• Kim Hansen, Adrian Boyle, Brian Holroyd, Georgina Phillips, Jonathan Benger, Lucas B Chartier, Fiona Lecky, Samuel Vaillancourt, Peter Cameron, Grzegorz Waligora, Lisa Kurland, Melinda Truesdale, and IFEM Quality and Safety Special Interest Group.
• Emergency Department, Prince Charles Hospital, Chermside, Queensland, Australia hansenke@gmail.com.
• Emerg Med J. 2020 Jul 1; 37 (7): 437-442.

ObjectivesQuality and safety of emergency care is critical. Patients rely on emergency medicine (EM) for accessible, timely and high-quality care in addition to providing a 'safety-net' function. Demand is increasing, creating resource challenges in all settings. Where EM is well established, this is recognised through the implementation of quality standards and staff training for patient safety. In settings where EM is developing, immense system and patient pressures exist, thereby necessitating the availability of tiered standards appropriate to the local context.MethodsThe original quality framework arose from expert consensus at the International Federation of Emergency Medicine (IFEM) Symposium for Quality and Safety in Emergency Care (UK, 2011). The IFEM Quality and Safety Special Interest Group members have subsequently refined it to achieve a consensus in 2018.ResultsPatients should expect EDs to provide effective acute care. To do this, trained emergency personnel should make patient-centred, timely and expert decisions to provide care, supported by systems, processes, diagnostics, appropriate equipment and facilities. Enablers to high-quality care include appropriate staff, access to care (including financial), coordinated emergency care through the whole patient journey and monitoring of outcomes. Crowding directly impacts on patient quality of care, morbidity and mortality. Quality indicators should be pragmatic, measurable and prioritised as components of an improvement strategy which should be developed, tailored and implemented in each setting.ConclusionEDs globally have a remit to deliver the best care possible. IFEM has defined and updated an international consensus framework for quality and safety.© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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