We are the Emergency Care providers, whether doctor or nurse or the paramedics. We are expected to treatment patients based upon scientific knowledge and deal with them in professional manner. Patient safety and quality care should be kept in focus all the time. All patients require timely intervention, yet there are some who need prompt care earlier than other patients. This is done through the process of triage. Triage is very important and ensure quality care when done appropriately.
Stable patients need to wait if the ED is busy with patients, and stable patients are requested to wait till the doctors are ready to see them. If this is not done appropriately then there is potential for harm to sick patients by letting them wait to be seen. Periodically the triage process needed to be reviewed to make sure the person doing the triage is not under triaging or over triaging. When patients are assigned higher triage category than their level of sickness, it is called over triaging. And similarly when patients are assigned a triage category lower than they actually are clinically, it is called under triaging.
In order to achieve better quality, it is important to understand that if we want to improve anything, we should be able to measure it to see where and how and how much improvement is needed. So we need evaluate the system of care, monitor the process, make some changes and then evaluate it again. This process of knowing where we stand, and then make changes and re-evaluate should continue all the time. The key components of the quality assurance are following:
- Clinical guidelines and protocols.
- Performance indicators.
- Data collection and analysis.
- Patient safety initiative, and staff teaching.
- Patient’s experience and feedback.
- Interdisciplinary collaboration.
- Regulatory compliance.
- Continuous quality improvement.
Strategies which can help achieve the quality care are following:
- Leadership commitment.
- Quality initiative and quality committee.
- Technology and innovation.
- Patient-centered care.
- Feedback.
Each aspect of the strategy is equally important and needed for the improvement. We should realize that the idea of improvement has to start from the top, and if the top leadership is not on the same page and with the right understanding of the quality improvement or the process of it, then it may become a futile exercise and can result in more harm to the institution through sub-standard care. When leadership is backing the quality then forming a committee makes sure that the process is in place and it is moving in right direction. Help from technology makes it much easier and scalable to not just initiate it, but also to help keep it going. This all should be done to provide better care to the patient: our prime objective. And the way we know is through feedback. Feedback from all stakeholders and most important of them are the patients. It is also very important to know outcome of our care in terms of clinical outcome, as well as non-clinical features of the quality, like financial outcome, staff involvement and burnout and management quality.
Quality assurance in the emergency department is a multifaceted process that requires a comprehensive approach to ensure high standards of clinical care. By focusing on clinical guidelines, performance metrics, patient safety, staff training, and continuous improvement, EDs can enhance patient outcomes, safety, and satisfaction. Effective QA programs are essential for maintaining trust, reliability, and excellence in emergency healthcare services.