Emergency clinician output in a district hospital emergency centre : a cross-sectional analysis

dc.contributor.advisorMcCaul, Michaelen_ZA
dc.contributor.advisorHendrickse, Clinten_ZA
dc.contributor.authorHoffe, Mary Elizabethen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Family and Emergency Medicine. Emergency Medicine.en_ZA
dc.date.accessioned2021-11-17T12:56:01Z
dc.date.accessioned2021-12-22T14:21:08Z
dc.date.available2021-11-17T12:56:01Z
dc.date.available2021-12-22T14:21:08Z
dc.date.issued2021-12
dc.descriptionThesis (MMed)--Stellenbosch University, 2021.en_ZA
dc.description.abstractENGLISH SUMMARY : Introduction: Appropriate and efficient staffing is a cornerstone of emergency centre performance. There is however a paucity of literature describing clinician output in low- and middle-income countries with current staffing models based on anecdotal evidence. This study aimed to assess clinician output at a district level emergency centre, and how it varied depending on shift, clinician, and workload factors. Methods: We conducted a retrospective cross-sectional study using an existing electronic patient registry, to determine the patients consulted per hour (PPH) during each clinician shift and how this is affected by various clinician, shift, and workload factors. Data was collected over three non-contiguous randomly selected four-week cycles from Mitchells Plain Hospital's electronic patient registry. Associations between PPH and various factors were assessed using the ANOVA and post-hoc adjustments where appropriate. The correlation between PPH and workload metrics was calculated with the Pearson’s Rank correlation test. Statistical significance was defined as p<0.05. Results: A total of 1 289 clinician shifts were analysed with an overall PPH of 0.7. A significant association between PPH and shift type (p 0.021), clinician category (p<0.001) and cumulative shifts (p<0.001) were shown. There was a decline in clinician output during a shift and output was significantly decreased by the number of boarders in the emergency centre but increased with higher numbers of patients waiting at the start of the shift. Conclusion: This study describes a relatively low clinician output as compared to evidence from high-income countries and has highlighted several associations with various shift, clinician, and workload factors. The results from this study will form the basis of quality improvement interventions to improve patient throughput and will inform staff scheduling and surge planning strategies.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.af_ZA
dc.description.versionMasters
dc.format.extent53 pages ; illustrations, includes annexures
dc.identifier.urihttp://hdl.handle.net/10019.1/123782
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch University
dc.rights.holderStellenbosch University
dc.subjectEmergency medicine -- Labor productivity -- Developing countriesen_ZA
dc.subjectTrauma centers -- Overcrowding -- Developing countriesen_ZA
dc.subjectPatient flow management -- Developing countriesen_ZA
dc.subjectUCTD
dc.titleEmergency clinician output in a district hospital emergency centre : a cross-sectional analysisen_ZA
dc.typeThesisen_ZA
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