Factors contributing to overcrowding at the emergency department of the St. Francis community Hospital in Nairobi Kenya
Date
2018
Authors
Njogu, Mary Wanjiru
Journal Title
Journal ISSN
Volume Title
Publisher
Strathmore University
Abstract
Emergency department (ED) overcrowding is a major barrier to safe and efficient health services delivery across hospitals. This study sought to identify and assess factors contributing to overcrowding at the ED of the St. Francis Community Hospital in Nairobi. The objectives were to describe the patterns of association between patients’ characteristics and overcrowding at the emergency department of the hospital, examine the institutional factors that contribute to overcrowding and determine the extent to which the hospital is complying with its own throughput target of four hours per client. A quantitative cross-sectional study was subsequently done with patients and staff over a two-week period. Data was collected using a questionnaire. Descriptive statistics were used to describe the association between patients’ characteristics and overcrowding. Non-parametric tests (factor analysis) were used to describe institution factors that contribute to overcrowding, with Wilcoxon rank test being used to check whether patients took the four-hour ED timeframe specified in the hospital charter. The IBM-SPSS Statistics software was used for analysis. The study found that different patient characteristics contributed to overcrowding at the ED. Patient factors included age, mode of arrival, level of education and gender. Institutional factors contributing to overcrowding included nursing staff shortage, excessive time spent at the laboratory, poor coordination of workers, and an overall lack of inpatient beds, admissions rooms, and other resources. The hospital was found not to comply with the four-hour per-client throughput target specified on the charter. The study showed that overcrowding is a multifaceted challenge caused by a combination of patient, policy, and institutional factors. Study findings will inform policy and practitioners on areas to focus on in trying to reduce ED overcrowding and improving patient flow and experience through the health system.
Description
Keywords
Emergency department, Efficient health services, Overcrowding, Patients’ characteristics, Institutional factors