Patients perspective on the non-urgent use of the emergency department in Kenya
Date of Award
Master of Medicine (MMed)
Dr. Benjamin Wachira
Dr. Njeri Nyanja
Dr. Caroline Kathomi
Family Medicine (East Africa)
Background: Globally, there is an increasing demand for emergency department (ED) care in many countries accompanied by the dire need to optimize scant resources. Sub Saharan Africa (SSA) is facing a rapid surge in the prevalence of non-communicable diseases (NCDs) compounded by an already prevailing significant problem of communicable diseases and injuries. This has led to increased demand for emergency care expertise owing to acute complications of all these conditions. The impact includes ED overcrowding, increased healthcare costs, extended waiting periods and overstretched essential services. To mitigate this, it is imperative that EDs be utilized appropriately to continue providing quality emergency medical care services.
Objectives: The objectives of the study were to establish why patients visit the ED in a tertiary hospital for non-urgent care, whether they understood the role of the ED and their perception of the urgency of their presenting medical conditions.
Methodology: An exploratory qualitative study was conducted. In-depth interviews were conducted among patients triaged as non-urgent using an interview guide. Interviews were audio recorded, transcribed verbatim and analyzed thematically using NVivo 12 software.
Results: Thematic saturation was reached after interviewing a total of 24 patients. The results showed that several factors contributed to the non-urgent use of the ED: lack of awareness on alternative places to seek care, familiarity with the ED, closure of other departments after hours and on weekends and teamwork by ED staff. Most of the patients understood that the ED was a place where patients needing urgent medical attention with life threatening conditions were attended to and such patients were not required to queue. Majority of the patients felt their conditions were life threatening.
Conclusion: Several reasons were identified in this study as to why patients with non-urgent medical conditions sought care in the ED. This was despite a majority of the patients being able to correctly define the role of the ED. There is need to continuously educate patients on which conditions are appropriate to be seen in the ED and provide mechanisms of referring patients with non-urgent conditions to alternative sites of care.
Matifary, C. R. (2019). Patients perspective on the non-urgent use of the emergency department in Kenya (Unpublished master's dissertation). Aga Khan University, East Africa.