SA emergency rooms to change
Last updated: Thursday, July 06, 2006 PrintThe Triage system (derived from the French word “trier”, which means to sort) is set to reduce waiting times, improve patient flow and improve the general working environment for the often over-burdened staff working at these emergency facilities.
Dr Clive Balfour, head of Emergency Services at the Medi-Clinic private hospital group, says the greatest advantage of such a system is the reduction in both mortality and morbidity rates. Dr Balfour convened the Triage Group in April 2004 that designed the triage system. He is a specialist Emergency Physician, and is Chairman of the Emergency Medicine Society of South Africa.
“Recent studies at a number of emergency units at both private and state facilities have documented significant improvements in the levels of service to patients attending emergency facilities,” he says.
50% reduction in mortality
“As a further example, a triage study at a provincial emergency hospital in the Cape demonstrated a 50% reduction in the mortality rate over a two month period,” Dr Balfour continues.
Explaining the Triage tool, Dr Balfour says the system allows for the early identification of patients requiring the most urgent care. “Patients will be assessed upon arrival at the emergency unit, and will be colour categorised according to the severity of their condition,” he explains.
The colour categorisation
- Red – these patients are suffering from life-threatening conditions and will be taken to the resuscitation area where they’ll be immediately attended to.
- Orange – conditions are serious and patients should be attended to by a doctor within ten minutes
- Yellow –these conditions are less serious, and will be attended to after any red or orange coded patients.
- Green – the majority of this category will have acute primary care type medical problems, and will be attended to as soon as possible, but not before yellow coded patients
- Blue categorisation indicates death.
After assessing triage systems that are currently being used in some developed countries, this protocol was adapted in order to accommodate the pathological profile of the average South African emergency patient.
ER patients different in SA
Dr Balfour says the profile of the typical South African emergency patient often differs significantly from the profile of most emergency patients in developed countries.
“In the United Kingdom injured (trauma) patients make up approximately eight percent of the patients attending emergency departments, and in the US this figure is around 12%. In South Africa, approximately one third of patients attending our emergency units have suffered a physical injury (trauma).
“South Africa currently has two ongoing epidemics, trauma and HIV/Aids – these are the patients that seek help in emergency units as the first line of help. In addition, the severity of the injuries seen in South Africa is greater. This is largely due to drunk driving and inter-personal violence,” Dr Balfour explains.
Dr Basil Bonner, head of the Emergency Unit at the Milnerton Medi-Clinic in Cape Town, says the new system will impact positively on patient outcomes.
Will increase patient flow
“The emergency unit at the Milnerton Medi-Clinic is one of the busiest private emergency units in the country. The Triage tool will expedite the delivery of time-critical treatment for severe conditions. It will also help improve patient flow and decrease overcrowding,” Dr Bonner says.
The South African Triage Group (SATG) was founded on the 16th of June this year to implement this system nationally. The SATG will be responsible for the training of emergency personnel, implementing the new triage system, and reviewing the system by carrying out regular audits and research.
This body will consist of representatives from all nine provinces, including doctors, emergency nurses, and Paramedics. The SATG's parent body is the Emergency Medicine Society of South Africa - the professional society representing specialist Emergency Physicians, as well as non-specialist emergency doctors.
The Triage protocol is expected to be introduced countrywide at Medi-Clinic emergency units by the end of 2006. – (Medi-Clinic)
Source: Press release from Medi-Clinic
Read more:
When to go to the ER
Why mercy flight pilot died
July 2006
advertisement
