Original Investigation

Implementation of a Package of Emergency Care Interventions and Clinical Outcomes

JAMA Network Open 10.1001/jamanetworkopen.2025.39471

October 27, 2025 at 11:00 AM EDT

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Is a package of quality improvement interventions associated with improved clinical outcomes in a resource-limited setting in Liberia?This quality improvement study of 344 preimplementation patient encounters compared with 1073 enrolled during program implementation found that implementation of a package of low-cost interventions was associated with improvements in emergency care quality and significant reductions in early death.These results suggest that prehospital and emergency unit mortality in this setting accounts for a substantial proportion of overall mortality in the health system, and low-cost interventions have the potential to lead to significant immediate and sustained improvements in both emergency unit quality and patient mortality.

Corresponding Author: Corey B. Bills, MD, Department of Emergency Medicine, University of Colorado, School of Medicine, Leprino Bldg, 12401 E 17th Ave, Aurora, CO 80045 (corey.bills@cuanschutz.edu).

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