Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa

Ruit, Catherine van de; Lahri, Saʼad; Wallis, Lynne

doi:10.1016/j.afjem.2019.12.004

Cited by 9 publications

(9 citation statements)

References 41 publications

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“…Fragmented efforts in terms of the steps required to implement the plan have hampered the institution's overall preparation for the NHI. These conclusions are supported by another author [ 33 ], whose analysis of the historical foundations of the present public health concerns in South Africa, highlighted a lack of stewardship in hospital departments as well as a lack of coherence.…”

Section: Discussionmentioning

confidence: 75%

Factors influencing the preparedness for the implementation of the national health insurance scheme at a selected hospital in Gauteng Province, South Africa

Mukwena

Manyisa

2022

BMC Health Serv Res

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Research studies as well as anecdotal evidence suggest that there are challenges regarding the NHI plan implementation. These include problems such as an increase in illnesses and a shortage of personnel to drive the project in South African public hospitals. This is exacerbated by the existing situation of most government-funded healthcare institutions, which are characterized by bad administration, insufficient budget, inadequate infrastructure, and insufficient drug supply, as highlighted in several studies. The hospital under investigation is one such facility, with a history of patients sleeping on the floor and people being turned away owing to a shortage of experts and an overburdened staff. This situation is concerning, given that the government claims to be providing appropriate funds to the institution. The hospital under research is highly regarded by the surrounding community. However, a visit by the Health MEC in 2014 revealed that the facility had insufficient sanitary standards and a high complaint rate. Based on the foregoing, as well as the difficulties that both employees and patients are confronted with at the selected hospital, the question that emerges is whether the hospital is fit for the implementation of the NHI.Aim: The aim of this study was to assess the preparation for the launch of the national health insurance scheme at a Johannesburg hospital.Setting: The study was conducted at a hospital situated in eastern suburbs of Johannesburg, Gauteng, South Africa.Method: The study employed a qualitative method with an explorative, descriptive, qualitative study design. The population consisted of selected hospital employees, such as doctors, dispensary officers, hospital managers, human resources workers, facility managers, and administration record officials who were employed at the selected hospital. Purposive sampling was used to select participants.Sample size: Category saturation was used to determine the sample size. The participants for the study were chosen using purposeful sampling, with the researcher aiming for those who were familiar with the NHI scheme at the institution. Semi structured interviews and a focus group discussion were used to gather data. The data from the focus group discussion and semi-structured interviews were analysed using thematic analysis.Results: The investigation found that the hospital was preparing to for the NHI implementation, but that was riddled with lack of resources, poor infrastructure, lack of training, delays in development and poor technological advances.Recommendations: The paper suggests that human resources be increased, infrastructure be upgraded, medicines and equipment be increased, and enough training on NHI implementation be provided.Contribution: The paper adds to the body of knowledge regarding the NHI in South Africa.

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Section: Discussionmentioning

confidence: 75%

Factors influencing the preparedness for the implementation of the national health insurance scheme at a selected hospital in Gauteng Province, South Africa

Mukwena

Manyisa

2022

BMC Health Serv Res

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“…In this study, the mean waiting time for patients from reporting to the reception area up to being triaged was 3 h and 17 min, which is acceptable compared to the recommended triage waiting time for non-urgent patients in South African Triage Scale (SATS) of 4 h [ 27 , 39 ]. These findings are congruent with the findings of other studies, which reported shorter waiting times of <4 h for non-urgent patients to be triaged [ 39 ].…”

Section: Discussionmentioning

confidence: 95%

“…Due to the quadruple burden diseases and limited resources in South Africa the rate of patients seeking emergency care has increased alarmingly, leading to crowding and subsequently prolonged LOS in the ED [ 22 , 26 ]. Yet, in South Africa, a set target for the average LOS in the ED is not specified [ 27 ]. In the study conducted in Cape Town public EDs, health care providers described limited bed availability, staff shortage and high rate of boarders in the ED as outcomes of crowding which lead to prolonged ED LOS [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

