Obstetric Triage

Angelini, Diane J.; Howard, Elisabeth D.

doi:10.1097/nmc.0000000000000069

Cited by 41 publications

(13 citation statements)

References 24 publications

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“…In a recent systematic review of literature on obstetric triage published from 1998 to 2013, the authors identified quality improvement strategies that track acuity, length of stay, and patient satisfaction as important components of best practice (Angelini & Howard, 2014). The obstetric triage unit functions uniquely as an outpatient assessment center in an inpatient unit in most hospitals.…”

Section: Background and Significancementioning

confidence: 99%

“…T riage, in the context of health care, involves the process of determining the priority of patient care according to the urgency of their need for treatment and is often associated with emergency and disaster services (McBrien, 2009). Triage concepts have become part of obstetric practice to improve utilization of bed capacity, increase immediate and appropriate response to obstetric emergencies, decrease wait times, prevent unnecessary admissions, and standardize assessment (Angelini & Howard, 2014). Obstetric triage is defined as the ability to appropriately prioritize and assess pregnant women in a timely manner, to improve patient flow, and enhance patient safety (Paisley, Wallace, & DuRant, 2011).…”

mentioning

confidence: 99%

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Women’s Satisfaction With Obstetric Triage Services

Evans

Watts

Gratton

2015

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Section: Background and Significancementioning

confidence: 99%

mentioning

confidence: 99%

Women’s Satisfaction With Obstetric Triage Services

Evans

Watts

Gratton

2015

Journal of Obstetric, Gynecologic & Neonatal Nursing

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“…In many obstetric units in these hospitals, there is a separate triage area with dedicated staff to receive and rapidly assess women in order to quickly treat complications [8]. The Association of Women’s Health Obstetric and Neonatal Nurses (AWHONN) recommends that the triage assessment begin within 10 min of arrival to a facility [7].…”

Section: Introductionmentioning

confidence: 99%

The third delay: understanding waiting time for obstetric referrals at a large regional hospital in Ghana

Owen

Srofenyoh²,

Olufolabi

et al. 2017

BMC Pregnancy Childbirth

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BackgroundDelay in receiving care significantly contributes to maternal morbidity and mortality. Much has been studied about reducing delays prior to arrival to referral facilities, but the delays incurred upon arrival to the hospital have not been described in many low- and middle-income countries.MethodsWe report on the obstetric referral process at Ridge Regional Hospital, Accra, Ghana, the largest referral hospital in the Ghana Health System. This study uses data from a prospectively-collected cohort of 1082 women presenting with pregnancy complications over a 10-week period. To characterize which factors lead to delays in receiving care, we analyzed wait times based on reason for referral, time and day of arrival, and concurrent volume of patients in the triage area.ResultsThe findings show that 108 facilities refer patients to Ridge Regional Hospital, and 52 facilities account for 90.5% of all transfers. The most common reason for referral was fetal-pelvic size disproportion (24.3%) followed by hypertensive disorders of pregnancy (9.8%) and prior uterine scar (9.1%). The median arrival-to-evaluation (wait) time was 40 min (IQR 15–100); 206 (22%) of women were evaluated within 10 min of arrival. Factors associated with longer wait times include presenting during the night shift, being in latent labour, and having a non-time-sensitive risk factor. The median time to be evaluated was 32 min (12–80) for women with hypertensive disorders of pregnancy and 37 min (10–66) for women with obstetric hemorrhage. In addition, the wait time for women in the second stage of labour was 30 min (12–79).ConclusionsReducing delay upon arrival is imperative to improve the care at high-volume comprehensive emergency obstetric centers. Although women with time-sensitive risk factors such as hypertension, bleeding, fever, and second stage of labour were seen more quickly than the baseline population, all groups failed to be evaluated within the international standard of 10 min. This study emphasizes the need to improve hospital systems so that space and personnel are available to access high-risk pregnancy transfers rapidly.

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“…A 2014 review of obstetric triage practices searched English language articles from 1998 to 2013 and of 33 relevant articles, none were from LMICs. 28 …”

Section: Reflectionmentioning

confidence: 99%

Addressing the third delay: implementing a novel obstetric triage system in Ghana

et al. 2018

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Institutional delivery has been proposed as a method for reducing maternal morbidity and mortality, but little is known about how referral hospitals in low-resource settings can best manage the expected influx of patients. In this study, we assess the impact of an obstetric triage improvement programme on reducing hospital-based delay in a referral hospital in Accra, Ghana. An Active Implementation Framework is used to describe a 5-year intervention to introduce and monitor obstetric triage capabilities. Baseline data, collected from September to November 2012, revealed significant delays in patient assessment on arrival. A triage training course and monitoring of quality improvement tools occurred in 2013 and 2014. Implementation barriers led to the construction of a free-standing obstetric triage pavilion, opened January 2015, with dedicated midwives. Data were collected at three time intervals following the triage pavilion opening and compared with baseline including: referral indications, patient and labour characteristics, waiting time from arrival to assessment and the documentation of a care plan. An obstetric triage improvement programme reduced the median (IQR) patient waiting time from facility arrival to first assessment by a midwife from 40 min (15–100) to 5 min (2–6) (p<0.001) over the 5-year intervention. The triage pavilion enhanced performance resulting in the elimination of previous delays associated with the time of admission and disease acuity. Care plan documentation increased from 51% to 96%. Obstetric triage, when properly implemented, reduced delay in a busy, low-resource hospital. The implementation process was sustained under local leadership during transition to a new hospital.

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Obstetric Triage

Abstract: Seven key triage categories from the literature were identified and best practices were developed for obstetric triage units from this systematic review. Both can be used to guide future practice and research within obstetric triage.

Cited by 41 publications

References 24 publications

Women’s Satisfaction With Obstetric Triage Services

Women’s Satisfaction With Obstetric Triage Services

The third delay: understanding waiting time for obstetric referrals at a large regional hospital in Ghana

Addressing the third delay: implementing a novel obstetric triage system in Ghana

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