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

Figures & data

Table 1. Demographic characteristics of study participants.

Category	Frequency (n)	Percentage (%)	Category	Frequency (n)	Percentage (%)
Gender
Female	2	20	Male	8	80
Race
Black	4	40	White	4	40
Indian	1	10	Coloured	1	10
Age
30–39	1	10	40–49
50–59	6	60	60–69	1	10
70–79	1	10
Undergraduate qualifications
Bachelor of Medicine and Surgery	6	60	Bachelor of Nursing	1	10
Bachelor of Dentistry	1	10
Post graduate Qualification
Postgraduate Certificates/Diplomas	10	100	Master’s Degree	6	60
Doctoral Degree	2	20
Number of years working in current field
5–10 years	1	10	11–20 years	5	50
21–30 years	2	20	Currently retired	2	20

Table 2. Experts’ level of consensus on recommendations to strengthen emergency care.

Final Recommendations		Consensus (%)
Education & Training	Basic emergency skills training is required for all health care practitioners working at District Health Disagree Care facilities.	100
	Emergency skills training should be context specific and appropriate for the scope and capacity of the health care practitioner.	100
Role Definition	A strategy for placement of specialised emergency care practitioners needs to be developed to include the District Health Care System as a setting for their practice.	88
	The role and definition of Emergency Care as an overarching system of care, and the role and definition of Emergency Medical Services and Emergency Medicine should be clarified.	100
Leadership in Emergency Care	A position of leadership for emergency care at a national health level is required to ensure that emergency care becomes a priority for the National Health Care System.	100
	One office for emergency care should be established which covers the spectrum of emergency care including emergency medical services to ensure an integrated approach to emergency care	100
	Leadership at a district level to champion the cause of emergency care and provide support for the implementation of policies is recommended, and therefore dedicated posts for emergency specialist practitioners should be created within the District Health System.	100
A national plan for Emergency Care	Policy requirements and standards should acknowledge variations in context between facilities and provide appropriate direction for these different levels of care.	100
	A multi-level emergency network or system that coordinates emergency care at all levels is needed.	88
	A clear referral process, appropriate for various contexts should be developed at the level of each district involving stakeholders from all facilities and coordinated by the emergency care office.	100
	A consolidation of emergency care centres should be conducted to identify facilities within the District Health Care System that have greater capacity to manage complicated emergencies, while lower level facilities are empowered to stabilise and refer.	100
	A National Emergency Care strategy must be developed in order to form a strong emergency system that integrates functionally with the District Health Care System.	100
	The content of a national emergency care strategy should emphasise the processes and quality of the service and not only the physical requirements, with a specific focus on the health outcomes of emergency care including mortality and morbidity.	100
	The development of a system for data capturing regarding emergency services is needed to provide feedback on the efficiency and effectiveness of the service, this includes the development of a diagnostic coding system.	100