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Exploring the third delay: an audit evaluating obstetric triage at Mulago National Referral Hospital

Forshaw, J; Raybould, S; Lewis, E; Muyingo, M; Weeks, A; Reed, K; Manikam, L; (2016) Exploring the third delay: an audit evaluating obstetric triage at Mulago National Referral Hospital. BMC Pregnancy and Childbirth , 16 (1) , Article 300. 10.1186/s12884-016-1098-2. Green open access

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Abstract

Background: Mulago National Referral Hospital has the largest maternity unit in sub-Saharan Africa. It is situated in Uganda, where the maternal mortality ratio is 310 per 100,000 live births. In 2010 a ‘Traffic Light System’ was set up to rapidly triage the vast number of patients who present to the hospital every day. The aim of this study was to evaluate the effectiveness of the obstetric department’s triage system at Mulago Hospital with regard to time spent in admissions and to identify urgent cases and factors adversely affecting the system. Methods:A prospective audit of the obstetric admissions department was carried out at the Mulago Hospital. Data were obtained from tagged patient journeys using two data collection tools and compiled using Microsoft Excel. StatsDirect was used to compose graphs to illustrate the results. Results: Informal triage was occurring 46 % of the time at the first checkpoint in a woman’s journey, but the ‘Traffic Light System’ was not being used and many of the patient’s vital signs were not being recorded. Conclusions: It is hypothesised that the ‘Traffic Light System’ is not being used due to its focus on examination finding and diagnosis, implying that it is not suitable for an early stage in the patient’s journey. Replacing it with a simple algorithm to categorise women into the urgency with which they need to be seen could rectify this.

Type: Article
Title: Exploring the third delay: an audit evaluating obstetric triage at Mulago National Referral Hospital
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12884-016-1098-2
Publisher version: http://dx.doi.org/10.1186/s12884-016-1098-2
Language: English
Additional information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Obstetric, Triage
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1537483
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