Development of a tool to define the population of emergency medical care users in South Africa

Abstract

Prehospital emergency medical service (EMS) data is essential for understanding the functioning of the services as well as the community's health. Being able to clearly and accurately define the patient population in terms of demographics and clinical condition may guide the EMS in resource management, clinical governance, research, education and political decisions. However, such data is limited in South Africa. This research, therefore, aimed to develop a data collection tool to determine the population of prehospital emergency medical care patients in South Africa. The objectives were: (i) determination of what data needed to be collected, (ii) development of a tool to collect the data, and (iii) testing the tool for ease and appropriateness of use and completeness of data collection in an authentic environment. A mixed-method, predominantly qualitative methodological design was used, with some elements of grounded theory. There were three phases corresponding to the objectives. The first two were qualitative and the third was both qualitative and quantitative. In the first phase expert consensus was sought, using a focus group discussion and Delphi study, to develop a minimum data set (MDS) to describe the patient population. The resultant MDS consisted of 18 data elements which could be categorised into demographics, time and location of EMS use, the clinical reasons for EMS use, and the actual use of the EMS. A tool and associated user instructions, based on the findings of Phase One, were developed and refined during Phase Two. Phase Three was used for testing the tool in an authentic environment. The tool was found to be acceptable and user-friendly. Further testing of the tool for accuracy and reliability is recommended.