Evaluation of the implementation of the South African Triage System at an academic hospital in central Haiti
Section snippets
Background
As emergency medicine continues to expand globally, it is increasingly important that hospitals adopt strategies to improve the quality and efficiency of emergency care. Triage, the process of sorting patients according to need so that the sickest patients receive priority treatment [1], has become a corner stone of emergency department (ED) quality and patient flow [2]. Triage allows for early recognition and treatment of critically ill patients, improves resource utilization and patient
Study design
The study was a retrospective chart review of a sample of patients who presented to UTHM ED during a one-month period (October 2013). This study was approved by institutional review boards at Partners Healthcare (Boston, USA) and Zanmi Lasante (Port–au-Prince, Haiti).
Study setting
UTHM is a 300-bed academic referral center in central Haiti. At the time of the study, the ED was a 15-bed unit that saw all non-obstetric emergency patients with a visit volume of approximately 1100 patients per month. Emergency
Results
There were 1060 ED visits during the study period. Of the 400 randomly selected encounters, three were duplicate encounters (e.g. – the exact same visit had been erroneously registered twice), four were actually outside the study period, and seven charts were unable to located, leaving 386 encounters eligible for inclusion. Of these, 381 (98.7%) contained a triage form and were included in the analysis. Most patients were over age 12 (69.6%) and 49.9% were male. The majority (80.6%) were
Discussion
Triage systems are an essential for high quality emergency care. This study demonstrates that the SATS, a triage system developed for low resource settings, was implemented in Haiti with limited training. However, it also demonstrates that in our context, some parts of the system are more widely used than others, suggesting where future training resources should be focused.
Overall at UTHM, triage was widely used despite the limited training permitted by time and resource constraints. In a
Conclusion
This study shows that the SATS can be implemented with only minimal training in a resource-limited environment, but that some components of the triage system were more commonly adopted than others. It also demonstrates that triage audits in a low-resource setting can identify areas in which triage can be strengthened.
Conflict of interest
None
Ethical statement
This study was approved by institutional review boards at Partners Healthcare (Boston, USA) and Zanmi Lasante (Port–au-Prince, Haiti).
Funding source
This work was supported by the Massachusetts Medical Society Resident Research Grant.
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