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The level of evidence for emergency department performance indicators: systematic review
Silkeborg Hospital and University of Copenhagen, Denmark.
Ashburton Hospital, Canterbury DHB, New Zealand; University of Turku, Finland.
Department of Emergency Medicine and Services, Helsinki University Hospital and Helsinki University, Finland.
Department of Clinical Science and Education, Karolinska Institutet; Department of Emergency Medicine, Södersjukhuset, Stockholm, Sweden.
2015 (English)In: European journal of emergency medicine, ISSN 0969-9546, E-ISSN 1473-5695, Vol. 22, no 5, 298-305 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to perform a comprehensive systematic review of emergency department performance indicators in relation to evidence. A systematic search was performed through PUBMED, EMBASE, CINAHL and COCHRANE databases with (and including synonyms of) the search words: [emergency medicine OR emergency department] AND [quality indicator(s) OR performance indicator(s) OR performance measure(s)]. Articles were included according to the inclusion/exclusion criteria using the PRISMA protocol. The level of evidence was rated according to the evidence levels by the Oxford Centre for Evidence-Based Medicine. Performance indicators were extracted and organized into five categories; outcome, process, satisfaction, equity and structural/organizational measures. Six thousand four hundred and forty articles were initially identified; 127 provided evidence for/against a minimum of one performance indicator: these were included for further study. Of the 127 articles included, 113 (92%) were primary research studies and only nine (8%) were systematic reviews. Within the 127 articles, we found evidence for 202 individual indicators. Approximately half (n=104) of all this evidence (n=202) studied process-type indicators. Only seven articles (6%) qualified for high quality (level 1b). Sixty-six articles (51%) were good retrospective quality (level 2b or better), whereas the remaining articles were either intermediate quality (25% level 3a or 3b) or poor quality (17% level 4 or 5). We found limited evidence for most emergency department performance indicators, with the majority presenting a low level of evidence. Thus, a core group of evidence-based performance indicators cannot currently be recommended on the basis of this broad review of the literature.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2015. Vol. 22, no 5, 298-305 p.
Keyword [en]
emergency department; emergency medicine; performance indicators; performance measures; quality indicators; quality measures; systematic review
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:oru:diva-59261DOI: 10.1097/MEJ.0000000000000279ISI: 000360659300002PubMedID: 25969341Scopus ID: 2-s2.0-84941000060OAI: oai:DiVA.org:oru-59261DiVA: diva2:1135435
Available from: 2017-08-23 Created: 2017-08-23 Last updated: 2017-08-31Bibliographically approved

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