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Adewole JA, Tumbo JM, Okonta HI. Emergency care visits at a South African hospital: Implications for healthcare services and policy. S Afr Fam Pract (2004) 2024; 66:e1-e6. [PMID: 38572872 PMCID: PMC11019032 DOI: 10.4102/safp.v66i1.5816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/23/2023] [Accepted: 11/25/2023] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND A robust knowledge on the pattern of use of emergency care resources not only serves as an indicator of universal access to care but also provides a basis for quality improvement within the health system. This study was undertaken to describe the pattern of emergency room visits at Brits District Hospital (BDH) in North West province, South Africa. The objectives of this study were to determine the sociodemographic characteristics of emergency department (ED) users and other patterns of ED use. METHODS This was a cross-sectional descriptive study that was conducted at a district hospital. All patients who reported for emergency care in the ED in 2016 were eligible for the study. Data were extracted and analysed from a systematic sample of 355 clinical notes and hospital administrative records. RESULTS The age group that visited the ED most frequently (25.3%) was 25-34 years old. A high proportion of the ED users (60%) were self-referred, and only 38% were transported by the emergency medical response services (EMRS). Few (5.6%) presentations were of a non-urgent nature. Trauma-related conditions accounted for the most frequent presentation at the ED (36.5%). CONCLUSION Although most ED users were self-referred, their clinical presentations were appropriate and underscore the need for policy strategies to reduce the burden of trauma in the catchment populationContribution: The study findings may have an impact on future health policies by providing decision-makers with baseline information on the pattern of use of ED resources, ensuring better resource deployment and greater access to care.
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Affiliation(s)
- Jacob A Adewole
- Department of Family Medicine and Primary Health Care, Faculty of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa; and, Brits District Hospital, Bojanala District, Rustenburg.
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Kalan L, Chahine RA, Lasfer C. The Effectiveness and Relevance of the Canadian Triage System at Times of Overcrowding in the Emergency Department of a Private Tertiary Hospital: A United Arab Emirates (UAE) Study. Cureus 2024; 16:e52921. [PMID: 38406095 PMCID: PMC10894025 DOI: 10.7759/cureus.52921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
OBJECTIVE A systematic and straightforward triage system is crucial for the proper and timely care of patients within the emergency department (ED). This study unfolds a detailed understanding of the impact of the Canadian Triage and Acuity Scale (CTAS) on patient care and resource allocation in a private tertiary hospital. To the best of our knowledge, this is the only article studying the impact of the CTAS in one of the private hospitals in the United Arab Emirates (UAE) to achieve triage optimisation strategies. There is scope for further research in both public and private hospitals in the UAE. A triage system not only helps healthcare professionals prioritise cases conveniently but also guides patients to the most suitable area for a consultation. As a general rule, EDs follow an algorithm for the purpose of triage, and the aim of our study is to assess one such five-level triage system, CTAS, for its effectiveness and relevance during overcrowding in a UAE ED. METHOD Within a period of approximately three weeks, a total of 351 CTAS-triaged patients were included in a prospective observational study during peak hours (17:00-22:00) of an ED in the UAE. The CTAS app was used as the triage tool to assess relevance, in terms of patient waiting times, resource allocation, and urgency level distribution, to the Canadian scale. All patients presenting to the ED were included with no exclusion criteria. The relationship between urgency level, duration of visit, and resources used was assessed, and the department's triage results were compared with those of the CTAS app. RESULTS Our sample showed a female (187; 53.3%) and adult preponderance (215; 61.3%) with most of the adult patients aged between 30 and 40 (96; 44.65%). 41.5% (145) of the triage was mismatched between the department and the CTAS app with 115 (79.3%) cases of under-triaging and 30 (20.7%) cases of over-triaging. There was a statistically significant difference (p=0.004) between average waiting times across triage categories 4 and 5 with the former category patients waiting for a longer period of time. Cohen's kappa showed moderate inter-relatability (k=0.42). The average utilisation costs per triage category showed a positive correlation with the urgency level for CTAS (Pearson's r=0.59); however, the costs declined as the urgency level rose for the department. CONCLUSIONS The high compliance rate demonstrates that the CTAS can be applicable to institutions outside of Canada. The categorisation of patients by the CTAS and their resource allocation were more accurate than the standard triage proving its effectiveness as a triage tool. Lack of synchronisation among the triage nurses and inadequate triage training are the most plausible reasons for this comparison. The recommended "time to be seen by a physician" was achievable in our ED, and that, along with the expected relationship between CTAS and resource utilisation, can be seen as valid indicators for a quality triage system for use in the UAE.
