Optimising acute care delivery in resource-constrained settings: a scoping review of interventions, outcomes, and implementation realities
1 Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.
2 Colombo East Base Hospital, Sri Lanka.
3 International Research Collaborative, School of Health and Clinical Sciences, The University of Western Australia, Australia.
* Corresponding Author
Review
International Journal of Biological and Pharmaceutical Sciences Archive, 2026, 12(01), 142–155.
Article DOI: 10.53771/ijbpsa.2026.12.1.0079
Publication history:
Received on 26 July 2026; revised on 01 September 2026; accepted on 03 September 2026
Abstract:
Objectives: To synthesise evidence on quality improvement (QI) and audit-based interventions in emergency and acute care in resource-constrained settings, focusing on South Asia and implementation.
Design: Scoping review reported in accordance with PRISMA-ScR.
Data sources: Semantic search of >138 million papers in Semantic Scholar and OpenAlex via Elicit, plus targeted wider LMIC emergency care searches.
Eligibility criteria: South Asian emergency or acute care studies evaluating QI, clinical audit, continuous QI or audit–feedback interventions, reporting process, patient or system outcomes, and published in full.
Data extraction and synthesis: Machine-assisted charting of context, interventions, outcomes, implementation factors and design, then descriptive and thematic synthesis.
Results: Eighty South Asian sources were charted, with about 25 wider-LMIC sources. Process outcomes improved across triage, timeliness, guideline adherence and documentation. Mortality fell where baseline deficits were large; higher-performing systems gained process improvement without mortality benefit. Six themes were iterative cycles, training, checklists/protocols, leadership and team engagement, resource constraints and fragile prehospital/referral systems.
Conclusions: Locally adapted, team-based QI improves emergency care processes; patient-outcome effects depend on baseline deficits, staffing, supply chains and institutional embedding.
Keywords:
Quality Improvement; Emergency Care; Low- And Middle-Income Countries; Clinical Audit
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Copyright © 2026 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0