Abstract
Background: An emergency medical service can be described as an all-inclusive system that uses equipment and personnel to provide timely and effective health care to sick or injured individuals. Emergency medical services (EMS) are still considered relatively new in South Africa, but this branch of healthcare has undergone rapid development. South African EMS has developed somewhat uniquely, which has led to some novel challenges. One of these challenges is a lack of evidence-based literature relevant to EMS in South Africa, with most of the current standards and practices derived from research originating from high-income countries or the in-hospital environment. As such, assessing different EMS organisations’ quality and performance in South Africa using relevant research, has been practically impossible.
Considering the above, there is a need for local research that can be used to develop relevant, consistent standards for South African EMS. As a starting point, focus needs to be placed on developing standardised, relevant terminology and a common understanding of the capabilities of organisations providing out-of-hospital emergency medical care in South Africa. A logical way to do this is to describe the capabilities of EMS organisations at different levels of development in South Africa using a benchmarking tool. If one starts by creating a tool that describes the capabilities of EMS organisations of different maturities, this will allow for standard and consistent terminology on the operations of EMS organisations in South Africa. This is the first step in self-assessment and self-improvement, and a necessary starting point to eventually meaningfully assessing and improving the quality of EMS organisations in South Africa.
Methods: This was a prospective, quantitative study that made use of the Delphi technique. The study took place in South Africa, and the participants were individuals deemed experts in the field of emergency medical care. Data were collected by reviewing literature and using Delphi surveys to achieve consensus on 1) the components of an EMS organisation, and 2) level descriptors for each of these components. The data collection process was broken down into three separate phases, and data analysis was performed continuously and simultaneously with the data collection due to the nature of the Delphi technique.
The resulting data were quantitative in nature and therefore analysed statistically and presented in the form of tables and statistical summaries.
Results: The three phases of data collection and analysis resulted in consensus on 12 core components of an EMS organisation. Additionally, consensus was achieved on the level descriptors that described what each component would look like in an underdeveloped, developing or well-developed organisation. The study’s results were used to produce the final consensus-based capability benchmarking tool for EMS in South Africa.
Conclusion: The study produced a consensus-based capability benchmarking tool for EMS in South Africa. This tool can be used by EMS organisations for self-evaluation and improvement, and by businesses or individuals requiring these services to ensure the EMS organisation they select is capable of meeting their requirements. Additionally, the tool provides standardised terminology relevant to South African EMS. Further research into improving and validating this tool is recommended. Additionally, it is recommended that benchmarking, quality and performance within EMS in South Africa are also researched further.