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Table 1 Pacific Emergency Care Assessment (PECA) Table outline

From: A Pacific needs analysis model: a proposed methodology for assessing the needs of facility-based emergency care in the Pacific region

AreaDomainsObservations
Demographic data• Presentations – number, type, distribution
• ED relationship with hospital, community
Detailed observations covering all of these areas, including columns / rows for:
• Strengths
• Weaknesses
• Facilitators
• Barriers
• Identified gaps
• Possible solutions
• Recommendations
Pre-hospital• Transport mode, care, referral system
Triage• Presentations
• Triage nurses – training, supervision
• Location and equipment, amenity and safety
• Triage system and Clinical resources
• Observation of arrived/waiting patients
• Timeliness, accuracy, documentation
• Provision of 1st aid
Time to treatment• Nursing/medical
• Notification, sense of urgency, delays
Initial assessment• Systematic; teamwork; medical / nursing
• Access to lab/radiology; diagnosis and plan
Review of patient and ongoing care• Nursing, medical, inpatient (IP) units
• Adverse events
Trauma and resuscitation management• Trauma response
• Teamwork; effectiveness
Women’s health• Obstetric care
• Sexual violence; privacy
Paediatric care• Quality and safety
• Environment and equipment
• Staff training, communication, IP unit care
Access to treatment• Delays; limitations
Handover• Within ED; to IP units
Patient disposition• To Theatre, IP units, home
• Access Block
Transport of patients• Staff, timeliness, safety
Equipment• Availability; training; maintenance; supply
Infection control• Staff and patients
• Isolation; cleanliness
Standard and consistency of care• Protocols and guidelines
• Best practice; EBM; adverse events
Patient information management• Documentation; communication
• Forms, storage, access, technology use, data for research
Safety• Critical incidents; error and review
• Staff safety and amenity
ED staff• Number and rostering; Human resource use
• Education and training level, ED based teaching. Skill mix + supervision
• Scope of practice
Communication• Between ED staff; ED + hospital staff
• Between staff and patients/families
Culture of ED• Sense of ownership
• Leadership / responsibility
• Morale + Staff turnover
ED design and patient flowComprehensive mapping of ED design and how patients move through clinical areas, including
• Bottle-neck areas
• Access block (all contributing factors)
• Patient tracking
• Design features; amenity; functionality
Aerial diagrams of current and suggested ED layout with patient flow mapping
Recommendations aim to maximise safe and effective use of existing space