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

Very 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. Objectives: To describe the acuity of patients presenting to eight-hour facilities, and to determine patient mode of arrival as well as the current triage practice. Methods: A 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. Results: A 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%). Conclusions: This 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