scholarly journals Patients’ perceptions of the triage system in a primary healthcare facility, Cape Town, South Africa

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Adeloye A. Adeniji ◽  
Bob Mash
Keyword(s):  
Primary Care ◽  
Health Centre ◽  
Care Facility ◽  
Healthcare Facility ◽  
Support Staff ◽  
Patient Acceptance ◽  
Public Healthcare ◽  
Triage Nurse ◽  
Triage System ◽  
Healthcare Facilities

Background: In public healthcare facilities, where the patient numbers and the available resources are often disproportionate, triage is used to prioritise when patients are seen. Patients may not understand the triage process and have strong views on how to improve their experience.Aim: This study explored the views of patients who had undergone triage in the emergency centre of a primary care facility. Setting: Gugulethu Community Health Centre, Cape Town.Methods: A purposive sample consisted of five women (one coded green, three orange, one yellow) and four men (one coded green and three yellow). A semi-structured qualitative interview was conducted in either Xhosa or English and the transcripts analysed using the framework method.Results: All of the respondents complained of a lack of information and poor understanding of the triage process. Those coded green experienced the process as biased and unfair and reported that the triage nurse was rude and unprofessional. By contrast, those coded yellow or orange found the triage nurse to be helpful and professional. Most patients turned to support staff (e.g. security staff or cleaners) for assistance in dealing with the triage system. Most patients waited longer than the guidelines recommend and the green-coded patients complained about this issue.Conclusion: Patients did not have a good experience of the triage system. Managers of the triage system need to design better strategies to improve patient acceptance and share information. The important role of support staff needs to be recognised and strengthened.Keywords: emergency care; primary care; triage; patient satisfaction

scholarly journals Publicly funded interfacility ambulance transfers for surgical and obstetrical conditions: A cross sectional analysis in an urban middle-income country setting

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241553
Author(s):  
Paul Truche ◽  
Rachel E. NeMoyer ◽  
Sara Patiño-Franco ◽  
Juan P. Herrera-Escobar ◽  
Myerlandi Torres ◽  
...  
Keyword(s):  
Surgical Care ◽  
Healthcare Facility ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Publicly Funded ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Timely Access ◽  
Surgical Conditions

Introduction Interfacility transfers may reflect a time delay of definitive surgical care, but few studies have examined the prevalence of interfacility transfers in the urban low- and middle-income (LMIC) setting. The aim of this study was to determine the number of interfacility transfers required for surgical and obstetric conditions in an urban MIC setting to better understand access to definitive surgical care among LMIC patients. Methods A retrospective analysis of public interfacility transfer records was conducted from April 2015 to April 2016 in Cali, Colombia. Data were obtained from the single municipal ambulance agency providing publicly funded ambulance transfers in the city. Interfacility transfers were defined as any patient transfer between two healthcare facilities. We identified the number of transfers for patients with surgical conditions and categorized transfers based on patient ICD-9-CM codes. We compared surgical transfers from public vs. private healthcare facilities by condition type (surgical, obstetric, nonsurgical), transferring physician specialty, and transfer acuity (code blue, emergent, urgent and nonurgent) using logistic regression. Results 31,659 patient transports occurred over the 13-month study period. 22250 (70.2%) of all transfers were interfacility transfers and 7777 (35%) of transfers were for patients with surgical conditions with an additional 2,244 (10.3%) for obstetric conditions. 49% (8660/17675) of interfacility transfers from public hospitals were for surgical and obstetric conditions vs 32% (1466/4580) for private facilities (P<0.001). The most common surgical conditions requiring interfacility transfer were fractures (1,227, 5.4%), appendicitis (913, 4.1%), wounds (871, 3.9%), abdominal pain (818, 3.6%), trauma (652, 2.9%), and acute abdomen (271, 1.2%). Conclusion Surgical and obstetric conditions account for nearly half of all urban interfacility ambulance transfers. The most common reasons for transfer are basic surgical conditions with public healthcare facilities transferring a greater proportion of patient with surgical conditions than private facilities. Timely access to an initial healthcare facility may not be a reliable surrogate of definitive surgical care given the substantial need for interfacility transfers.

scholarly journals Strategizing Public Sector Hospitals In Megacity Karachi: A Case Study On Gender Based Healthcare Facility Selection Criteria And Concerns (From Demand And Supply Perspective)

