Health-related reasons patients transfer from a clinic or health post to the Emergency Department in a District Hospital in Botswana

Introduction: Rural health clinics in low-resource settings worldwide are usually staffed with health care workers with limited knowledge and skills in managing acute emergencies. The Emergency Centre (EC) at the district hospital or primary hospital serves as an entry point for patients with diverse medical needs from health posts and community clinics. The study described the socio-demographic characteristics, primary diagnosis, and disposition of patients transferred from the clinics and health posts to the district hospital in the Kweneng district. Method: This study is a chart audit of the triage sheets and admitting medical records (Botswana Integrated Patient Management System, IPMS) conducted for the period June through to December 2020. Descriptive statistics were used to analyze the quantitative data. Frequencies, percentages, and measures of central tendency were calculated using the software, SPSS version 27. Results: A total of 1565 charts were reviewed; 56% (n = 877) were females and 43.5% (n = 681) were males. Half of the patients presenting to the EC ranged from ages 21 to 50, with a mean age of 36.49. The most frequently reported reason for referral was "trauma," (23.5%, n = 368) whereas the second common reason for referral was abortion-related complications (14.2%, n = 222). The highest admissions were from abortion-related complications (20.2%, n = 169). Most patients' transfers were from clinics and health posts outside Molepolole (59.4%, n = 930). More than half of the patients (64.2%, n = 537) transferred from outside Molepolole were admitted than discharged from the EC. Discussion: Our study has shown significant transfers to a higher facility for emergency care. The higher number of transfers are trauma-related cases, whereas most patients were admitted for abortion-related complications indicating the need for skill-building in trauma care and management of abortions.

Pharmacist interventions throughout care transitions: a review of current practices.

Transitions of care occur each time a patient moves from one healthcare provider or care setting to another. Challenges that have been identified include: failure of the patient to keep appointments for outpatient chronic care; inability for smooth transfer of information between various healthcare providers; and failure to find appropriate placement for patients who can no longer manage independent living. As pharmacists representing an array of practice settings, these authors here present the models of contributions made by pharmacy services within such multifaceted approaches. An initial literature search was conducted using the National Library of Medicine via PubMed. Studies conducted in the United States that included at least one pharmacy service within the methods of intervention were selected for review. Where there are published findings from each setting, we include the measured impact, if reported. Although pharmacists represent the most skilled healthcare professionals in medication reconciliation and management, the best processes for tapping that expertise have yet to be fully elucidated. We present this review of current practices with the continued hope that the pharmacy profession will, not only continue to be the quiet patient advocate for best medication use, but also to open our minds to the need to measure, adjust, and measure again, the systems and processes we use to best integrate our knowledge for the overall benefit of the patient.

Pharmacist interventions throughout care transitions: a review of current practices.

Transitions of care occur each time a patient moves from one healthcare provider or care setting to another. Challenges that have been identified include: failure of the patient to keep appointments for outpatient chronic care; inability for smooth transfer of information between various healthcare providers; and failure to find appropriate placement for patients who can no longer manage independent living. As pharmacists representing an array of practice settings, these authors here present the models of contributions made by pharmacy services within such multifaceted approaches. An initial literature search was conducted using the National Library of Medicine via PubMed. Studies conducted in the United States that included at least one pharmacy service within the methods of intervention were selected for review. Where there are published findings from each setting, we include the measured impact, if reported. Although pharmacists represent the most skilled healthcare professionals in medication reconciliation and management, the best processes for tapping that expertise have yet to be fully elucidated. We present this review of current practices with the continued hope that the pharmacy profession will, not only continue to be the quiet patient advocate for best medication use, but also to open our minds to the need to measure, adjust, and measure again, the systems and processes we use to best integrate our knowledge for the overall benefit of the patient.