Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa
Introduction: Crowding is a significant challenge for emergency centres (ECs) globally. While South Africa is not alone in reckoning with high patient demand and insufficient resources to treat these patients; staff-to-patient ratios are generally lower than in the Global North. The study of crowdin...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-06-01
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| Series: | African Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211419X19301648 |
| _version_ | 1828901258803544064 |
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| author | Catherine van de Ruit Sa'ad Lahri Lee A. Wallis |
| author_facet | Catherine van de Ruit Sa'ad Lahri Lee A. Wallis |
| author_sort | Catherine van de Ruit |
| collection | DOAJ |
| description | Introduction: Crowding is a significant challenge for emergency centres (ECs) globally. While South Africa is not alone in reckoning with high patient demand and insufficient resources to treat these patients; staff-to-patient ratios are generally lower than in the Global North. The study of crowding and its consequences for patient care is a key research priority for strengthening the quality and efficacy of emergency care in South Africa. The study set out to understand frontline staff's perspectives on crowding in Cape Town public ECs to learn how they cope in such high- pressure working conditions, determine what they see as the factors contributing to crowding, and obtain their recommendations for reform. Methods: This research is a qualitative study from interviews and observations at five ECs in Cape Town, conducted in June and July 2017. In total 43 staff were interviewed individually or in pairs. The interviews included physicians of varying levels of experience (25), and registered or enrolled nurses (18). Data were analysed with the qualitative text-analysis software NVivo. Results: Both doctors and nurses saw crowding as a consequence of three factors: 1) limited bed space in the EC, 2) insufficient health professionals to care for admitted patients, and 3) the presence of boarders. Systemic or organizational factors as well as human resource scarcity were determined to be the key reasons for crowding. Discussion: With its high patient acuity and volume and its limited human and material resources, South Africa is an important case study for understanding how emergency care providers manage working in crowded conditions. The solutions to crowding recommended by interviewees were to expand the EC workforce and to add discharge lounges and examination tables. |
| first_indexed | 2024-12-13T15:58:38Z |
| format | Article |
| id | doaj.art-9c2f500e4a1143f7a0e1c4e1c0208740 |
| institution | Directory Open Access Journal |
| issn | 2211-419X |
| language | English |
| last_indexed | 2024-12-13T15:58:38Z |
| publishDate | 2020-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | African Journal of Emergency Medicine |
| spelling | doaj.art-9c2f500e4a1143f7a0e1c4e1c02087402022-12-21T23:39:15ZengElsevierAfrican Journal of Emergency Medicine2211-419X2020-06-011025257Clinical teams' experiences of crowding in public emergency centres in Cape Town, South AfricaCatherine van de Ruit0Sa'ad Lahri1Lee A. Wallis2Health and Exercise Physiology, Ursinus College, 601 E Main Street, Collegeville, PA 19426, United States; Corresponding author.Emergency Centre, Khayelitsha Hospital, Cape Town, South AfricaDivision of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South AfricaIntroduction: Crowding is a significant challenge for emergency centres (ECs) globally. While South Africa is not alone in reckoning with high patient demand and insufficient resources to treat these patients; staff-to-patient ratios are generally lower than in the Global North. The study of crowding and its consequences for patient care is a key research priority for strengthening the quality and efficacy of emergency care in South Africa. The study set out to understand frontline staff's perspectives on crowding in Cape Town public ECs to learn how they cope in such high- pressure working conditions, determine what they see as the factors contributing to crowding, and obtain their recommendations for reform. Methods: This research is a qualitative study from interviews and observations at five ECs in Cape Town, conducted in June and July 2017. In total 43 staff were interviewed individually or in pairs. The interviews included physicians of varying levels of experience (25), and registered or enrolled nurses (18). Data were analysed with the qualitative text-analysis software NVivo. Results: Both doctors and nurses saw crowding as a consequence of three factors: 1) limited bed space in the EC, 2) insufficient health professionals to care for admitted patients, and 3) the presence of boarders. Systemic or organizational factors as well as human resource scarcity were determined to be the key reasons for crowding. Discussion: With its high patient acuity and volume and its limited human and material resources, South Africa is an important case study for understanding how emergency care providers manage working in crowded conditions. The solutions to crowding recommended by interviewees were to expand the EC workforce and to add discharge lounges and examination tables.http://www.sciencedirect.com/science/article/pii/S2211419X19301648Qualitative researchEmergency careSouth Africa |
| spellingShingle | Catherine van de Ruit Sa'ad Lahri Lee A. Wallis Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa African Journal of Emergency Medicine Qualitative research Emergency care South Africa |
| title | Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa |
| title_full | Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa |
| title_fullStr | Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa |
| title_full_unstemmed | Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa |
| title_short | Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa |
| title_sort | clinical teams experiences of crowding in public emergency centres in cape town south africa |
| topic | Qualitative research Emergency care South Africa |
| url | http://www.sciencedirect.com/science/article/pii/S2211419X19301648 |
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