Indicators for Acute Care in Low and middle income countries Toolkit (IFACT)

The use of indicators to measure the quality and availability of emergency medical care is a key component indesigning and implementing improvements in emergency care systems. While high-income countries have already begun to implement and refine the use of quality indicators for emergency medicine, these indicators are not necessarily appropriate for use in low- and middle-income countries (LMICs) because of differences in the burden of disease, level of healthcare worker training, resources and range of interventions available, and the availability of reliable data sources.

Based on experience working on emergency medicine development and capacity-building in LMICs, sidHARTe has developed a list of performance indicators for emergency medicine—  appropriate for low-and-middle income countries at the district hospital level and higher. Indicators have been chosen to assess the quality and availability of emergency medical care at multiple levels, ranging from patient-level clinical care, to department- or hospital-level system preparedness and effectiveness, to national-level policies supporting emergency care. Clinical indicators are designed to be measurable even at hospitals relying on basic paper-based medical charting, and the indicator list was created with attention paid to balancing between structure, process, and outcome indicators. Population based indicators are collected infrequently to look at the effectiveness of the emergency care system using impact indicators that measure mortality.