To evaluate the application of a five-tiered Obstetrical Triage Acuity Scale (OTAS) in a tertiary care center by assessing the relationship between the triage score and time spent in triage.
A retrospective cohort study over a 2 month period in 2014 was conducted. The previously validated OTAS score for obstetrics was assigned to each patient. Seven scoring parameters were used to assign a final score, stratified into 5 categories: 1) resuscitative, 2) emergent, 3) urgent, 4) less urgent, and 5) non-urgent. Data about time from registration to room placement, time from room placement until nursing assessment and total time in the triage unit were collected. Median times were compared among the 5 groups using the Kruskal-Wallis test. Post-hoc analyses were performed using the Dunn test.
The cohort included 835 women. The duration of time from registration until room placement and the time from room placement until nursing assessment were similar across all acuity scores. However, total time in triage differed amongst the groups. Women with a level 4 acuity spent the shortest median time in triage 108 minutes (range: 14–578 minutes), while those categorized as level 5 had the longest triage stays (median 173 minutes; range 18–561 minutes).
Patients presenting to our obstetrical triage unit with the lowest level of acuity utilized the longest time in triage. Efforts to improve resource utilization in the hospital-based triage system may need to focus on better patient and provider education about triage use for non-acute issues.
Department of Obstetrics and Gynecology, Ohio State College of Medicine, Columbus, OH
Financial Disclosure: The authors did not report any potential conflicts of interest.