Abstract
The rate at which routine patients are using the emergency department (ED) as a path to enter into the healthcare system in South Africa’s community healthcare facilities and district hospitals is alarming. The increasing number of acutely presenting, less stable and routine patients are being left to the care of a reduced number of health carers after hours, at weekends and during public holidays. This circumstantial disproportionality forms the breeding ground for poor patient care, healthcare workers’ burnout and inappropriate use of referral pathways. Not all the patients occupying the ED waiting rooms actually need emergency care. A sizeable number of patients in the waiting line are routine cases that could wait without any undesirable clinical outcomes. This opinion paper looks into the use of telephones to control after-hours patient loads at primary health care facilities in South Africa.
Highlights
Management of the after-hours patient load at primary care emergency departments (EDs) and district hospitals is a matter for concern in South Africa
Introduction of telephone triage in South Africa for the control of the ED patient load will definitely open up an opportunity to identify its problems and disadvantages, which may be peculiar to South Africa
This article has focused on providing a feasible solution to a timecritical situation in healthcare delivery in South Africa
Summary
Management of the after-hours patient load at primary care emergency departments (EDs) and district hospitals is a matter for concern in South Africa. The non-emergency groups of patients combined with the actual emergency population make the management of the ED an unbearable burden for clinicians and other healthcare workers on call and on shift, respectively This uncontrolled patient load results in an excessive workload leading to mismanagement of patients, inappropriate referrals and burnout of HCWs. Working in the district and community health centres is a challenging task and provides a possible breeding ground for burnout and depression in medical doctors.[3] CHCs are uneconomical as the high, and rising, rates of ED use for non-emergency after-hours care contributes to inefficient use of resources and higher levels of spending. The reports on all callers, and their management, are to be submitted to the family physician for review
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