Nurses and the Manchester: rearranging the work process and emergency care?

Area of Science:

• Nursing Science
• Healthcare Management
• Organizational Behavior

Background:

• The implementation of standardized triage systems, such as the Manchester Triage System (MTS), significantly impacts healthcare delivery.
• Understanding the evolving roles of nurses within hospital organizational structures is crucial for effective healthcare management.

Purpose of the Study:

• To investigate the transformation of nursing roles in the context of labor division within emergency hospitals following the adoption of the Manchester Triage System.
• To analyze the impact of the MTS on nurses' work processes, autonomy, and professionalization.

Main Methods:

• An ethnographic study was employed, utilizing diverse data collection techniques.
• Qualitative data analysis was performed to interpret the findings.

Main Results:

• The implementation of the MTS led to the reorganization of patient flows and physical spaces, improving the quality of care and altering work processes.
• Disagreements regarding risk stratification emerged, highlighting conflict in interprofessional relationships.
• While nursing roles evolved, a fundamental structural shift in nurses' position within the hospital labor division was not observed.

Conclusions:

• The Manchester Triage System has reshaped traditional nursing responsibilities and practices.
• Nurses' professional autonomy and scope of practice are dynamic, influenced by the micropolitical landscape of healthcare governance.
• The study underscores the fluid nature of professional boundaries and the need for ongoing evaluation of nursing roles in evolving healthcare systems.