what role performance indicators? Qual Health Care 7(Suppl):S45–S50PubMed
17.
go back to reference Kruk ME, Freedman LP (2008) Assessing health system performance in developing countries: a review of the literature. Health Policy 85:263–276PubMedCrossRef Kruk ME, Freedman LP (2008) Assessing health system performance in developing countries: a review of the literature. Health Policy 85:263–276PubMedCrossRef
18.
go back to reference Goddard M, Mannion R, Smith P. The NHS performance framework: taking account of economic behaviour. Centre for health economics, The university of York. Discussion paper 158 Goddard M, Mannion R, Smith P. The NHS performance framework: taking account of economic behaviour. Centre for health economics, The university of York. Discussion paper 158
20.
go back to reference Bruijns SR, Wallis LA, Burch VC (2008) A prospective evaluation of the Cape triage score in the emergency department of an urban public hospital in South Africa. Emerg Med J 25:398–402PubMedCrossRef Bruijns SR, Wallis LA, Burch VC (2008) A prospective evaluation of the Cape triage score in the emergency department of an urban public hospital in South Africa. Emerg Med J 25:398–402PubMedCrossRef
21.
go back to reference Bruijns SR, Wallis LA, Burch VC (2008) Effect of introduction of nurse triage on waiting times in a South African emergency department. Emerg Med J 25:395–397PubMedCrossRef Bruijns SR, Wallis LA, Burch VC (2008) Effect of introduction of nurse triage on waiting times in a South African emergency department. Emerg Med J 25:395–397PubMedCrossRef
22.
go back to reference Wallis LA, Gottschalk SB, Wood D et al (2006) The Cape triage score—a triage system for South Africa. SAMJ 96(1) Wallis LA, Gottschalk SB, Wood D et al (2006) The Cape triage score—a triage system for South Africa. SAMJ 96(1)
23.
go back to reference Gottschalk SB, Wood D, DeVries S et al (2006) The Cape triage score: a new triage system for South Africa. Proposal from the cape Triage group. Emerg Med J 28:149–153CrossRef Gottschalk SB, Wood D, DeVries S et al (2006) The Cape triage score: a new triage system for South Africa. Proposal from the cape Triage group. Emerg Med J 28:149–153CrossRef
24.
go back to reference Hodkinson PW, Wallis LA (2010) Emergency medicine in the developing world: a Delphi study. Acad Emerg Med 17(7) Hodkinson PW, Wallis LA (2010) Emergency medicine in the developing world: a Delphi study. Acad Emerg Med 17(7)
Metadata
Title
Identification of performance indicators for emergency centres in South Africa: results of a Delphi study
Authors
David Maritz
Peter Hodkinson
Lee Wallis
Publication date
01-12-2010
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Emergency Medicine / Issue 4/2010
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI
https://doi.org/10.1007/s12245-010-0240-6

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