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. 2025 Jun 24;17(1):e1-e10.
doi: 10.4102/phcfm.v17i1.4891.

Integrating emergency medical services and palliative care: A nominal group technique

Caleb H Gage  1 , Liz Gwyther, Julia Ambler, Jan Burke, Katya Evans, Linley Holmes, René Krause, Kaleb Lachenicht, Danielle Lincoln, Kerene Payne, Mpho Ratshikana-Moloko, Charnelle Stander, Willem Stassen
Affiliations

Integrating emergency medical services and palliative care: A nominal group technique

Caleb H Gage et al. Afr J Prim Health Care Fam Med. .

Abstract

Background: The need for integrated healthcare has been increasingly recognised because of mounting challenges associated with the proliferation of injuries and noncommunicable diseases. A developing example of integration is between Emergency Medical Services (EMS) and palliative care. Despite recommendations for integration in South Africa (SA), these services remain segregated.

Aim: This study aimed to develop and prioritise approaches facilitating EMS and palliative care system integration within SA.

Setting: An online meeting was held with SA EMS and palliative care experts.

Methods: A nominal group technique was employed to answer the question, 'What do you think should be done to most effectively integrate EMS and palliative care services in SA?' Answers were categorised, awarded scores by participants, and ranked according to impact and feasibility.

Results: The following categories were generated: Awareness, Education, Community Engagement, Communication and Information Sharing, Stakeholder Collaborations, Alternative Pathways and Approaches, Research, Funding, Policy Development and Governance. The top five individual approaches were: (1) enable EMS to administer already prescribed medications, (2) Emergency Medical Services undergraduate training in palliative care, (3) improve EMS recognition of signs of dying at the end-of-life, (4) palliative care awareness for the EMS community, and (5) palliative care awareness for in-hospital healthcare providers, particularly those in emergency medicine.

Conclusion: The categories developed in this study should be used to guide EMS and palliative care integration in SA. Future research should aim at establishing the safety and efficacy of these interventions.Contribution: This study provides a structured approach to integrating EMS and palliative care in SA, enhancing holistic care for patients with palliative needs.

Keywords: EMS; South Africa.; ambulance; end-of-life; healthcare system integration; palliative care; paramedic; person-centred care.

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Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Prioritisation matrix.
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References

    1. World Health Organization . Global strategy on people-centred integrated health services: Interim report [homepage on the Internet]. 2015. [cited 2024 Dec 20]. Available from: https://apps.who.int/iris/handle/10665/155002
    1. Malekzadeh A, Michels K, Wolfman C, et al. Strengthening research capacity in LMICs to address the global NCD burden. Glob Health Action. 2020;13(1):1846904. 10.1080/16549716.2020.1846904 - DOI - PMC - PubMed
    1. Martin L, Knowles EE. Model for an integrated health system. J Integr Care. 2020;28(2):161–170. 10.1108/JICA-08-2019-0034 - DOI
    1. Valentijn PP, Schepman SM, Opheij W, Bruijnzeels MA. Understanding integrated care: A comprehensive conceptual framework based on the integrative functions of primary care. Int J Integr Care. 2013;13:e010. 10.5334/ijic.886 - DOI - PMC - PubMed
    1. Gage CH, Stander C, Gwyther L, Stassen W. Emergency medical services and palliative care: A scoping review. BMJ Open. 2023;13(3):e071116. 10.1136/bmjopen-2022-071116 - DOI - PMC - PubMed

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