Describing key performance indicators for waiting times in emergency centres in the Western Cape Province, South Africa, between 2013 and 2014

Cohen, K; Bruijns, Stevan R.

doi:10.7196/samj.2018.v108i7.12969

Cited by 9 publications

(10 citation statements)

References 10 publications

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“…In a Cape Town referral hospital, the median waiting time was 4.1 hours and 2.4 hours before and after introduction of the Cape triage score respectively [18]. A review of data from 52 Western Cape facilities revealed an overall mean waiting time of 2.1 hours [5]. The relatively poor performance of Princess Marina Hospital ED may be due to an overwhelmed system.…”

Section: Discussionmentioning

confidence: 99%

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Emergency Department Waiting Times and Determinants of Prolonged Length of Stay in a Botswana Referral Hospital

Siamisang¹,

Tlhakanelo²,

Mhaladi³

2020

OJEM

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Introduction: Emergency medicine is a critical component of quality public health service. In fact length of stay and waiting times in the Emergency department are key indicators of quality. The aim of this study was to determine waiting times and determinants of prolonged length of stay (LOS) in the Princess Marina Hospital Emergency Department. Methods: This was a retrospective observational study. It was done at Princess Marina, a referral hospital in Gaborone, Botswana. Triage forms of patients who presented between 19/11/ 2018 and 18/12/2018 were reviewed. Data from patient files was used to determine time duration from triage to being reviewed by a doctor, time duration from review by emergency doctor to patients' disposition and the time duration from patient's triage to disposition (length of stay). Prolonged length of stay was defined as duration > 6 hours. Results: A total of 1052 files representing patients seen over a 1-month period were reviewed. 72.5% of the patients had a prolonged length of stay. The median emergency doctor waiting time was 4.5 hours (IQR 1.6-8.3 hours) and the maximum was 27.1 hours. The median length of stay in the emergency department was 9.6 hours (IQR 5.8-14.6 hours) and the maximum was 45.9 hours. Patient's age (AOR 1.01), mental status (AOR 0.61), admission to internal medicine service (AOR 5.12) and pediatrics admissions (AOR 0.11) were significant predictors of prolonged length of stay in the emergency department. Conclusion: Princess Marina Hospital emergency department waiting times and length of stay are long. Age, normal mental status and internal medicine admission were independent predictors of prolonged stay (>6 hours). Admission to the pediatrics service was associated with shorter length of stay. There is a need for interventions to address the long waiting times and length of stay. Interventions should particularly focus on the identified predictors.

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Section: Discussionmentioning

confidence: 99%

“…Provision of quality emergency services is hampered by delays in the emergency department (ED). In fact emergency length of stay (LOS) is a key indicator of quality of care of health facilities and health departments [5]. It can therefore be used for performance monitoring and improvement of service.…”

Section: Introductionmentioning

confidence: 99%

Emergency Department Waiting Times and Determinants of Prolonged Length of Stay in a Botswana Referral Hospital

Siamisang¹,

Tlhakanelo²,

Mhaladi³

2020

OJEM

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“…It is recommended that patients triaged 'yellow' be seen within 1 h and patient's triaged 'green' be seen within 4 h. Despite these recommendations it is our anecdotal experience that because of patient overcrowding, which is a frequent problem in our ECs, patients may wait in excess of these time frames to be seen. 30,31 Thus, there has been much discussion in the literature of the advantages of nurse-driven analgesia at triage. 7,8 Our study has demonstrated that of a total of 976 individual medications prescribed for patients with minor trauma, only 145 (14.9%) were prescribed at presentation (at triage).…”

Section: Discussionmentioning

confidence: 99%

‘This won’t hurt a bit!’ – A descriptive review of health care professionals’ pharmacological management of pain in minor trauma

Havenga

Govender

Lewis

2021

South African Family Practice

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Background: Emergency Centres (ECs) have a prominent trauma burden requiring effective pain management. This study aimed to review analgesia-prescribing habits in minor trauma, reviewing the patient demographics and diagnoses, analgesia-prescribing habits of health care professionals (HCPs) managing these cases, and differences in prescribing noted by patients’ age group, gender and triage code.Methods: A prospective, cross-sectional, descriptive study was conducted in a regional EC in KwaZulu-Natal. HCPs managing minor trauma patients completed a closed-ended questionnaire which indicated the patients’ demographics, diagnosis and analgesia prescribed.Results: The study comprised of 314 cases of which the demographic most represented were male patients aged between 20–30 years with soft tissue injuries. Simple analgesics and weak opioids (paracetamol, ibuprofen and tramadol) accounted for 87.9% of prescriptions. Referral clinics prescribed less analgesics than that provided in the EC. There were mostly no significant differences in prescription habits by patients’ age group, gender and triage code.Conclusion: Presenting complaints in our study were varied and likely to result in mild to moderate pain. Only a minority of patients received analgesics at initial contact. Standardised protocols providing treatment guidance for nurse-initiated pain management at initial contact is thus important. There were no significant differences in analgesics prescribed for adults and the elderly, which is worrisome given the potential negative side effects of analgesics in the elderly. Similar concerns in our paediatric population were not noted. Ensuring adequate analgesia with cognisance for safety at the extremes of age is of paramount importance.

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“…Performance indicators may consist of direct or indirect indicators (Holloway 2009;Parmenter 2012). Performance indicators can also be used to measure quality (Cohen and Bruijns 2018). Well-constructed performance areas contribute to improved performance by assisting individuals to gain a deeper understanding of their priorities and the outcomes they must achieve and to understand more clearly the connections between their roles and their relationship to the organisation's strategic objectives.…”

Section: The Role Of Indicators In Performance Managementmentioning

confidence: 99%

Performance Management and the Integrated Development Plan of the Msunduzi Municipality in South Africa

Khunoethe

Reddy

Mthuli

2021

NISPAcee Journal of Public Administration and Policy

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Poor local government performance has been detrimental to South Africa’s development. The study explores the challenge(s) the Msunduzi Local Municipality is facing in ensuring good performance necessary for achieving its planned development. The study argues that flaws in the management of performance lead to poor performance. This research was interpretivist, used a case-study strategy and adopted a qualitative design / approach. Secondary data in the form of municipal publications and primary data in the form of interview information was collected and analysed. The findings demonstrated that there is a lack of alignment between the planned development and the necessary performance to achieve it in the Msunduzi Local Municipality. The Key Performance Areas of top managers were not aligned to the Integrated Development Plan goals; Key Performance Indicators (KPIs) were internally rather than externally focused; some of the KPIs were too vague to be measurable, and there was no agreement on the top five strategic objectives of the Municipality. This research investigation sought to contribute to the limited understanding of municipal performance and development policy alignment by improving municipal service delivery in developing countries. Lessons have been learnt on the need for policy alignment based on holistic thinking.

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Describing key performance indicators for waiting times in emergency centres in the Western Cape Province, South Africa, between 2013 and 2014

Cited by 9 publications

References 10 publications

Emergency Department Waiting Times and Determinants of Prolonged Length of Stay in a Botswana Referral Hospital

Emergency Department Waiting Times and Determinants of Prolonged Length of Stay in a Botswana Referral Hospital

‘This won’t hurt a bit!’ – A descriptive review of health care professionals’ pharmacological management of pain in minor trauma

Performance Management and the Integrated Development Plan of the Msunduzi Municipality in South Africa

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