ROLE OF OBSTETRIC TRIAGE IN IMPROVING PATIENT HEALTH CARE AT CMH KHARIAN-A COMPARITIVE STUDY

Abstract

Objective: To evaluate the up gradation of obstetric patient care by using obstetrics-specific triage acuity tool. Study design: Comparative prospective study Place and duration of study: This study was conducted at obstetrics unit of combined military hospital Kharian from June 2018 to Dec 2018. Methodology: Pregnant patients were triaged and prioritized according to Maternal fetal triage index (MFTI) into five levels. Primary outcome was time to triage and management plan documentation. Patient and health care provider satisfaction was evaluated using Likert’s scale before and after implementation of MFTI. Data was collected and expressed in frequencies and percentage. Chi square test was applied for association between before and after triage intervention variables, and a P value of 0.05 was considered significant. Results: A total of 1000 pregnant patients referred to OPD were enrolled, 500 patients before and 500 after implementation of MFTI. Patients were prioritized using MFTI system,10(2%) patients category 1 while category 2,3,4,and 5 were 28(5.6%),68(13.6%),150(30%) and 244(48.8%) respectively. There was significant reduction in waiting time from 35.4±8.2 minutes to18.2±6.5 p=<0.002. Hospital complaints reduced significantly from 25(5%) in before group to 4(0.8%) P=<0.001 after application of obstetric triage. Conclusion: Obstetric triage by MFTI focuses on the urgency and symptoms at presentation to decide further disposal. The usage of a systematic and properly developed triage system produces improvement in patient care. The results of study not only highlight the importance of usage of a triage system but also explore its usefulness and improvement in outcomes in a developing country like Pakistan.

Keywords

• maternal fetal triage index
• maternal mortality
• obstetric triage