Developing a quality assurance system for emergency medical care service delivery in Namibia.

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Namibia University of Science and Technology


Prehospital emergency care is an ever-evolving profession that requires constant review and improvement of services delivered. The evaluation of quality service delivery in the Namibian EMS setting has never been studied before. With the current changes in the international medical sphere, the measurement of quality delivery has become ever more so pertinent in the prehospital field. The aim of the study was to develop a quality assurance system for Namibian EMS service delivery. A comparative analysis was conducted on international quality assurance systems to identify quality indicators for the Namibian EMS industry. Furthermore, a three iteration Delphi study was conducted to get consensus from a group of experts on the proposed quality indicators. Finally, the investigator conducted a pilot study, following a cross-sectional quantitative design to evaluate the quality indicators to the current emergency services operation at two emergency services within Windhoek. The comparative analysis yielded n=67 quality indicators used by first world countries. The non-clinical domain (n=39) consisted of n=18 structure, n=18 process and n=0 outcome indicators; the clinical domain (n=28) consisted of n=0 structure, n=26 process, and n=2 outcome indicators. Experts reached consensus on n=42 quality indicators following the three iteration Delphi study (iteration 1: n=13, iteration 2: n=12, iteration 3: n=17). In the pilot study, company X had 50% (n=21) compliance on indicators, n=8 non-clinical, and n=13 clinical indicators. Variation was 50% (n=21), n=12 non-clinical, n=9 clinical indicators. Company Y had 36% (n=15) compliance on indicators, n=5 non-clinical, n=10 clinical. Variation was 64% (n=27), n=15 non-clinical, and n=12 clinical respectively. The study assisted in the extrapolation of quality indicators for the Namibian EMS service delivery quality assurance system. The pilot study has shown some compliance with the proposed quality indicators however, requires further evidence-based investigation to improve patient outcomes.



Emergency medical care, Emergency Medical Services, Emergency Care Practitioner


Diergaardt, B. (2020). Developing a quality assurance system for emergency medical care service delivery in Namibia [Unpublished masters thesis]. Namibia University of Science and Technology.