全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Waiting Times and Length of Stay of Trauma Patients in a Botswana Referral Hospital Emergency Department

DOI: 10.4236/ojem.2022.101005, PP. 54-65

Keywords: Emergency Department, Waiting Times, Length of Stay, Trauma, Botswana

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background: Mortality and morbidity due to trauma are a significant public health challenge. There is paucity of data on the waiting times and length of stay (LOS) of trauma patients in emergency departments in Botswana. The aim of this study was to determine the Emergency Department (ED) waiting times and LOS of trauma patients at Princess Marina Hospital in Gaborone, Botswana. Methods: This was a retrospective medical records review of waiting times (time from triage to review by ED medical officer) and LOS (time from triage to disposition from the emergency department). The waiting times for the different assigned acuities were assessed against the South African Triage System (SATS) standards. All trauma patients seen from 19/11/2018 to 18/12/2018 were included in the study. Prolonged length of stay was defined as duration > 6 hours. Categorical data was summarized with frequencies while numeric data was summarized with medians and interquartile ranges. Results: A total of 187 trauma patients’ files were analyzed. Of these, 72 (38.5%) were females. The median waiting time was 3.8 hours and the maximum was 19.2 hours. The median length of stay (LOS) was 8.8 hours with a maximum of 37.2 hours. Only 53 (28.3%) of the participants had a LOS of less than 6 hours. None of the emergent patients were seen immediately. Only 5 (4.0%) of the very urgent patients were seen within the target of 10 minutes. Finally, only 10 (20.4%) of urgent patients were seen within the target time of 1 hour. Conclusion: The waiting times and length of stay in Princess Marina Hospital were mostly above the recommended standards. Urgent interventions are needed to reduce waiting times and length of stay for trauma patients. More studies are needed to explore the sources of delay and investigate possible solutions to this public health challenge.

