Developing contextual quality standards for emergency departments in Palestine

dc.contributor.advisorStassen, Willem
dc.contributor.advisorHamdan, Motasem
dc.contributor.advisorWallis, Lee
dc.contributor.authorBani Odeh, Abed Alra'oof
dc.date.accessioned2026-02-02T13:07:16Z
dc.date.available2026-02-02T13:07:16Z
dc.date.issued2025
dc.date.updated2026-02-02T13:03:12Z
dc.description.abstractBackground: 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
dc.identifier.apacitationBani Odeh, A. A. (2025). <i>Developing contextual quality standards for emergency departments in Palestine</i>. (). University of Cape Town ,Faculty of Health Sciences ,Division of Emergency Medicine. Retrieved from http://hdl.handle.net/11427/42815en_ZA
dc.identifier.chicagocitationBani Odeh, Abed Alra'oof. <i>"Developing contextual quality standards for emergency departments in Palestine."</i> ., University of Cape Town ,Faculty of Health Sciences ,Division of Emergency Medicine, 2025. http://hdl.handle.net/11427/42815en_ZA
dc.identifier.citationBani Odeh, A.A. 2025. Developing contextual quality standards for emergency departments in Palestine. . University of Cape Town ,Faculty of Health Sciences ,Division of Emergency Medicine. http://hdl.handle.net/11427/42815en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Bani Odeh, Abed Alra'oof AB - 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 DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Emergency departments KW - Palestine LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - Developing contextual quality standards for emergency departments in Palestine TI - Developing contextual quality standards for emergency departments in Palestine UR - http://hdl.handle.net/11427/42815 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/42815
dc.identifier.vancouvercitationBani Odeh AA. Developing contextual quality standards for emergency departments in Palestine. []. University of Cape Town ,Faculty of Health Sciences ,Division of Emergency Medicine, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/42815en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDivision of Emergency Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectEmergency departments
dc.subjectPalestine
dc.titleDeveloping contextual quality standards for emergency departments in Palestine
dc.typeThesis / Dissertation
dc.type.qualificationlevelDoctoral
dc.type.qualificationlevelPhD
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