2019 ◽  
Vol 19 (1) ◽  
pp. 179-196
Author(s):  
Shamaila Burney ◽  
Khalid Mahmood Iraqi
Keyword(s):  
Public Sector ◽  
Selection Criteria ◽  
Healthcare Facility ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Demand And Supply ◽  
Healthcare Facilities ◽  
The Public

Karachi is the most populous city in Pakistan and it plays an important role in urban demography of Pakistan. It is growing rapidly, as every fifth urban citizen lives here. This urbanization creates serious challenges for all sectors of Karachi. Especially the health sector, from demand and supply view point is facing serious challenges in terms of non-availability of qualified doctors, specifically female doctors, medicines, latest equipment, poor infrastructure, and patient’s queues belonging to other rural areas because of the lack of quality healthcare facilities, makes the public hospitals crowded and overburdened. Like all over Pakistan, public sector hospitals are very much neglected in Karachi also and needs special consideration. The focus should be on developing patient oriented supply chains for efficient patient’s care and healthcare facilities. Moreover, the case study of Qatar hospital a part of our basic research study also highlighted the depriving condition for women patients’ in Emergency Department, because only male doctors are there but female doctors are not available. Although we observed that the gender wise daily patient flow was consist of 65% females, whereas only 35% male patients. The study suggests that there is an urgent need of women doctors and paramedics staff in the public sector hospitals of suburbs of Karachi. This paper presents a synoptic view of concerns of the residents of Karachi, and identification of their selection criteria of health care facilities. The study also aimed to provide solutions and recommendations for the improvement of these facilities. Cross sectional questionnaire and random sampling with two stage clusters sampling was used to record the responses of 1991 households, 46% respondents were female and 54% were male. Among the total of 11127 respondents, only 580, (5.2 %) sought treatment in public health hospitals and, 2440 (21.9 %) visited private hospitals. Research results shows that Cost is the only significant factor because of which people opt for treatment at public healthcare facility.

scholarly journals The experience, results, and possible perspectives of organizing the optimally accessible primary medical care for the rural population of Zaporizhzhia region

2021 ◽  
Vol 14 (3) ◽  
pp. 369-373
Author(s):  
O. H. Aleksieiev ◽  
V. V. Taranov ◽  
V. P. Petrykhin
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Rural Population ◽  
Healthcare Facility ◽  
Service Area ◽  
Healthcare Facilities ◽  
Care Facilities

Nowadays, the assessment of the activity of the domestic healthcare system is an important and actual issue, especially against the background the active reformation of this industry. One of the important elements of the assessment is studying the availability of primary healthcare to the rural population. The aim of this work is to study the territorial accessibility of primary healthcare, the adequacy and effectiveness of the principles of forming a network of primary care facilities in the rural areas of Zaporizhzhia region that enables to address issues and optimize the location of primary care facilities in the rural areas. Materials and methods. The materials of the research were the data of the official statistical reports for the past 20 years, which characterize the state of health and the degree of medical care accessibility to the rural population. During the research, the technique of complex social and hygienic research was applied, with the use of historical, sociological, sanitary and statistical methods, organizational experiment and others. Results. The article presents the main results of studying the current state of primary healthcare organization for the rural population of Zaporіzhzhia region against the background of active reforming processes. According to the research results, the main elements forming the system of accessibility are territorial, medical, social and economic. The main factors of impact on territorial accessibility are identified. These are: the nature of the settlement of rural residents (density, compactness, service-area radius, the proportion of the rural population, the distance between villages, the distance from a household to a healthcare facility); quality of roads; transport connections between settlements and healthcare facilities; availability of communication means. Conclusions. As a result of the research, the following conclusions were drawn. Such factors as population density, compactness of its location, service-area radius, distance between villages, distance from a household to a healthcare facility, condition and quality of roads, transport connections between settlements and healthcare facilities are important during forming or improving the network of healthcare facilities in rural areas. These factors must be considered for the rational placement of primary care facilities in rural areas.  

scholarly journals Supply-Side Barriers to the Use of Public Healthcare Facilities for Childhood Illness Care in Rural Zambia: A Cross-Sectional Study Linking Data from a Healthcare Facility Census to a Household Survey

2021 ◽  
Vol 18 (10) ◽  
pp. 5409
Author(s):  
Keiji Mochida ◽  
Daisuke Nonaka ◽  
Jason Wamulume ◽  
Jun Kobayashi
Keyword(s):  
Human Resources ◽  
Household Survey ◽  
Healthcare Facility ◽  
Cross Sectional Study ◽  
Public Healthcare ◽  
Supply Side ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Rural Zambia ◽  
The Village

