Quantifying access block in a South African major trauma centre: a retrospective exploratory study.

Cohort studyAfrican journal of emergency medicine : Revue africaine de la medecine d'urgence· Sep 2026

Quantifying access block in a South African major trauma centre: a retrospective exploratory study.

Nicholas George Chapman, Ryoko Kinukawa, Elchanan Reuven Nudelman, Devorah Leah Wineberg

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Emergency Department FlowCohort studyQ2IF 1.2

Access block delayed 61% of admitted trauma patients beyond 8 hours in this Emergency Department.

Quantifying access block in a South African major trauma centre: a retrospective exploratory study.

Nicholas George Chapman … Devorah Leah Wineberg

African journal of emergency medicine · Sep 2026 · Q2 in Emergency Medicine

Background

Access block is defined as a delay in access to inpatient beds for patients from the Emergency Department (Emergency Department).

Purpose

This study aimed to quantify access block within Chris Hani Baragwanath Academic Hospital's Trauma Emergency Unit (Trauma Emergency Unit) and identify associated factors.

Methods

Aged <14 years (<10 for burns) and those managed by other services were excluded.

n = 2270 patients

61.3%

Results

61.3%

most admitted trauma patients waited over 8 hours for a bed

n = 2270 patients

More results

During the study period, 2270 patients were admitted from the resuscitation room to the ward without first requiring the operating theatre, of whom 2091 had a recorded length-of-stay.

More results

Conversely, presenting with penetrating trauma (OR 0.61), burns (OR 0.50), and undergoing intercostal catheter insertion (OR 0.53) were associated with significantly lower odds of access block.

Time-to-CT was significantly longer in patients with access block (366 vs 165 min; P < 0.01).

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Conclusion · 1 of 2

Most admitted patients were affected by access block. Associated factors included CT imaging, intensive care unit admission, mechanical ventilation, and presentation at night.

Conclusion · 2 of 2

This corroborates the international consensus that whole-of-system solutions are necessary to remedy it.

Quantifying access block in a South African major trauma centre: a retrospective exploratory study.

Quantifying access block in a South African major trauma centre: a retrospective exploratory study.

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