Article type
Abstract
Introduction : The development of care and management protocols is a part of an overall quality approach in the healthcare system. Their implementation is a very important factor that can modify our usual practices. However, it is often difficult for healthcare professionals to support changes in their daily practices.
Objectives : Set-up a strategy for implementation of emergency protocols established by l’Instance Nationale pour l’Evaluation et l’Accréditation en Santé (INEAS) in 2023.
Materiel and Methods : A Tunisian emergency protocol was elaborated in 2023 with the collaboration of several scientific societies. Various items were treated in this document from patient registration in emergency department, triage, management, coordination between healthcare professionals in various department, until home return.
Discussion between various members of the working group about how to improve these protocols in our daily practice concluded that the best method for implementation will be to :
üSelect two or at least three emergency departments as pilot sites
üCommunication and triage : were choosed as items to be implemented.
A methodological approach based on multiple steps was adopted :
-Planify the implementation,
-Identify the gap between knowledge and practice,
-Adapt knowledge to context,
-Identify influencing factors,
-Select, adapt and implement strategies
-Monitor and evaluate knowledge use
-Promote sustainability.
Results : Many meetings were organised with different components of the project (INEAS, health professionnel from differents emergency departments, ministery of health) to discuss about different problems incountered, proposed solutions and the state of progress of the project.
Six months later an initial assessment was done we noted regression of :
•indesirable events linked to communication
•regression of results delivery time for investigations (laboratory and radiology),
•regression of violence between healthcare professionals and patients
•better coordination between emergency and other referral depatments
Conclusion : implementation of health strategies requires a rigourous methodology and the collaboration of several partners implicated in particulary the ministery of health.
Objectives : Set-up a strategy for implementation of emergency protocols established by l’Instance Nationale pour l’Evaluation et l’Accréditation en Santé (INEAS) in 2023.
Materiel and Methods : A Tunisian emergency protocol was elaborated in 2023 with the collaboration of several scientific societies. Various items were treated in this document from patient registration in emergency department, triage, management, coordination between healthcare professionals in various department, until home return.
Discussion between various members of the working group about how to improve these protocols in our daily practice concluded that the best method for implementation will be to :
üSelect two or at least three emergency departments as pilot sites
üCommunication and triage : were choosed as items to be implemented.
A methodological approach based on multiple steps was adopted :
-Planify the implementation,
-Identify the gap between knowledge and practice,
-Adapt knowledge to context,
-Identify influencing factors,
-Select, adapt and implement strategies
-Monitor and evaluate knowledge use
-Promote sustainability.
Results : Many meetings were organised with different components of the project (INEAS, health professionnel from differents emergency departments, ministery of health) to discuss about different problems incountered, proposed solutions and the state of progress of the project.
Six months later an initial assessment was done we noted regression of :
•indesirable events linked to communication
•regression of results delivery time for investigations (laboratory and radiology),
•regression of violence between healthcare professionals and patients
•better coordination between emergency and other referral depatments
Conclusion : implementation of health strategies requires a rigourous methodology and the collaboration of several partners implicated in particulary the ministery of health.