Perception of Komfo Anokye Teaching Hospital Emergency Centre staff on acuity of patients” presentation and appropriateness of attendance

Emergency Centre (EC) overcrowding influences patient outcomes, use of resources, staff morale, and patient satisfaction. Inappropriate attenders contribute to overcrowding in the EC. Patel found that 24.5% of patients who present to EC do not require emergency care in Canada. The EC of Komfo Anokye Teaching Hospital has overcrowding challenges and health workers’ perception of causes of overcrowding may inform their approach to care of emergency patients. The aim was to describe EC staff perception of acuity of presentation and appropriateness of attendance of emergency patients. Methods: 95 EC staff comprising 34 physicians and 61 nurses were asked to complete a structured questionnaire to assess perceptions of appropriateness of patients presenting to the EC. Staff sampled could participate in the study if they had previously worked or were currently working in the EC. Answers given on the questionnaire were analysed using STATA 11.0. Results: 55.8% of staff thought that walk-in patients attended the EC more frequently than referred patients. 50.5% of staff thought that referred patients often presented with acute conditions and a similar number (49.5%) thought that for walk-in patients. 67% of staff had turned patients away from the EC when they felt their attendance was inappropriate. Of these, 84.2% had turned away more walk-in patients than referred patients. 66.2% of staff thought that referred patients, though often appropriate attenders were frequently triaged to lower than expected acuity category. Discussion: Staff in this study were not unanimous on the acuity of presentation of walk-in patients and referred patients. Walk-in patients were more likely turned away from the EC. Though perception of staff may hold inherent weakness of objectiveness, this may inform staff attitudes to care for walk-in patients. Negative perceptions of staff on overcrowding in EC could be addressed through staff training and policy directed at reducing EC overcrowding.

Abstract licence: CC BY-NC-ND

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