Child mortality due to malaria and diarrhea can be reduced if proper treatment is received timely at healthcare facilities, but various factors hinder this. The present study assessed the associations between the use of public healthcare facilities among febrile/diarrheal children in rural Zambia and supply-side factors (i.e., the distance from the village to the nearest facility and the availability of essential human resources and medical equipment at the facility). Data from the Demographic and Health Survey 2018 and the Health Facility Census 2017 were linked. Generalized linear mixed models were used to assess the associations, controlling for clustering and other variables. The median distances to the nearest facility were 4.5 km among 854 febrile children and 4.6 km among 813 diarrheal children. Children who were over 10 km away from the facility were significantly less likely to use it, compared to those within 5 km (fever group: odds ratio (OR) = 0.37, 95% confidence interval (CI) = 0.21–0.68; diarrhea group: OR = 0.32, 95% CI = 0.20–0.50). The availability of human resources and equipment was, however, not significantly associated with facility use. Poor geographic access could be a critical barrier to facility use among children in rural Zambia.

scholarly journals Modeling the impact of hospital logistics on quality of care and patient satisfaction: Results of a survey in three public healthcare facilities in Fez, Morocco

2020 ◽  
Vol 13 (2) ◽  
pp. 296
Author(s):  
Youness Frichi ◽  
Fouad Jawab ◽  
Said Boutahari
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Large Scale ◽  
Scale Validation ◽  
Healthcare Facility ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
The Impact ◽  
Physical Accessibility

Purpose: The objective of this research is to examine the role of hospital logistics in improving quality of care and patient satisfaction. Thus, the paper focuses on modeling and evaluating the relationship between these three constructs.Design/methodology/approach: In the present study, hospital logistics was specified as a second-order construct composed of five first-order constructs: physical accessibility, waiting time, consultation time, hospital hotel services, and administrative procedures. A questionnaire was developed and administered face-to-face to 384 hospitalized patients in three public healthcare facilities in Fez-Morocco. Collected data were processed and analyzed deploying the PLS-SEM method and using SmartPLS3 software. Data analysis was carried out by considering two types of patient circuits according to the admission modes in the healthcare facility: Urgent Patients Circuit and Scheduled Patients Circuit. Thus, two PLS-SEM models were evaluated and validated.Findings: Results highlighted the significant impact of hospital logistics on quality and satisfaction. In particular, the results of the two models showed that the most preponderant hospital logistics component is physical accessibility which consists of the availability and accessibility of ambulances, medical and nursing staff, support and guidance staff, technical facilities and equipment, etc. Thus, hospital managers and health system stakeholders should pay particular attention to hospital logistics activities in general and specifically to the physical accessibility to improve the quality of care and patient satisfaction.Research limitations/implications: This study only included patients from three public healthcare facilities in Fez-Morocco. Also, the model variables of hospital logistics construct are restricted and were applied in a specific context. Besides, the sample size was relatively reduced. Thus, results generalization might be limited. Further studies including more patients from other territories and including other logistics components are needed for large-scale validation of the proposed model. Originality/value: The results of this study contribute to the scientific literature on hospital logistics and its role as a lever for quality of care and patient satisfaction.

Coronavirus Pandemic- The real lessons are learnt in the time of crises

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1011-1014
Author(s):  
Rathi Saurabh D ◽  
Nikhade P ◽  
Motwani N ◽  
Baror S ◽  
Jaiswal A
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Care Facility ◽  
Health Care Facility ◽  
Healthcare Facility ◽  
Control Measures ◽  
Public Health Care ◽  
Standard Equipment ◽  
Healthcare Facilities ◽  
Private Care

The world for every human has changed in the past few months, with one single reason for all- nCOVID-19. Coronavirus had left a significant impact on our life as an individual and as a nation. Every sector in the country is affected, and every situation deemed changed from the previous one. Post-Covid is a new era in itself. This pandemic had helped us to show our inefficiencies in different sectors and profession, including healthcare facilities. Change in the healthcare facility has to be focused. Indian health care facility is based on private care, whereas the pandemic requires public health care approach. The focus needs to be shifted from personal care to community-based care. The annual budget for health welfare is 1-2 per cent of the GDP, which in the future should be increased. More investment, more funds, and more number of doctors can help to combat with such crises efficiently. India has poor infection control standards and policies. Strict infection control measures, standard equipment and training of the paramedics and other healthcare workers are the areas that we can improve. This article highlights the lessons our healthcare facility can learn from this coronavirus pandemic and changes that await for our healthcare system.

