Strategy to Improve Quality in Emergency Medical Services: from Assessment to Policy

  • Fimka Tozija Institute of Public Health, Skopje
  • Nikola Jankulovski Medical School, Skopje
Keywords: emergency medical treatment, national health policy, pre-hospital emergency health care

Abstract

The aim of this paper was to present the strategic approach applied for improvement of quality in emergency medical services (EMS) in theFormer Yugoslav Republic of Macedonia. This approach was accomplished through three stages: (I) assessment and recommendations for policies; (II) development of innovative evidence-based programmes; and (III) policy implementation. Strategic assessment ofEMSwas performed by applying WHO standard methodology. A survey was conducted in 2006/2007 on the national level in fifteen general hospitals, four university hospitals, and sixteen pre-hospitalEMS. The overall evaluation was based on a hospital emergency department (ED) questionnaire, information on the general characteristics of the pre-hospital dispatch centre, review of ED medical records, and the patient questionnaire. The key findings of the assessment showed thatEMSrequired extensive changes and improvements. Pre-hospitalEMSwas not well-developed and utilised. Hospital EDs were not organised as separate divisions ran by a head medical doctor. The diagnostic and treatment capacities were insufficient or outdated. Most of the surveyed hospitals were capable of providing essential diagnostic tests in 24 h or less. There was no follow-up of theEMSpatients or an appropriate link between the hospital EDs and primary health care facilities. The main findings of the assessment, recommendations, and proposals for action served as the basis for new policies and integrated intoMacedonia’s official strategy for emergency medical services 2009-2017.

Published
2013-12-15
How to Cite
1.
Tozija F, Jankulovski N. Strategy to Improve Quality in Emergency Medical Services: from Assessment to Policy. Arh Hig Rada Toksikol [Internet]. 2013Dec.15 [cited 2024Mar.29];64(4). Available from: https://arhiv.imi.hr/index.php/arhiv/article/view/102
Section
Professional paper