Quality indicators development and prioritisation for emergency medical call centres: a stakeholder consensus

Abstract

IntroductionEmergency medical regulation is a risky activity. In France, emergency medical societies have proposed activity and performance indicators, but their lists are non-exhaustive, unstructured and used heterogeneously among emergency medical call centres (Centres de Réception et de Régulation des Appels, CRRA). Our objective was to build by means of regional stakeholder consensus an operational quality dashboard for CRRAs.MethodsWe conducted an observational step in a French CRRA from June to September 2018 and at the same time listed existing activity and quality indicators through a rapid international literature review. We adapted and classified all indicators identified in a structured table. We prioritised them from April to September 2019 by seeking consensus with one regulator physician and one medical regulation assistant from the 13 CRRAs of the largest French region. We used an adapted Delphi method with a prioritisation scale from 1 to 9.ResultsThe rapid review of literature included 33 studies among the 414 identified and, with the first observational step, resulted in a list of 360 quality indicators covering the following areas: material resources, human resources, quality approach, call handling and postcall support. 15 of the 26 members participated in the entire process. Seventy indicators were considered as priorities with strong agreement among participants. We built an operational dashboard of quality indicators deemed high priority and provided 70 descriptive indicator sheets.ConclusionOur study allowed to build an operational quality dashboard for CRRAs as a ready-to-use support for an internal audit, for prioritisation of quality approach actions and for national and international benchmarking.

Telephone Referral to a Paediatric Emergency Department: Why Do Parents Not Show Up?

“…In Europe, the organisation of CCs varies strongly from country to country from publicly funded and organized regional centres to in-house hospital or clinic-based CC triage, through privately run CCs most often affiliated to healthcare insurances and/or providers. For example, in France and Spain, telephone triage is a public remit, organized at a regional or departmental level and considered as a medical act [13,14]. In Denmark and the Netherlands, calls centres are integrated to out-of-hours medical services, from which a physician will answer the phone call, and either provide a consultation on the phone, ask the caller to come for a consultation at the out-of-hours centre or refer the caller to an emergency department.…”

Photography tele-transmission by regular ambulance staff for the management of mild traumatic injury: the NiCEPHORE randomised-controlled trial

“…In a context of increasing use of EMCCs and EDs in Europe [ 5 – 7 ], any information that facilitates the decision of EMCC physicians is crucial [ 2 – 4 , 8 ]. Irrelevant referral of patients with mild traumatic injuries (MTI) to the ED unnecessarily increases their already heavy workload and generates extra costs to the healthcare system [ 9 – 12 ].…”