scholarly journals Women’s experiences on the use of Implanon as a contraceptive method in a selected primary healthcare facility in KwaZulu-Natal

Curationis ◽  
2021 ◽  
Vol 44 (1) ◽  
Author(s):  
Lucky N. Mgobhozi ◽  
Pretty N. Mbeje ◽  
Gugu G. Mchunu
Keyword(s):  
Side Effects ◽  
Primary Healthcare ◽  
Teenage Pregnancy ◽  
Health Centre ◽  
Healthcare Facility ◽  
Public Healthcare ◽  
Structured Interviews ◽  
Expiry Date ◽  
Kwazulu Natal ◽  
Contraceptive Implant

Background: The South African department of health recently introduced subdermal Implanon contraceptive implant with the aim to reduce teenage pregnancy and maternal mortality. First used in all public healthcare facilities across the country since early 2014, this method of contraception has been described as highly effective. However, some women have reported unbearable side effects, forcing them to remove the contraceptive implant early before its expiry date. Negligible emphasis has been placed on staff training and development to equip the nurses with new protocol and policies on Implanon.Objectives: The objective of this study was to explore experiences of women using Implanon as method of contraception at a selected primary healthcare facility in KwaZulu-Natal province of South Africa.Methods: A qualitative, descriptive and exploratory study design was used. A purposive sampling technique was used and a sample of seven women aged between 15 and 50 years was selected for this study. Semi-structured interviews were used in the data collection process. The Tesch’s method for data coding and data analysis was utilised. Necessary ethical measures were taken to ensure that the study is trustworthy. The study was conducted at Community Health Centre, KwaZulu-Natal between June 2017 and December 2018.Results: The findings showed that some participants were still willing to continue using this method of contraception regardless of the unwanted side effects. Major side effects reported were heavy menstrual bleeding, pain and discomfort, weight loss, insomnia and decreased sexual interest, which resulted in most participants stopping the use of Implanon.Conclusion: Most of the participants’ experience unwanted side effects because of poor screening, counselling and support. There is a clear demand to develop a screening tool and facilitate training of healthcare workers when initiating the use of Implanon.

scholarly journals Lessons for test and treat in an antiretroviral programme after decentralisation in Uganda: a retrospective analysis of outcomes in public healthcare facilities within the Lablite project

2019 ◽  
Vol 12 (5) ◽  
pp. 429-443
Author(s):  
S Kiwuwa-Muyingo ◽  
G Abongomera ◽  
I Mambule ◽  
D Senjovu ◽  
E Katabira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Central Region ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
Test And Treat ◽  
The North ◽  
Art Initiation ◽  
Care Facilities

Abstract Background We describe the decentralisation of antiretroviral therapy (ART) alongside Option B+ roll-out in public healthcare facilities in the Lablite project in Uganda. Lessons learned will inform programmes now implementing universal test and treat (UTT). Methods Routine data were retrospectively extracted from ART registers between October 2012 and March 2015 for all adults and children initiating ART at two primary care facilities (spokes) and their corresponding district hospitals (hubs) in northern and central Uganda. We describe ART initiation over time and retention and use of Cox models to explore risk factors for attrition due to mortality and loss to follow-up. Results from tracing of patients lost to follow-up were used to correct retention estimates. Results Of 2100 ART initiations, 1125 were in the north, including 944 (84%) at the hub and 181 (16%) at the spokes; children comprised 95 (10%) initiations at the hubs and 14 (8%) at the spokes. Corresponding numbers were 642 (66%) at the hub and 333 (34%) at the spokes in the central region (77 [12%] and 22 [7%], respectively, in children). Children &lt;3 y of age comprised the minority of initiations in children at all sites. Twenty-three percent of adult ART initiations at the north hub were Option B+ compared with 45% at the spokes (25% and 65%, respectively, in the central region). Proportions retained in care in the north hub at 6 and 12 mo were 92% (95% CI 90 to 93) and 89% (895% CI 7 to 91), respectively. Corresponding corrected estimates in the north spokes were 87% (95% CI 78 to 93) and 82% (95% CI 72 to 89), respectively. In the central hub, corrected estimates were 84% (95% CI 80 to 87) and 78% (95% CI 74 to 82), and were 89% (95% CI 77.9 to 95.1) and 83% (95% CI 64.1 to 92.9) at the spokes, respectively. Among adults newly initiating ART, being older was independently associated with a lower risk of attrition (adjusted hazard ratio [aHR] 0.93 per 5 y [95% CI 0.88 to 0.97]). Other independent risk factors included initiating with a tenofovir-based regimen vs zidovudine (aHR 0.60 [95% CI 0.46 to 0.77]), year of ART initiation (2013 aHR 1.55 [95% CI 1.21 to 1.97], ≥2014 aHR 1.41 [95% CI 1.06 to 1.87]) vs 2012, hub vs spoke (aHR 0.35 [95% CI 0.29 to 0.43]) and central vs north (aHR 2.28 [95% CI 1.86 to 2.81]). Independently, patient type was associated with retention. Conclusions After ART decentralisation, people living with human immunodeficiency virus (HIV) were willing to initiate ART in rural primary care facilities. Retention on ART was variable across facilities and attrition was higher among some groups, including younger adults and women initiating ART during pregnancy/breastfeeding. Interventions to support these groups are required to optimise benefits of expanded access to HIV services under UTT.

