A descriptive analysis of Emergency Department overcrowding in a selected hospital in Kigali, Rwanda

IntroductionEmergency Centre (EC) overcrowding is a global concern. It limits timeous access to emergency care, prolongs patient suffering, compromises quality of clinical care, increases staff frustration and chances of exposing staff to patient violence and is linked to unnecessary preventable fatalities. The literature shows that a better understanding of this phenomenon may contribute significantly in coming up with solutions, hence the need to conduct this study in Rwanda.MethodsA quantitative descriptive design, guided by the positivist paradigm, was adopted in this study. Self-administered questionnaires were distributed to 40 nurses working in the EC. Only 38 returned questionnaires, thus making the response rate 95%.ResultsThe findings revealed that EC overcrowding in Rwanda is characterised by what is considered as reasonable waiting time for a patient to be seen by a physician, full occupancy of beds in the EC, time spent by patients placed in the hallways waiting, and time spent by patients in waiting room before they are attended. Triggers of EC overcrowding were classified into three areas: (a) those associated with community level services; (b) those associated with the emergency centre; (c) those associated with inpatient and emergency centre support services.DiscussionA number of recommendations were made, including the Ministry of Health in Rwanda adopting a collaborative approach in addressing EC overcrowding with emergency trained nurses and doctors playing an active role in coming up with resolutions to this phenomenon; conducting research that will lead to an African region definition of EC overcrowding and solutions best suited for the African context; and increasing the pool of nurses with emergency care training