References

[1]  Hanche-Olsen, T.P., Alemu, L., Viste, A., Wisborg, T. and Hansen, K.S. (2012) Trauma Care in Africa: A Status Report from Botswana, Guided by the World Health Organization’s “Guidelines for Essential Trauma Care”. World Journal of Surgery, 36, 2371-2383. https://doi.org/10.1007/s00268-012-1659-0
https://link.springer.com/article/10.1007/s00268-012-1659-0
[2]  Cox, M., Becker, T.D. and Motsumi, M. (2018) Head Injury Burden in a Major Referral Hospital Emergency Centre in Botswana. African Journal of Emergency Medicine, 8, 100-105. https://doi.org/10.1016/j.afjem.2018.02.003
https://www.sciencedirect.com/science/article/pii/S2211419X17300812
[3]  Motsumi, M.J., Mashalla, Y., Sebego, M., Ho-Foster, A., Motshome, P., Mokokwe, L., et al. (2020) Developing a Trauma Registry in a Middle-Income Country—Botswana. African Journal of Emergency Medicine, 10, S29-S37.
https://www.sciencedirect.com/science/article/pii/S2211419X20300641
https://doi.org/10.1016/j.afjem.2020.06.011
[4]  Siamisang, K., Tlhakanelo, J.T. and Mhaladi, B.B. (2020) Emergency Department Waiting Times and Determinants of Prolonged Length of Stay in a Botswana Referral Hospital. Open Journal of Emergency Medicine, 8, 59-70.
https://www.scirp.org/journal/paperinformation.aspx?paperid=101690
https://doi.org/10.4236/ojem.2020.83007
[5]  Hosseininejad, S.M., Aminiahidashti, H., Pashaei, S.M., Khatir, I.G., Montazer, S.H., Bozorgi, F., et al. (2017) Determinants of Prolonged Length of Stay in the Emergency Department; a Cross-Sectional Study. Emergency, 5, e53.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325925
[6]  Statistics Botswana (2021) 2021 Population & Housing Census Project Document.
https://botswana.unfpa.org/sites/default/files/pub-pdf/census_project_document_-_2021_population_and_housing_census.pdf
[7]  Chandra, A., Mullan, P., Ho-foster, A., Langeveldt, A., Caruso, N., Motsumi, J., et al. (2014) Epidemiology of Patients Presenting to the Emergency Centre of Princess Marina Hospital in Gaborone. African Journal of Emergency Medicine, 4, 109-114.
https://www.sciencedirect.com/science/article/pii/S2211419X14000305
https://doi.org/10.1016/j.afjem.2013.12.004
[8]  Mullan, P.C., Torrey, S.B., Chandra, A., Caruso, N. and Kestler, A. (2014) Reduced Overtriage and Undertriage with a New Triage System in an Urban Accident and Emergency Department in Botswana: A Cohort Study. Emergency Medicine Journal, 31, 356-360. https://doi.org/10.1136/emermed-2012-201900
https://www.researchgate.net/publication/235620465_Reduced_overtriage_and_undertriage_with_a_new_triage_system_in_an_urban_accident_and_emergency_department_in_Botswana_A_cohort_study
[9]  Dalwai, M.K., Twomey, M., Maikere, J., Said, S., Wakeel, M., Jemmy, J.P., et al. (2014) Reliability and Accuracy of the South African Triage Scale When Used by Nurses in the Emergency Department of Timergara Hospital, Pakistan. South African Medicine Journal, 104, 372-375. https://doi.org/10.7196/SAMJ.7604
[10]  Meyer, G.D., Meyer, T.N. and Gaunt, C.B. (2018) Validity of the South African Triage Scale in a Rural District Hospital. African Journal of Emergency Medicine, 8, 145-149. https://www.sciencedirect.com/science/article/pii/S2211419X17302148
https://doi.org/10.1016/j.afjem.2018.07.004
[11]  Tshitenge, S.T., Ogunbanjo, G.A. and Mbuka, D.O. (2016) The Effectiveness of the South African Triage Toll Use in Mahalapye District Hospital—Emergency Department, Botswana. African Journal of Primary Healthcare, 8, e1-e5.
https://doi.org/10.4102/phcfm.v8i1.1030
[12]  Rosedale, K., Smith, Z.A., Davies, H. and Wood, D. (2011) The Effectiveness of the South African Triage Score (SATS) in a Rural Emergency Department. South African Medical Journal, 101, 537-540.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992184
[13]  Rominski, S., Bell, S.A., Oduro, G., Ampong, P., Oteng, R. and Donkor, P. (2014) The Implementation of the South African Triage Score (SATS) in an Urban Teaching Hospital, Ghana. African Journal of Emergency Medicine, 4, 71-75.
https://www.sciencedirect.com/science/article/pii/S2211419X14000020
https://doi.org/10.1016/j.afjem.2013.11.001
[14]  Cooke, M.W., Wilson, S. and Pearson, S. (2002) The Effect of a Separate Stream for Minor Injuries on Accident and Emergency Department Waiting Times. Emergency Medicine Journal, 19, 28-30. https://doi.org/10.1136/emj.19.1.28
https://emj.bmj.com/content/emermed/19/1/28.full.pdf
[15]  Horwitz, L.I., Green, J. and Bradley, E. (2010) US Emergency Department Performance on Wait Time and Length of Visit. Annals of Emergency Medicine, 55, 133-141. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2830619
https://doi.org/10.1016/j.annemergmed.2009.07.023
[16]  Daniels, J., Zweigenthal, V. and Reagon, G. (2017) Assessing the Impact of a Waiting Time Survey on Reducing Waiting Times in Urban Primary Care Clinics in Cape Town, South Africa. Journal of Public Health Africa, 8, 98-102.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708303
https://doi.org/10.4081/jphia.2017.639
[17]  Nkomazana, O., Mash, R., Shaibu, S. and Phaladze, N. (2015) Stakeholders’ Perceptions on Shortage of Healthcare Workers in Primary Healthcare in Botswana: Focus Group Discussions. PLoS ONE, 10, e0135846.
https://doi.org/10.1371/journal.pone.0135846
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0135846
[18]  Nkomazana, O., Peersman, W., Willcox, M., Mash, R. and Phaladze, N. (2014) Human Resources for Health in Botswana: The Results of In-Country Database and Reports Analysis. African Journal of Primary Health Care, 6, a716.
http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362014000100042&lng=en&tlng=en
https://doi.org/10.4102/phcfm.v6i1.716
[19]  Driesen, B.E.J.M., Van Riet, B.H.G., Verkerk, L., Bonjer, H.J., Merten, H. and Nanayakkara, P.W.B. (2018) Long Length of Stay at the Emergency Department Is Mostly Caused by Organisational Factors outside the Influence of the Emergency Department: A Root Cause Analysis. PLoS ONE, 13, e0202751.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202751
https://doi.org/10.1371/journal.pone.0202751
[20]  Sacks, E., Morrow, M., Story, W.T., Shelley, K.D., Shanklin, D., Rahimtoola, M., et al. (2019) Beyond the Building Blocks: Integrating Community Roles into Health Systems Frameworks to Achieve Health for All. British Medical Journal Global Health, 3, e001384.
https://gh.bmj.com/content/bmjgh/3/Suppl_3/e001384.full.pdf
https://doi.org/10.1136/bmjgh-2018-001384
[21]  Mashao, K., Heyns, T. and White, Z. (2021) Areas of Delay Related to Prolonged Length of Stay in an Emergency Department of an Academic Hospital in South Africa. African Journal of Emergency Medicine, 11, 237-241.
https://www.sciencedirect.com/science/article/pii/S2211419X21000124
https://doi.org/10.1016/j.afjem.2021.02.002
[22]  Nyce, A., Gandhi, S., Freeze, B., Bosire, J., Ricca, T., Kupersmith, E., et al. (2021) Association of Emergency Department Waiting Times with Patient Experience in Admitted and Discharged Patients. Journal of Patient Experience, 8, 1-7.
https://doi.org/10.1177/23743735211011404
[23]  Guttmann, A., Schull, M.J., Vermeulen, M.J. and Stukel, T.A. (2011) Association between Waiting Times and Short Term Mortality and Hospital Admission after Departure from Emergency Department: Population Based Cohort Study from Ontario, Canada. British Medical Journal, 342, Article No. 7809.
https://www.bmj.com/content/bmj/342/bmj.d2983.full.pdf
https://doi.org/10.1136/bmj.d2983

Full-Text

Contact Us

[email protected]

QQ:3279437679

WhatsApp +8615387084133