Triage System in Chiang Mai Neurological Hospital

Abstract

This descriptivestudyaims toinvestigateand find the wayto develop triage system in Chiang Mai Neurological Hospital. The methodology used in this study was the concept of PDCA (plan-do-check-act). A total of 15 physicians and registered nurses in emergency and out-patient departments were recruited to participate in this study. The study consisted of three phases. In the first phase, secondary data from documents, medical records, registration service and incidents related to triage system were retrieved. All the participants were
interviewed about triage system, such as interviewing and steps of triage. In the second phase, researchers observed the participants during patient screening and classification. Inthethird phase, researchers reviewed literaturesand useanalyzed data to find the way to develop triagesystem manuals and guidelines for patient
screening and patient care. The research instruments consisted of Emergency Screening Questionnaires, interview form and observation form. All data was analyzed using descriptive statistics and grouping data from interview and observation.

The results revealed that the system of triage was unclear. The main problems were that some staffs had never received orientation/training course and/ornever read triage guidelines. Onlyonenursecould correctly describe work flow and steps in triage system. For screening observation, all participants could classify patients correctly. Inappropriate activity was to make decision for emergency indication (40.0%).Theactivity that should havestaffshad never been done were pain assessment (70.0%). The main causes of delayed triage incidents included comprised of unclear system of triage, different experiences/or skills among staffs, ambiguous in using available triage tools and falsifying information provided by patientsor their relatives. The proposed recommendations werethat the hospital should have 1) correct triagesystem 2) official document and practical guidelines of triage system for emergency patients 3) provide orientation and
training courses of emergency patient triage.

The study provides useful information regarding emergency patient triage system, problems and causes of the delayed and misclassified emergency patients for further development of triage system in Chiang Mai Neurological Hospital.