Obstetrical triage units faced with overcrowding, prolonged wait times, and limited resources will be able to use this new reliable obstetrical triage tool. The tool “OTAS” helps identify the patients’ level of need and directs priority assessment for pregnant women and the fetus, while lower need patients are directed to an efficient fast track care pathway. The success of this innovation has driven the creation of a National Obstetrical Triage Working Group to facilitate regional and national implementation, establish national research priorities, and to guide the continued refinement of OTAS to meet the needs of obstetrical triage units across the country. To standardize the implementation regionally and nationally, we are developing an OTAS Providers Course and an OTAS Instructors Course that will include principles and methodology to assess patient flow and guidelines for establishing fast track pathways for lower acuity patients. This innovation will improve patient care, reduce wait times overall, and may be useful as a guideline for triage in other emergency specialties.