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Developing contextual quality standards for emergency departments in Palestine
Background: Emergency departments (EDs) are crucial for delivering timely, life-saving care, particularly in low-resource and conflict-affected areas like Palestine. Palestinian hospitals face significant pressure in their EDs due to a heavy workload from routine injuries and those resulting from on...
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| Format: | Thesis |
| Language: | English English |
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Division of Emergency Medicine
2026
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| _version_ | 1867614163292913664 |
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| access_status_str | Open Access |
| author | Bani Odeh, Abed Alra'oof |
| author2 | Stassen, Willem |
| author_browse | Bani Odeh, Abed Alra'oof Stassen, Willem |
| author_facet | Stassen, Willem Bani Odeh, Abed Alra'oof |
| author_sort | Bani Odeh, Abed Alra'oof |
| collection | Thesis |
| description | Background: Emergency departments (EDs) are crucial for delivering timely, life-saving care, particularly in low-resource and conflict-affected areas like Palestine. Palestinian hospitals face significant pressure in their EDs due to a heavy workload from routine injuries and those resulting from ongoing Israeli occupation. Enhancing healthcare quality at all levels of the health system is a national priority, with a focus on improving emergency care. However, the absence of specific national standards for measuring ED quality hinders efforts to standardize and enhance ED services in Palestine. Aims and Objectives: This PhD thesis aims to establish contextual quality standards for EDs in Palestine. It focuses on developing, validating, and assessing the feasibility of implementing Emergency Department Quality Standards (EDQS) tailored to the specific challenges of the Palestinian healthcare system. Methods: This research utilized a multi-methods approach. In the first study, a preliminary EDQS appropriate for hospital EDs in Palestine was developed through a literature review and refined using expert group discussions. The second study employed the e-Delphi technique to validate these EDQS. The third study assessed the feasibility of implementing the EDQS by conducting qualitative interviews with 10 ED front desk staff across nine hospitals in the West Bank. Results: The PhD research successfully developed contextually validated EDQS. In the first phase, 103 preliminary standards for emergency department operations were established across 16 sub-domains. The second phase validated 100 standards with an 80% consensus from 53 experts, resulting in minor adjustments. The administrative domain achieved a 97.3% consensus, while the clinical domain reached 96.4%. The third phase identified four key themes and 16 subthemes on the feasibility of EDQS in Palestinian EDs. Strong acceptance was noted, but challenges such as knowledge gaps, resource constraints, and resistance to change were highlighted. Nonetheless, participants believed EDQS could improve patient care and workflow efficiency with proper resources and strategies. Conclusions: This study enhances emergency care quality in Palestine by developing and validating the EDQS. Using a systematic, evidence-based approach, 100 standards were formulated to address clinical and administrative needs, incorporating international best practices while accounting for local challenges like resource limitations, conflict disruptions, and staff shortages. Expert validation underscored the standards' relevance, while a feasibility assessment identified barriers such as inadequate resources, lack of commitment, and knowledge gaps, highlighting the need for strategies like capacity building and stakeholder engagement. These findings are crucial for improving emergency care in low-resource, conflict- affected regions. The standards offer a framework for enhancing services, ensuring patient safety, and improving outcomes. Future efforts should focus on implementing and evaluating these standards to measure their impact on patient outcomes and satisfaction |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/42815 |
| institution | University of Cape Town (South Africa) |
| language | English eng |
| last_indexed | 2026-06-10T12:47:40.489Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| publisher | Division of Emergency Medicine |
| publisherStr | Division of Emergency Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/42815 Developing contextual quality standards for emergency departments in Palestine Bani Odeh, Abed Alra'oof Stassen, Willem Hamdan, Motasem Wallis, Lee Emergency departments Palestine Background: Emergency departments (EDs) are crucial for delivering timely, life-saving care, particularly in low-resource and conflict-affected areas like Palestine. Palestinian hospitals face significant pressure in their EDs due to a heavy workload from routine injuries and those resulting from ongoing Israeli occupation. Enhancing healthcare quality at all levels of the health system is a national priority, with a focus on improving emergency care. However, the absence of specific national standards for measuring ED quality hinders efforts to standardize and enhance ED services in Palestine. Aims and Objectives: This PhD thesis aims to establish contextual quality standards for EDs in Palestine. It focuses on developing, validating, and assessing the feasibility of implementing Emergency Department Quality Standards (EDQS) tailored to the specific challenges of the Palestinian healthcare system. Methods: This research utilized a multi-methods approach. In the first study, a preliminary EDQS appropriate for hospital EDs in Palestine was developed through a literature review and refined using expert group discussions. The second study employed the e-Delphi technique to validate these EDQS. The third study assessed the feasibility of implementing the EDQS by conducting qualitative interviews with 10 ED front desk staff across nine hospitals in the West Bank. Results: The PhD research successfully developed contextually validated EDQS. In the first phase, 103 preliminary standards for emergency department operations were established across 16 sub-domains. The second phase validated 100 standards with an 80% consensus from 53 experts, resulting in minor adjustments. The administrative domain achieved a 97.3% consensus, while the clinical domain reached 96.4%. The third phase identified four key themes and 16 subthemes on the feasibility of EDQS in Palestinian EDs. Strong acceptance was noted, but challenges such as knowledge gaps, resource constraints, and resistance to change were highlighted. Nonetheless, participants believed EDQS could improve patient care and workflow efficiency with proper resources and strategies. Conclusions: This study enhances emergency care quality in Palestine by developing and validating the EDQS. Using a systematic, evidence-based approach, 100 standards were formulated to address clinical and administrative needs, incorporating international best practices while accounting for local challenges like resource limitations, conflict disruptions, and staff shortages. Expert validation underscored the standards' relevance, while a feasibility assessment identified barriers such as inadequate resources, lack of commitment, and knowledge gaps, highlighting the need for strategies like capacity building and stakeholder engagement. These findings are crucial for improving emergency care in low-resource, conflict- affected regions. The standards offer a framework for enhancing services, ensuring patient safety, and improving outcomes. Future efforts should focus on implementing and evaluating these standards to measure their impact on patient outcomes and satisfaction 2026-02-02T13:07:16Z 2026-02-02T13:07:16Z 2025 2026-02-02T13:03:12Z Thesis / Dissertation Doctoral PhD http://hdl.handle.net/11427/42815 en eng application/pdf Division of Emergency Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Emergency departments Palestine Bani Odeh, Abed Alra'oof Developing contextual quality standards for emergency departments in Palestine |
| thesis_degree_str | Doctoral |
| title | Developing contextual quality standards for emergency departments in Palestine |
| title_full | Developing contextual quality standards for emergency departments in Palestine |
| title_fullStr | Developing contextual quality standards for emergency departments in Palestine |
| title_full_unstemmed | Developing contextual quality standards for emergency departments in Palestine |
| title_short | Developing contextual quality standards for emergency departments in Palestine |
| title_sort | developing contextual quality standards for emergency departments in palestine |
| topic | Emergency departments Palestine |
| url | http://hdl.handle.net/11427/42815 |
| work_keys_str_mv | AT baniodehabedalraoof developingcontextualqualitystandardsforemergencydepartmentsinpalestine |