Consensus-based recommendations for strengthening emergency care at primary health care level: a Delphi study

Abstract

Background Emergency care at a primary health care (PHC) level must be strengthened to reduce overall mortality and morbidity in any country. Developing recommendations for improvement in this area should take into consideration the context and nuances of the current emergency care system and primary health care context. Contribution to policy from the experts in the cross-cutting fields of PHC and emergency care is lacking. Objectives This study aims to evaluate the strengths and weaknesses of emergency care in primary health settings and develop consensus-based recommendations for the strengthening of emergency care at this level. Methods Using a modified Delphi technique, data were collected from various data sources to evaluate the strengths and weaknesses of emergency care at PHC level, from which recommendation statements were developed. These recommendations were proposed to a panel of experts using a Delphi survey to build consensus on 14 recommendations to strengthen emergency care at PHC level. Results Ten experts were recruited to participate (n = 10) with a response rate of 90% in round II and 80% in round III of Delphi. Recommendations broadly addressed the areas of education and training in emergency care, the role and placement of various actors, leadership in emergency care and the development of a national plan for emergency care. Consensus was reached in round II for 97.61% of the statements and after modification based on open-ended comments, 98.21% consensus was reached in round III. Conclusion Strengthening emergency care at primary and subsequent levels of health care requires a coordinated effort and mandate from authority in order to effect real change.

Barriers faced by primary healthcare providers in addressing emergency situations in the Northern region of Palestine before and during the Gaza war

“…The integration of e cient emergency care management into primary care helps to lessen the burden on hospital emergency rooms (2,6,7,8). It also lowers mortality and disability and can impact the entire health system (9,10). Preparedness involves equipped facilities, appropriate supplies and medications, and routine health care personnel training.…”

Barriers Impact the Primary Healthcare Providers When Dealing With Emergency Cases: A Cross-Sectional Study in Al-Ahsa, Saudi Arabia

“…However, many studies called for better enhancing emergency case management at the PHC levels, thus decreasing the load on the emergency department and helping in stabilization and early initiation of diagnosis and management of emergency cases. It is also recommended that more integration between PHC and emergency departments should be planned [ 4 , 7 , 25 , 26 ].…”

Expert consensus guidelines: Intravenous iron uses, formulations, administration, and management of reactions

“…The Delphi method is a structured process used to produce a wellgrounded consensus by a group of experts using an iterative process of survey rounds with controlled feedback. 4 After an initial videoconference meeting to discuss and confirm the outline of this guidance paper, the group conducted a comprehensive literature search to develop a draft for each section. The primary author compiled the drafted sections noting the aspects where there was a lack of evidence or divergence from FDA labeling, necessitating expert consensus.…”