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The International Federation for Emergency Medicine framework for quality and safety in the emergency department
  1. Fiona Lecky1,
  2. Jonathan Benger2,
  3. Suzanne Mason3,
  4. Peter Cameron4,5,
  5. Chris Walsh6
  6. On behalf of the IFEM Quality Symposium Working Group
  1. 1University of Sheffield/University of Manchester/Salford Royal Hospital NHS Foundation Trust, Emergency Medicine Research in Sheffield (EMRiS), School of Health and Related Research (ScHARR), Sheffield, UK
  2. 2Department of Emergency Care, Emergency Department, Bristol Royal Infirmary, Bristol, UK
  3. 3School of Health and Related Research, University of Sheffield, Sheffield, UK
  4. 4Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
  5. 5Monash University, Melbourne, Australia
  6. 6College of Emergency Medicine, London, UK
  1. Correspondence to Professor Jonathan Benger, Department of Emergency Care, Emergency Department, Bristol Royal Infirmary, Bristol BS2 8HW, UK; Jonathan.Benger{at}


All emergency departments (EDs) have an obligation to deliver care that is demonstrably safe and of the highest possible quality. Emergency medicine is a unique and rapidly developing specialty, which forms the hub of the emergency care system and strives to provide a consistent and effective service 24 h a day, 7 days a week. The International Federation of Emergency Medicine, representing more than 70 countries, has prepared a document to define a framework for quality and safety in the ED. Following a consensus conference and with subsequent development, a series of quality indicators have been proposed. These are tabulated in the form of measures designed to answer nine quality questions presented according to the domains of structure, process and outcome. There is an urgent need to improve the evidence base to determine which quality indicators have the potential to successfully improve clinical outcomes, staff and patient experience in a cost-efficient manner—with lessons for implementation.

  • guidelines
  • quality assurance
  • management, emergency department management
  • management, quality assurance
  • management, risk management

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