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Affiliation(s)
- Laila Kalan
- Trauma and Orthopaedics, University Hospitals Birmingham National Health Service (NHS) Foundation Trust, Birmingham, GBR
| | - Racha A Chahine
- Quality and Risk Management, Fakeeh University Hospital, Dubai, ARE
| | - Chafika Lasfer
- Emergency Medicine, Fakeeh University Hospital, Dubai, ARE
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Kim SW, Kim YW, Min YH, Lee KJ, Choi HJ, Kim DW, Jo YH, Lee DK. Development and Validation of Simple Age-Adjusted Objectified Korean Triage and Acuity Scale for Adult Patients Visiting the Emergency Department. Yonsei Med J 2022; 63:272-281. [PMID: 35184430 PMCID: PMC8860940 DOI: 10.3349/ymj.2022.63.3.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The study aimed to develop an objectified Korean Triage and Acuity Scale (OTAS) that can objectively and quickly classify severity, as well as a simple age-adjusted OTAS (S-OTAS) that reflects age and evaluate its usefulness. MATERIALS AND METHODS A retrospective analysis was performed of all adult patients who had visited the emergency department at three teaching hospitals. Sex, systolic blood pressure, diastolic blood pressure, pulse rate, respiratory rate, body temperature, O2 saturation, and consciousness level were collected from medical records. The OTAS was developed with objective criterion and minimal OTAS level, and S-OTAS was developed by adding the age variable. For usefulness evaluation, the 30-day mortality, the rates of computed tomography scan and emergency procedures were compared between Korean Triage and Acuity Scale (KTAS) and OTAS. RESULTS A total of 44402 patients were analyzed. For 30-day mortality, S-OTAS showed a higher area under the curve (AUC) compared to KTAS (0.751 vs. 0.812 for KTAS and S-OTAS, respectively, p<0.001). Regarding the rates of emergency procedures, AUC was significantly higher in S-OTAS, compared to KTAS (0.807 vs. 0.830, for KTAS and S-OTAS, respectively, p=0.013). CONCLUSION S-OTAS showed comparative usefulness for adult patients visiting the emergency department as a triage tool compared to KTAS.
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Affiliation(s)
- Seung Wook Kim
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yong Won Kim
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Yong Hun Min
- Department of Emergency Medicine, Pohang St. Mary's Hospital, Pohang, Korea
| | - Kui Ja Lee
- Department of Emergency Medical Services, Kyungdong University, Wonju, Korea
| | - Hyo Ju Choi
- Department of Emergency Medical Services, Kyungdong University, Wonju, Korea
| | - Dong Won Kim
- Department of Emergency Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
| | - You Hwan Jo
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Keon Lee
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
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Alfaleh A, Alkattan A, Alageel A, Salah M, Almutairi M, Sagor K, Alabdulkareem K. The role of telemedicine services in changing users’ intentions for presenting to the emergency departments in Saudi Arabia. Digit Health 2022; 8:20552076221091358. [PMID: 35694122 PMCID: PMC9185009 DOI: 10.1177/20552076221091358] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background Emergency department (ED) overcrowding is described as one of the main issues
in any hospital. In Saudi Arabia, the ministry of health applied new
telemedicine technology to serve patients by using the mobile application,
including the Sehha application and 937 medical call center. The main aim of
this study is to determine the role of different telemedicine services in
changing the intention users’ intentions for visiting the emergency
departments in Saudi Arabia. Methods A cross-sectional study was conducted during August 2020 to May 2021 among
319 patients using two telemedicine services in Saudi Arabia, including the
medical call center and Sehha smartphone application. The primary endpoint
of this study was to determine the number of patients intended to visit ER
before and after contacting one of the two telemedicine services and the
frequency of people who changed their opinion to visit an ED. Results This study analyzed the data from 319 patients who completed the survey
provided by the Saudi Ministry of Health concerning information related to
their health status and ED visits. Among patients that had the intention to
visit the ED (N = 159), 53 of them did not go to EDs after
using telemedicine services (p < 0.01). Regarding the
medical call center and Sehha application, 9.6% and 24.4%, respectively, of
the patients who used these telemedicine services changed their minds
concerning visiting ED after taking the medical advice
(p < 0.01). Conclusions The implemented telemedicine services in Saudi Arabia, namely the Sehha
application and medical call center, could reduce those intended to visit ED
and consequently reduce the overload of EDs by providing medical advice to
patients concerning their minor medical issues.
