Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
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, con- ducted 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 the EC workforce and to add discharge lounges and examination tables.
Description
CITATION: Van De Ruit, C., Lahri, S. & Wallis, L. A. 2020. Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa. African Journal of Emergency Medicine, 10(2):52-57, doi:10.1016/j.afjem.2019.12.004.
The original publication is available at https://www.sciencedirect.com/journal/african-journal-of-emergency-medicine
The original publication is available at https://www.sciencedirect.com/journal/african-journal-of-emergency-medicine
Keywords
Hospitals -- Emergency services -- Utilization -- Cape Town (South Africa), Emergency health services -- Cape Town (South Africa), Medical care -- Utilization -- Cape Town (South Africa)
Citation
Van De Ruit, C., Lahri, S. & Wallis, L. A. 2020. Clinical teams' experiences of crowding in public emergency centres in Cape Town, South Africa. African Journal of Emergency Medicine, 10(2):52-57, doi:10.1016/j.afjem.2019.12.004