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Evaluating emergency care capacity in Africa: an iterative, multicountry refinement of the Emergency Care Assessment Tool

Healthcare facilities in low-income and middle-income countries lack an objective measurement tool to assess emergency care capacity. The African Federation for Emergency Medicine developed the Emergency Care Assessment Tool (ECAT) to fulfil this function. The ECAT assesses the provision of key medi...

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Autores principales: Bae, Crystal, Pigoga, Jennifer L, Cox, Megan, Hollong, Bonaventure, Kalanzi, Joseph, Abbas, Gamal, Wallis, Lee A, Calvello Hynes, Emilie J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195145/
https://www.ncbi.nlm.nih.gov/pubmed/30364370
http://dx.doi.org/10.1136/bmjgh-2018-001138
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author Bae, Crystal
Pigoga, Jennifer L
Cox, Megan
Hollong, Bonaventure
Kalanzi, Joseph
Abbas, Gamal
Wallis, Lee A
Calvello Hynes, Emilie J
author_facet Bae, Crystal
Pigoga, Jennifer L
Cox, Megan
Hollong, Bonaventure
Kalanzi, Joseph
Abbas, Gamal
Wallis, Lee A
Calvello Hynes, Emilie J
author_sort Bae, Crystal
collection PubMed
description Healthcare facilities in low-income and middle-income countries lack an objective measurement tool to assess emergency care capacity. The African Federation for Emergency Medicine developed the Emergency Care Assessment Tool (ECAT) to fulfil this function. The ECAT assesses the provision of key medical interventions (signal functions) that emergency units (EUs) should be able to perform to adequately treat six common, life-threatening conditions (sentinel conditions). We describe the piloting and refinement of the ECAT, to improve usability and context-appropriateness. We undertook iterative, multisite refinement of the ECAT. After pilot testing at a South African referral hospital, subsequent studies occurred at district, regional and central facilities across four countries representing the major regions of Africa: Cameroon, Uganda, Egypt and Botswana. At each site, the tool was administered to three participants: one senior physician, one senior nurse and one other clinical provider. Feedback informed refinements of the ECAT, and an updated tool was used in the next-studied country. Iteratively implementing refined versions of the tool in various contexts across Africa resulted in a final ECAT that uses signal functions, categorised by sentinel conditions and evaluated against discrete barriers to emergency care service delivery, to assess EUs. It also allowed for refinement of administration and data analysis processes. The ECAT has a total of 71 items. Advanced facilities are expected to perform all 71 signal functions, while intermediate facilities should be able to perform 53. The ECAT is the first tool to provide a standardised method for assessing facility-based emergency care in the African context. It identifies where in the maturation process a hospital or system is and what gaps exist in delivery of care, so that a comprehensive roadmap for development can be established. Although validity and feasibility testing have now occurred, reliability studies must be conducted prior to amplification across the region.
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spelling pubmed-61951452018-10-24 Evaluating emergency care capacity in Africa: an iterative, multicountry refinement of the Emergency Care Assessment Tool Bae, Crystal Pigoga, Jennifer L Cox, Megan Hollong, Bonaventure Kalanzi, Joseph Abbas, Gamal Wallis, Lee A Calvello Hynes, Emilie J BMJ Glob Health Practice Healthcare facilities in low-income and middle-income countries lack an objective measurement tool to assess emergency care capacity. The African Federation for Emergency Medicine developed the Emergency Care Assessment Tool (ECAT) to fulfil this function. The ECAT assesses the provision of key medical interventions (signal functions) that emergency units (EUs) should be able to perform to adequately treat six common, life-threatening conditions (sentinel conditions). We describe the piloting and refinement of the ECAT, to improve usability and context-appropriateness. We undertook iterative, multisite refinement of the ECAT. After pilot testing at a South African referral hospital, subsequent studies occurred at district, regional and central facilities across four countries representing the major regions of Africa: Cameroon, Uganda, Egypt and Botswana. At each site, the tool was administered to three participants: one senior physician, one senior nurse and one other clinical provider. Feedback informed refinements of the ECAT, and an updated tool was used in the next-studied country. Iteratively implementing refined versions of the tool in various contexts across Africa resulted in a final ECAT that uses signal functions, categorised by sentinel conditions and evaluated against discrete barriers to emergency care service delivery, to assess EUs. It also allowed for refinement of administration and data analysis processes. The ECAT has a total of 71 items. Advanced facilities are expected to perform all 71 signal functions, while intermediate facilities should be able to perform 53. The ECAT is the first tool to provide a standardised method for assessing facility-based emergency care in the African context. It identifies where in the maturation process a hospital or system is and what gaps exist in delivery of care, so that a comprehensive roadmap for development can be established. Although validity and feasibility testing have now occurred, reliability studies must be conducted prior to amplification across the region. BMJ Publishing Group 2018-10-15 /pmc/articles/PMC6195145/ /pubmed/30364370 http://dx.doi.org/10.1136/bmjgh-2018-001138 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Practice
Bae, Crystal
Pigoga, Jennifer L
Cox, Megan
Hollong, Bonaventure
Kalanzi, Joseph
Abbas, Gamal
Wallis, Lee A
Calvello Hynes, Emilie J
Evaluating emergency care capacity in Africa: an iterative, multicountry refinement of the Emergency Care Assessment Tool
title Evaluating emergency care capacity in Africa: an iterative, multicountry refinement of the Emergency Care Assessment Tool
title_full Evaluating emergency care capacity in Africa: an iterative, multicountry refinement of the Emergency Care Assessment Tool
title_fullStr Evaluating emergency care capacity in Africa: an iterative, multicountry refinement of the Emergency Care Assessment Tool
title_full_unstemmed Evaluating emergency care capacity in Africa: an iterative, multicountry refinement of the Emergency Care Assessment Tool
title_short Evaluating emergency care capacity in Africa: an iterative, multicountry refinement of the Emergency Care Assessment Tool
title_sort evaluating emergency care capacity in africa: an iterative, multicountry refinement of the emergency care assessment tool
topic Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195145/
https://www.ncbi.nlm.nih.gov/pubmed/30364370
http://dx.doi.org/10.1136/bmjgh-2018-001138
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