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Affiliation(s)
- Amjad Alfaleh
- Department of Research and Development, General Directorate of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia
- General Director Office, General Directorate of School Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Alkattan
- Department of Research and Development, General Directorate of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia
| | - Alaa Alageel
- Department of Research and Development, General Directorate of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia
| | - Mohammed Salah
- Department of Health Statistics, General Directorate of Primary Health Centers, Ministry of Health, Riyadh, Saudi Arabia
| | - Mona Almutairi
- Department of Research and Development, General Directorate of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia
| | - Khlood Sagor
- Department of Research and Development, General Directorate of Medical Consultations, Ministry of Health, Riyadh, Saudi Arabia
| | - Khaled Alabdulkareem
- Research Department, Assistant Deputy Minister for Primary Healthcare, Ministry of Health, Riyadh, Saudi Arabia
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Jabour AM, Dixon BE, Jones JF, Haggstrom DA. Toward Timely Data for Cancer Research: Assessment and Reengineering of the Cancer Reporting Process. JMIR Cancer 2018; 4:e4. [PMID: 29496653 PMCID: PMC5856936 DOI: 10.2196/cancer.7515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 07/30/2017] [Accepted: 11/24/2017] [Indexed: 12/17/2022] Open
Abstract
Background Cancer registries systematically collect cancer-related data to support cancer surveillance activities. However, cancer data are often unavailable for months to years after diagnosis, limiting its utility. Objective The objective of this study was to identify the barriers to rapid cancer reporting and identify ways to shorten the turnaround time. Methods Certified cancer registrars reporting to the Indiana State Department of Health cancer registry participated in a semistructured interview. Registrars were asked to describe the reporting process, estimate the duration of each step, and identify any barriers that may impact the reporting speed. Qualitative data analysis was performed with the intent of generating recommendations for workflow redesign. The existing and redesigned workflows were simulated for comparison. Results Barriers to rapid reporting included access to medical records from multiple facilities and the waiting period from diagnosis to treatment. The redesigned workflow focused on facilitating data sharing between registrars and applying a more efficient queuing technique while registrars await the delivery of treatment. The simulation results demonstrated that our recommendations to reduce the waiting period and share information could potentially improve the average reporting speed by 87 days. Conclusions Knowing the time elapsing at each step within the reporting process helps in prioritizing the needs and estimating the impact of future interventions. Where some previous studies focused on automating some of the cancer reporting activities, we anticipate much shorter reporting by leveraging health information technologies to target this waiting period.
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Affiliation(s)
- Abdulrahman M Jabour
- Health Informatics Department, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia.,Department of BioHealth Informatics, School of Informatics and Computing, Indiana University & Purdue University Indianapolis, Indianapolis, IN, United States
| | - Brian E Dixon
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, United States.,Department of Epidemiology, Richard M Fairbanks School of Public Health, Indiana University, Indianapolis, IN, United States.,Health Services Research and Development Center for Health Information and Communication, Roudebush Veterans Affairs Medical Center, Indianapolis, IN, United States
| | - Josette F Jones
- Department of BioHealth Informatics, School of Informatics and Computing, Indiana University & Purdue University Indianapolis, Indianapolis, IN, United States
| | - David A Haggstrom
- Health Services Research and Development Center for Health Information and Communication, Roudebush Veterans Affairs Medical Center, Indianapolis, IN, United States.,Division of General Internal Medicine, Department of Medicine, Indiana University, Indianapolis, IN, United States.,Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, United States
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Urgent Care Centre's: "Urgent Need of the Hour?". Indian J Pediatr 2017; 84:774-776. [PMID: 28868584 DOI: 10.1007/s12098-017-2458-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/09/2017] [Indexed: 10/18/2022]
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