Table 3 Foremost problems of emergency medicine in Serbia and priorities for system development. A summary of the findings from focus group discussions with providers of emergency medical services.

FINANCE:

   ≺ Inadequate financial resources for essential equipment, supplies, and medications

   ≺ Discouraged emergency medical service personnel due to meager salaries, difficult work conditions, and large workloads

   ≺ Inadequate number of properly equipped ambulances and functioning radio equipment

   ≺ Very few computers and no health information systems to track patient health records

ORGANIZATION:

   ≺ Need for federal regulation of emergency medical services

   ≺ Lack of sufficient protocols for the standardization of triage and treatment

   ≺ Inadequate coordination between the institutions providing emergency medical services

   ≺ Need for further development of emergency medicine as its own specialty

EDUCATION:

   ≺ Inadequate training in emergency medicine during medical school

   ≺ Insufficient practical training of emergency medical service providers

   ≺ Few opportunities for professional development and continuing education of emergency service providers

   ≺ Limited access to medical innovations through the internet, foreign professional journals, conferences, courses, and seminars

   ≺ Lack of health management training for leaders of health care institutions

   ≺ Need for public education about the emergency medical services system and how to properly utilize them

SUGGESTED PRIORITIES FOR THE DEVELOPMENT OF EMERGENCY MEDICINE IN SERBIA

FINANCE:

   ≺ Secure funding for essential medications, supplies, equipment, employee salaries, and maintenance of health care facilities

   ≺ Consider long-term sources of continuous funding for emergency services such as the government budget instead of the social health insurance fund

ORGANIZATION:

   ≺ Develop national protocols for the standardization of emergency triage and treatment

   ≺ Further develop emergency medicine as its own specialty

   ≺ Clearly define the responsibilities and emergency services of physicians in each health care facility

   ≺ Institute a system to promote better coordination between the primary health centers, the hospital emergency departments, and the Emergency Center

   ≺ Implement quality control measures for the delivery of emergency medical services

   ≺ Establish a health information system to facilitate the tracking of patients

EDUCATION:

   ≺ Introduce required continuing medical education supported by legislation that would provide health care professionals leave from work to attend this periodic training

   ≺ Provide health care professionals with access to continuing medical education through the internet, professional journals, conferences, seminars, and practical training

   ≺ Develop a fellowship program for emergency medicine physicians

   ≺ Increase the level of practical emergency medical experience provided in medical school and postgraduate training

   ≺ Implement training in BLS, ALS, and emergency triage for all health care providers

   ≺ Institute a health management training courses for leaders of health care institutions

   ≺ Educate the public regarding the level of emergent care that each health care institution provides and how to properly utilize the available health care services