Analysis of patient flow in the Accident and Emergency Department at Mulago National Referral Hospital, Kampala

Abstract

Background: The patient flow processes refer to the sequence of events in clinical care that patients experience from the point of entry until they are discharged from the hospital premises. Processes involved in patient handling and flow at hospital emergency departments lead to delays in patient care and management, overcrowding, increased medical errors, reduced patient satisfaction, and it increases mortality and morbidity. Improving patient flow is key in process management in health care facilities. It is therefore worthwhile to establish the patient flow process and the factors affecting the patient flow process at the A & Et. Objective: To assess the patient flow at Accident and Emergency Department at Mulago National Referral Hospital. This was categorized into actual patient flow and factoring affecting patient flow. Methods: A qualitative cross-sectional research approach was adopted and utilized key informant and in-depth interviews respectively on a total of 13 respondents that were purposively selected. Results: The findings indicate that patients accessed A&E Department from triage area as an entry point, records unit, yellow area, red area, theatre, laboratory unit. In some instances, there was forth back movement of patients to these areas and units and this practical interaction was drawn diagrammatically. Secondly, the following factors affected how patients flow at A&E Department; facility based or infrastructural, health worker based, patient based and environmental factors. Conclusions and recommendations: The flow of patients at A&E Department was not sequentially organized. Several factors affected the patient flow process including the high patient volumes, under staffing, and insufficient equipment. Interventions should therefore be developed to improve the patient flow process at the A&E.