Enhancing Emergency Obstetric Care Through Implementation of a Triage Acuity Score: A Quality Improvement Initiative

Area of Science:

• Obstetrics and Gynecology
• Emergency Medicine
• Quality Improvement Science

Background:

• Maternal morbidity and mortality in the U.S. present ongoing challenges, especially in emergency settings.
• Inefficient triage in obstetric emergencies leads to care delays and adverse outcomes.
• Obstetric emergency departments struggle with acuity-based care alignment, impacting provider response times.

Purpose of the Study:

• To evaluate the impact of the maternal-fetal triage index (MFTI) system on triage efficiency.
• To assess the alignment between MFTI scores and provider-at-bedside (PAB) times.
• To determine if the MFTI system improves care quality in obstetric emergency departments.

Main Methods:

• A quality improvement initiative was implemented using the MFTI system.
• Pre- and post-implementation data were collected to analyze triage processes.
• MFTI scores were used to prioritize patients based on acuity, guiding provider response.

Main Results:

• Alignment between MFTI scores and provider-at-bedside (PAB) times improved substantially, from 40% to 90%.
• Documentation rates for MFTI scores and PAB times increased post-implementation.
• Total patient visit times remained stable, indicating no increase in overall length of stay.

Conclusions:

• The MFTI system effectively enhanced triage efficiency and care quality in obstetric emergency settings.
• Acuity-based triage using the MFTI system is feasible and beneficial in obstetric emergencies.
• Provider satisfaction with the MFTI system was noted in survey data.