“…Yet, in South Africa, a set target for the average LOS in the ED is not specified [ 27 ]. In the study conducted in Cape Town public EDs, health care providers described limited bed availability, staff shortage and high rate of boarders in the ED as outcomes of crowding which lead to prolonged ED LOS [ 27 ]. The ED of the study hospital is often understaffed and overburdened as in the case of many similar hospitals in South Africa [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

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Areas of delay related to prolonged length of stay in an emergency department of an academic hospital in South Africa

Mashao

Heyns

White

2021

African Journal of Emergency Medicine

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Introduction Globally, length of stay of patients in emergency departments remains a challenge. Remaining in the emergency department for >12 h increases health care costs, morbidity and mortality rates and leads to crowding and lower patient satisfaction. The aim of this research was to describe the areas of delay related to prolonged length of stay in the emergency department of an academic hospital. Methods A quantitative retrospective study was done. The Input-Throughput-Output model was used to identify the areas of patients' journey through the emergency department. The possible areas of delay where then described. Using systematic sampling, a total of 100 patient files managed in an emergency department of an academic hospital in South Africa were audited over a period of 3 months. Descriptive statistics and regression analysis was used to analyse data. Results The mean length of stay of patients in the emergency department was 73 h 49 min. The length of stay per phase was: input (3 h 17 min), throughput (16 h 25 min) and output (54 h 7 min). A strong significant relationship found between the length of stay and the time taken between disposition decision (throughput phase) disposition decision to admission or discharge of patients from the ED (output phase) (p < 0.05). Conclusion The output phase was identified as the longest area of delay in this study, with the time taken between disposition decision to admission or discharge of patients from the ED (patients waiting for inpatient beds) as the main significant area of delay.

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“…Additionally, even where cases are accurately diagnosed, self-protection of HCWs is difficult due to IPC measure limitations in infrastructure and equipment, such as overcrowded settings ( van de Ruit et al. , 2020 ), in which proper distancing is more challenging and lacking supply or access to PPE material ( Desai et al.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence and risk factors of COVID-19 in healthcare workers from 11 African countries: a scoping review and appraisal of existing evidence

Müller

Wood

Hanefeld

et al. 2021

Health Policy and Planning

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A better understanding of serological data and risk factors for coronavirus disease 2019 (COVID-19) infection in healthcare workers (HCWs) is especially important in African countries where human resources and health services are more constrained. We reviewed and appraised the evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and its risk factors in HCWs in Africa to inform response and preparedness strategies during the SARS-CoV-2 pandemic. We followed the Preferred Reporting Items for systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines in this scoping review. Databases including PubMed, Embase and preprint servers were searched accordingly from the start of the COVID-19 pandemic to 19 April 2021. Our search yielded 12 peer-reviewed and four pre-print articles comprising data on 9223 HCWs from 11 countries in Africa. Seroprevalence varied widely and ranged from 0% to 45.1%. Seropositivity was associated with older age, lower education, working as a nurse/non-clinical HCW or in gynaecology, emergency, outpatient or surgery departments. Asymptomatic rates were high and half of the studies recommended routine testing of HCWs. This scoping review found a varying but often high SARS-CoV-2 seroprevalence in HCWs in 11 African countries and identified certain risk factors. COVID-19 public health strategies for policy and planning should consider these risk factors and the potential for high seroprevalence among HCWs when prioritizing infection prevention and control measures and vaccine deployment.

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Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa

Cited by 9 publications

References 41 publications

Factors influencing the preparedness for the implementation of the national health insurance scheme at a selected hospital in Gauteng Province, South Africa

Factors influencing the preparedness for the implementation of the national health insurance scheme at a selected hospital in Gauteng Province, South Africa

Areas of delay related to prolonged length of stay in an emergency department of an academic hospital in South Africa

Seroprevalence and risk factors of COVID-19 in healthcare workers from 11 African countries: a scoping review and appraisal of existing evidence

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