Providing emergency care and assessing a patient triage system in a referral hospital in Somaliland: a cross-sectional study

Hdl Handle:
http://hdl.handle.net/10144/336636
Title:
Providing emergency care and assessing a patient triage system in a referral hospital in Somaliland: a cross-sectional study
Authors:
Sunyoto, T; Van den Bergh, R; Valles, P; Gutierrez, R; Ayada, L; Zachariah, R; Yassin, A; Hinderaker, S; Harries, A D
Journal:
BMC Health Services Research
Abstract:
BackgroundIn resource-poor settings, where health systems are frequently stretched to their capacity, access to emergency care is often limited. Triage systems have been proposed as a tool to ensure efficiency and optimal use of emergency resources in such contexts. However, evidence on the practice of emergency care and the implementation of triage systems in such settings, is scarce. This study aimed to assess emergency care provision in the Burao district hospital in Somaliland, including the application of the South African Triage Scale (SATS) tool.MethodsA cross-sectional descriptive study was undertaken. Routine programme data of all patients presenting at the Emergency Department (ED) of Burao Hospital during its first year of service (January to December 2012) were analysed. The American College of Surgeons Committee on Trauma (ACSCOT) indicators were used as SATS targets for high priority emergency cases (¿high acuity¿ proportion), overtriage and undertriage (with thresholds of >25%, <50% and <10%, respectively).ResultsIn 2012, among 7212 patients presented to the ED, 41% were female, and 18% were aged less than five. Only 21% of these patients sought care at the ED within 24 hours of developing symptoms. The high acuity proportion was 22.3%, while the overtriage (40%) and undertriage (9%) rates were below the pre-set thresholds. The overall mortality rate was 1.3% and the abandon rate 2.0%. The outcomes of patients corresponds well with the color code assigned using SATS.ConclusionThis is the first study assessing the implementation of SATS in a post-conflict and resource-limited African setting showing that most indicators met the expected standards. In particular, specific attention is needed to improve the relatively low rate of true emergency cases, delays in patient presentation and in timely provision of care within the ED. This study also highlights the need for development of emergency care thresholds that are more adapted to resource-poor contexts. These issues are discussed.
Issue Date:
6-Nov-2014
URI:
http://hdl.handle.net/10144/336636
DOI:
10.1186/s12913-014-0531-3
PubMed ID:
25373769
Language:
en
ISSN:
1472-6963
Appears in Collections:
Operational Research Courses

Full metadata record

DC FieldValue Language
dc.contributor.authorSunyoto, Ten_GB
dc.contributor.authorVan den Bergh, Ren_GB
dc.contributor.authorValles, Pen_GB
dc.contributor.authorGutierrez, Ren_GB
dc.contributor.authorAyada, Len_GB
dc.contributor.authorZachariah, Ren_GB
dc.contributor.authorYassin, Aen_GB
dc.contributor.authorHinderaker, Sen_GB
dc.contributor.authorHarries, A Den_GB
dc.date.accessioned2014-12-04T16:00:58Z-
dc.date.available2014-12-04T16:00:58Z-
dc.date.issued2014-11-06-
dc.identifier.citationProviding emergency care and assessing a patient triage system in a referral hospital in Somaliland: a cross-sectional study. 2014, 14 (1):531 BMC Health Serv Resen_GB
dc.identifier.issn1472-6963-
dc.identifier.pmid25373769-
dc.identifier.doi10.1186/s12913-014-0531-3-
dc.identifier.urihttp://hdl.handle.net/10144/336636-
dc.description.abstractBackgroundIn resource-poor settings, where health systems are frequently stretched to their capacity, access to emergency care is often limited. Triage systems have been proposed as a tool to ensure efficiency and optimal use of emergency resources in such contexts. However, evidence on the practice of emergency care and the implementation of triage systems in such settings, is scarce. This study aimed to assess emergency care provision in the Burao district hospital in Somaliland, including the application of the South African Triage Scale (SATS) tool.MethodsA cross-sectional descriptive study was undertaken. Routine programme data of all patients presenting at the Emergency Department (ED) of Burao Hospital during its first year of service (January to December 2012) were analysed. The American College of Surgeons Committee on Trauma (ACSCOT) indicators were used as SATS targets for high priority emergency cases (¿high acuity¿ proportion), overtriage and undertriage (with thresholds of >25%, <50% and <10%, respectively).ResultsIn 2012, among 7212 patients presented to the ED, 41% were female, and 18% were aged less than five. Only 21% of these patients sought care at the ED within 24 hours of developing symptoms. The high acuity proportion was 22.3%, while the overtriage (40%) and undertriage (9%) rates were below the pre-set thresholds. The overall mortality rate was 1.3% and the abandon rate 2.0%. The outcomes of patients corresponds well with the color code assigned using SATS.ConclusionThis is the first study assessing the implementation of SATS in a post-conflict and resource-limited African setting showing that most indicators met the expected standards. In particular, specific attention is needed to improve the relatively low rate of true emergency cases, delays in patient presentation and in timely provision of care within the ED. This study also highlights the need for development of emergency care thresholds that are more adapted to resource-poor contexts. These issues are discussed.en_GB
dc.languageENG-
dc.language.isoenen
dc.rightsArchived with thanks to BMC Health Services Researchen_GB
dc.titleProviding emergency care and assessing a patient triage system in a referral hospital in Somaliland: a cross-sectional studyen
dc.identifier.journalBMC Health Services Researchen_GB

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