Abstract

BackgroundWorldwide, patients visiting health care facilities in the public health care sector have to wait for attention from health care professionals. In South Africa, the Cape Triage Score system was implemented successfully in hospitals’ emergency departments in the Cape Metropole. The effective utilisation of triage could improve the flow of primary health care (PHC) patients and direct the patients to the right health care professional immediately.AimNo literature could be traced on the implementation of triage in PHC facilities in South Africa. Consequently, a study addressing this issue could address this lack of information, reduce waiting times in PHC facilities and improve the quality of care.SettingPHC facilities in a sub-district of the North West province of South Africa.MethodA quantitative, exploratory, typical descriptive pre-test–post-test design was used. The study consisted of two phases. During phase 1, the waiting time survey checklist was used to determine the baseline waiting times. In phase 2, the Cape Triage Score system that triaged the patients and the waiting time survey checklist were used.ResultsData were analysed using Cohen’s effect sizes by comparing the total waiting times obtained in both phases with the waiting time survey checklist. Results indicated no reduction in the overall waiting time; however, there was a practical significance where triage was applied. Referral was much quicker to the correct health professional and to the hospitals.ConclusionAlthough the results indicated no reduction in the overall waiting time of patients, structured support systems and triage at PHC facilities should be used to make referral quicker to the correct health professional and to the hospitals.

Highlights

  • Primary health care (PHC) in South Africa’s public health care sector provides the first level of health care contact for 83% of the South African population (Rabie, Coetzee & Klopper 2016)

  • Human resourcerelated factors include that professional nurses, working in PHC facilities, might lack clinical skills and training to manage PHC patients (Lekhuleni, Khoza & Amusa 2013; Mashia & Van Wyk 2004; Thandrayen & Saloojee 2010) contributing to ineffective triage (Lekhuleni et al 2013; Mashia & Van Wyk 2004; Thandrayen & Saloojee 2010)

  • The allocation of specific professional nurses to rendering a single service per day such as antenatal care or treating patients suffering from common conditions (Finamore & Turris 2009; Rhoda et al 2010) plays a role in extending PHC patients’ waiting times

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Summary

Introduction

Primary health care (PHC) in South Africa’s public health care sector provides the first level of health care contact for 83% of the South African population (Rabie, Coetzee & Klopper 2016). Extended patients’ waiting times from presentation to treatment affect many South Africans seeking health care in the public health care sector (Finamore & Turris 2009). Nurses’ absenteeism, caused by attending training or meetings, being on maternity leave or being absent because of other legal reasons (Couper et al 2007) contributed to patients’ extended waiting times because of overcrowding (Finamore & Turris 2009; Mashia & Van Wyk 2004; Rhoda et al 2010). The allocation of specific professional nurses to rendering a single service per day such as antenatal care or treating patients suffering from common conditions (Finamore & Turris 2009; Rhoda et al 2010) plays a role in extending PHC patients’ waiting times. The effective utilisation of triage could improve the flow of primary health care (PHC) patients and direct the patients to the right health care professional immediately

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