دورية أكاديمية
أعرض في EDS

Quality improvement initiative: improving obstetric triaging practices in a rural maternal hospital in central India.

التفاصيل البيبلوغرافية
العنوان: Quality improvement initiative: improving obstetric triaging practices in a rural maternal hospital in central India.
المؤلفون: Ranade M; Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India., Jain S; Obstetrics and Gynecology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India shuchijain@mgims.ac.in., Shivkumar PV; Obstetrics and Gynecology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India., Gupta S; Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India., Jain M; Pediatrics, MGIMS, Wardha, Maharashtra, India.
المصدر: BMJ open quality [BMJ Open Qual] 2024 May 07; Vol. 13 (Suppl 1). Date of Electronic Publication: 2024 May 07.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101710381 Publication Model: Electronic Cited Medium: Internet ISSN: 2399-6641 (Electronic) Linking ISSN: 23996641 NLM ISO Abbreviation: BMJ Open Qual Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BMJ Publishing Group
مواضيع طبية MeSH: Triage*/methods , Triage*/standards , Triage*/statistics & numerical data , Quality Improvement*, Humans ; Female ; India ; Pregnancy ; Hospitals, Rural/statistics & numerical data ; Hospitals, Rural/standards ; Hospitals, Rural/organization & administration ; Adult ; Obstetrics/standards ; Obstetrics/methods
مستخلص: Triaging of obstetric patients by emergency care providers is paramount. It helps provide appropriate and timely management to prevent further injury and complications. Standardised trauma acuity scales have limited applicability in obstetric triage. Specific obstetric triage index tools improve maternal and neonatal outcomes but remain underused. The aim was to introduce a validity-tested obstetric triage tool to improve the percentage of correctly triaged patients (correctly colour-coded in accordance with triage index tool and attended to within the stipulated time interval mandated by the tool) from the baseline of 49% to more than 90% through a quality improvement (QI) process.A team of nurses, obstetricians and postgraduates did a root cause analysis to identify the possible reasons for incorrect triaging of obstetric patients using process flow mapping and fish bone analysis. Various change ideas were tested through sequential Plan-Do-Study-Act (PDSA) cycles to address issues identified.The interventions included introduction and application of an obstetric triage index tool, training of triage nurses and residents. We implemented these interventions in eight PDSA cycles and observed outcomes by using run charts. A set of process, output and outcome indicators were used to track if changes made were leading to improvement.Proportion of correctly triaged women increased from the baseline of 49% to more than 95% over a period of 8 months from February to September 2020, and the results have been sustained in the last PDSA cycle, and the triage system is still sustained with similar results. The median triage waiting time reduced from the baseline of 40 min to less than 10 min. There was reduction in complications attributable to improper triaging such as preterm delivery, prolonged intensive care unit stay and overall morbidity. It can be thus concluded that a QI approach improved obstetric triaging in a rural maternity hospital in India.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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فهرسة مساهمة: Keywords: Control charts/Run charts; Healthcare quality improvement; Maternal Health Services; PDSA
تواريخ الأحداث: Date Created: 20240508 Date Completed: 20240508 Latest Revision: 20240512
رمز التحديث: 20240512
مُعرف محوري في PubMed: PMC11086565
DOI: 10.1136/bmjoq-2022-001870
PMID: 38719495
قاعدة البيانات: MEDLINE
الوصف
تدمد:2399-6641
DOI:10.1136/bmjoq-2022-001870