INNOVATION FUND Innovation, Integration, & Implementation Women and Children SHOWCASE 2016 INNOVATION FUND Innovation, Integration, & Implementation Women and Children SHOWCASE 2016

Optimization of Patient Flow: Implementation of a Fast Track Assessment Pathway in Obstetrical Triage

Women and Children

robert_gratton

Robert Gratton

Rob.gratton@lhsc.on.ca

519-685-8500 ext 64052

Department of Ob Gyn, London Health Sciences Centre, Western University

Highlights

The Obstetrical Triage Acuity Scale (OTAS) is the first comprehensive obstetric acuity classification tool with established reliability and validity.  Standardized assessment of acuity with OTAS prioritizes patient care and enables assessment of resource requirements and quality of care based on acuity. OTAS has wide application to obstetrical triage units and emergency departments that provide urgent care to pregnant women.

Abstract

Obstetrical triage units face many of the same problems as emergency departments with overcrowding, prolonged wait times, and limited resources.  The Obstetrical Triage Acuity Scale (OTAS) is the first valid and reliable obstetric triage tool.  It identifies high acuity and directs priority assessment for pregnant women and the fetus. OTAS also identifies lower acuity patients that can receive care in an efficient fast track care pathway. Standardized acuity assessment with OTAS and measurement of patient flow has been implemented at London Health Sciences Centre, and in several other hospitals across Canada. The OTAS scoring system has provided an understanding of acuity distribution and enabled the measurement of flow and patient care based on acuity. A fast track area for lower acuity patients was successfully implemented and decreased the overall length of stay (LOS) and the LOS of lower acuity (OTAS 4,5) patients. A National Obstetrical Triage Working Group has been formed to facilitate regional and national implementation. Standardized assessment of acuity with OTAS prioritizes patient care and enables assessment of resource requirements and quality of care based on acuity. Assessment of patient flow stratified by acuity allows innovative models of care such as a fast track for assessment and treatment. We believe that OTAS has wide application to obstetrical triage units and emergency departments that provide urgent care to pregnant women.

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