Integrated emergency, critical, and operative care: A coordinated approach to strengthening emergency care and health service delivery

Emergency, critical

Emergency, critical, and operative (ECO) care services are essential components of well-functioning health systems.They play crucial roles in responding to acute health conditions and emergency illness or injury, thereby saving lives and reducing the burden of disease.These services encompass a range of interventions, including out-of-facility emergency medical services, facility-based emergency care units, hospital critical care units, and surgical services.
They are staffed by distinct teams of health professionals in diverse settings, including those in community facilities, prehospital care settings, primary care settings, or ambulatory and emergency centers in small or large hospitals.7][8] The World Health Organization (WHO) has been a leading advocate for the development of comprehensive health systems that address the diverse health needs of individuals across the course of their lives.At the recent 76th World Health Assembly (WHA) in Geneva, Switzerland, member nation states of the WHO adopted resolution 76.2 (ECO resolution/76.2) titled "Integrated emergency, critical and operative care for universal health coverage and protection from health emergencies" (ECO resolution.76.2). 9 Building upon previous WHA resolutions, ECO resolution/76.2 is another significant milestone in strengthening health systems and improving health outcomes worldwide.It aims to address the crucial need for a comprehensive approach to health service delivery that integrates ECO services.By recognizing the interdependence of these services, as well as the interdependence of emergency care with primary care, the resolution offers significant opportunities for the development of emergency care systems, which ultimately leads WHO Emergency Care: https:// www.who.int/ teams/ integ rated -healt h-servi ces/ clini cal-servi ces-and-syste ms/ emerg ency-and-criti cal-care.

AUTH O R CO NTR I B UTI O N S
Janis P. Tupesis conceived of the editorial and drafted the manuscript.All authors contributed substantially to its revision.Janis P.
Tupesis takes responsibility for the paper as a whole.
to more universal access to high-quality emergency care services globally.Better integrated health care systems can more effectively respond to an individual's specific needs, in a comprehensive, coordinated way, throughout the course of their lives and the course of their emergency illness or injury.By emphasizing the interdependence between primary care, emergency care, and hospital-based care, it provides opportunities to bridge the gap between preventive, promotive, and curative services.Highlighting the importance of ECO services in primary (first-contact) health care has several advantages.Placing primary health care at the core of integrated health services ensures that health systems can build strong foundations for comprehensive and people-centered emergency care.Better linkages between first-contact This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.© 2023 The Authors.Academic Emergency Medicine published by Wiley Periodicals LLC on behalf of Society for Academic Emergency Medicine.Supervising Editor: Kamna Singh Balhara For Affiliation refer page on 101 | 101 TUPESIS et al.care in the primary care setting and subsequent ECO services mean individuals can receive timely and appropriate interventions, saving lives and money.The approach outlined in the ECO resolution/76.2 enhances coordination and collaboration among different groups of health professionals.It recognizes that emergency care services are delivered by diverse providers, including physicians, nurses, technicians, prehospital care providers, and members of the community/ public.By fostering collaboration and skill sharing, the resolution promotes a team-based approach to care.As demonstrated by the recent COVID-19 pandemic, emergency care and health systems need to be agile and adaptive to effectively manage and contain emerging health threats.Effective health systems must respond to people's needs for time-sensitive emergency care and ensure swift access to critical care and operative services that can only be delivered safely in a hospital setting.A well-functioning acute and emergency care system comprising emergency departments, intensive care units, surgical facilities, and anesthesia services is crucial.By strengthening the intrinsic capacity of global health systems to provide ECO services, countries can improve their responses to crises and better protect their populations from largescale problems caused by infectious disease or disasters that are now more common with global warming.As representatives from the world's largest global emergency care professional organizations, we are committed to advancing the implementation of the ECO resolution/76.2 resolution.We encourage the world's emergency care organizations and professionals to involve themselves in capacity-building initiatives, ensuring that pathways of emergency care from the home to the specialist services of hospitals, are planned properly and integrated across organizational boundaries.Referral and interfacility transfer systems are vital because they enable patients to access the necessary care that they need.These systems ensure that patients, especially those requiring specialized or advanced care, are efficiently directed to the appropriate healthcare facility equipped to meet their specific needs, enhancing the overall quality of care and optimizing patient outcomes.We urge the development of comprehensive training programs and educational resources that enhance the skills and knowledge of emergency care providers.We must promote interprofessional collaboration, recognizing the diverse range of providers involved in delivering emergency care globally.Further, we encourage and support collaborative research initiatives that generate evidence on the effectiveness and impact of emergency care.We encourage partnerships to facilitate knowledge sharing and dissemination of research findings contributing to evidence policy and practice.Health care professionals look to foster relationships with governments, nongovernmental organizations, and international agencies, pooling resources and expertise to support the implementation of the ECO resolution.By fostering these networks, we strengthen our global community, while looking to these same networks to involve themselves in policy implementation.We must encourage and assist member states in achieving the intent of the ECO resolution/76.2, offering technical expertise and monitoring progress as required.Achieving all of this on a global scale requires commitment, resources, and investment.As a collective we are committed to the collaborative development of indicators and assessment frameworks that measure the performance and impact of integrated care initiatives.This is crucial in ensuring accountability and in driving continuous improvement.Through our collective efforts, we aim to improve health outcomes, enhance emergency response capabilities, and ensure that individuals receive comprehensive and quality emergency care by strengthening emergency care systems worldwide.LINK SWHO Integrated Health Services: https:// www.who.int/ teams/ integ rated -healt h-services.WHO Clinical Services and Systems: https:// www.who.int/ teams/ integ rated -healt h-servi ces/ clini cal-servi ces-and-systems.WHO Integrated Emergency, Critical and Operative Care: https://www.who.int/teams/integrated-health-services/clinicalservices-and-systems/emergency--critical-and-operative-care#:~:tex t=Emergency %2C%20 critical%20and%20 operative%20 care%20(ECO)%20represent%20a%20people,referral%20and%20 counter%2Dreferral%20mechanisms.