A prospective evaluation of emergency patients presenting to 8-hour primary care clinics

BackgroundVery little is known about the acuity case mix of patients presenting to eight-hour primary care facilities. Emergency centre triage identifies patients in urgent need of care and speeds up disposition to higher levels of care.ObjectivesTo describe the acuity of patients presenting to eight-hour facilities, and to determine patient mode of arrival as well as the current triage practice.MethodsA descriptive study of patients arriving at eight-hour primary care clinics in the Western Cape was conducted at four facilities in the Western Cape for a three-month period. The triage nurses collected routine observations from all monthly unscheduled walk-inpatients seen at these facilities. The Triage Early Warning Score was then calculated and the South African Triage Scale acuity level identified and recorded.ResultsA total of 1801 patients were included in the study. The total acuity distribution of the four facilities was as follow: emergency (0.3%), very urgent (15.3%), urgent (26.5%) and non-urgent (57.8%). The 2 smaller clinics (De Doorns and Heideveld) saw a higher percentage of emergency/very urgent/urgent versus non-urgent patients (85% versus 15%).ConclusionsThis study shows that eight-hour primary care facilities have a large proportion of urgent patients (42%) and would benefit from a standardised emergency centre triage tool for patients. Therefore it is recommended that the South African Triage Scale be implemented at these facilities as soon as possible