Profile of acupuncture use among primary care physicians working in the Brazilian public healthcare system

2020 ◽  
Vol 38 (5) ◽  
pp. 319-326
Author(s):  
Fernanda Bedin ◽  
Ari Ojeda Ocampo Moré ◽  
Jardel Corrêa de Oliveira ◽  
Charles Dalcanale Tesser ◽  
Li Shih Min
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Trigger Point ◽  
Physical Space ◽  
Acupuncture Point ◽  
Patient Acceptance ◽  
Care Practice ◽  
Public Healthcare ◽  
Point Selection ◽  
Introductory Course

Background: An introductory acupuncture course has been offered to primary health care physicians and family medicine residents in southern Brazil since 2011. Objective: To analyze the profile of acupuncture utilization of primary care physicians who completed an introductory course of acupuncture between 2011 and 2018. Method: A survey using an electronic questionnaire was sent to all 119 physicians who completed the course. Results: Fifty-five physicians answered the questionnaire. The majority of them reported continuation of the practice of acupuncture in scheduled appointments and on spontaneous demand. The most commonly used principles of point selection were traditional acupuncture point function, myofascial trigger point needling and point protocols. As barriers to the practice of acupuncture, time limitation and inadequate physical space were predominant. The participants described the problem-solving potential of the procedure and good patient acceptance as facilitators. The most common problems treated with acupuncture were musculoskeletal pain, and mood and anxiety disorders. A reduction in referrals to specialists and reduced prescription of pain medications were also reported. Most physicians answered that they often combined acupuncture with other medications or associated acupuncture with other complementary practices. The main adverse events reported by the participants were vascular trauma and fainting. Conclusion: Most primary care physicians who completed the introductory course and answered the survey still used acupuncture in their routine, primarily for the management of musculoskeletal conditions and mental health conditions. These physicians reported reductions in specialist referrals and prescription of pain medication after integrating basic acupuncture skills into primary care practice.

scholarly journals DEEP SCOPE: A Framework for Safe Healthcare Design

2021 ◽  
Vol 18 (15) ◽  
pp. 7780
Author(s):  
Ellen Taylor ◽  
Sue Hignett
Keyword(s):  
Human Factor ◽  
Healthcare Facility ◽  
Built Environments ◽  
Facility Design ◽  
Healthcare Facilities ◽  
Healthcare Design ◽  
Accident Causation ◽  
Healthcare Facility Design

Thinking in patient safety has evolved over time from more simplistic accident causation models to more robust frameworks of work system design. Throughout this evolution, less consideration has been given to the role of the built environment in supporting safety. The aim of this paper is to theoretically explore how we think about harm as a systems problem by mitigating the risk of adverse events through proactive healthcare facility design. We review the evolution of thinking in safety as a safety science. Using falls as a case study topic, we use a previously published model (SCOPE: Safety as Complexity of the Organization, People, and Environment) to develop an expanded framework. The resulting theoretical model and matrix, DEEP SCOPE (DEsigning with Ergonomic Principles), provide a way to synthesize design interventions into a systems-based model for healthcare facility design using human factors/ergonomics (HF/E) design principles. The DEEP SCOPE matrix is proposed to highlight the design of safe healthcare facilities as an ergonomic problem of design that fits the environment to the user by understanding built environments that support the “human” factor.

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