Timeliness of Care for Emergency Patients in St Paul General Specialized Hospital, Addis Ababa, Ethiopia

Abstract

Background: The inability to give timely care for emergency patients after they reach healthcare facilities is becoming a growing concern among healthcare institutions, the public and policy makers. Delay in rendering health care to emergency patients is not only about having unsatisfied clients but compromises the quality of care and leading to poor treatment outcome. Time studies are effective methods of identifying specific areas of delays and inefficiencies. Objective: It is to determine the timeliness of care given for emergency patients at the emergency department (ED) of St Paul Hospital after their arrival to the emergency department. It focuses on timeliness to get initial assessment by healthcare provider, time to get investigations ordered and done, and total length of stay before discharge, admission or referral. Methods: A cross-sectional study was conducted from November 13 - 24, 2009 where 315 patients who got care in the emergency department of St Paul Hospital during the study period were observed and tracked throughout their stay in the emergency department using systematic random sampling by predetermined random time points. Results: The median time from arrival to triage assessment was 23 minutes and the median duration from arrival to evaluation by a physician was 54minutes. The median duration from triage to initiation of treatment was 25 minutes and the duration from order of laboratory to arrival of result was a median of 2.08hrs and was 4.16hrs for radiologic investigations. The total length of stay in the ED for all categories of patients was a median of 4hrs with a median duration of 3hrs, 7hrs and 39min, for discharged cases (85.1%), admitted cases (9.8%) and cases referred to other facility (3.8%) respectively. Four (1.3%) cases that died stayed for mean duration of 23hrs. Conclusion: The median time interval from arrival to triage assessment was fairly short but the findings show a relatively prolonged time interval from arrival to evaluation by a physician. There was a prolonged total length of stay in the ED for admitted cases. The median time interval from order of laboratory and radiologic investigations to arrival of result was long and those patients who stayed longer due to delay in investigations were more likely found to be unsatisfied