Advancing Delivery of Emergency Care in Honduras: Implementing a Triage System

Abstract

Introduction:

Overcrowding in the Emergency Room (ER) is a worldwide phenomenon affecting healthcare professionals' ability to apply life-saving interventions to critically wounded and sick patients. Implementing a routine triage system allows the early recognition and treatment of critical conditions such as polytrauma, difficulty in breathing, shock, and altered mental status. Furthermore, a triage system allows the prioritization of patients and the delivery of timely care. We describe the improvements in patient care for the critically ill through the implementation of a triage system in Hospital Escuela (HE), a 1306-bed, academic, tertiary care hospital in Honduras

Method:

Demographic data was recovered through paper triage forms from January 2020 until December 2021. From January 2022 to June 2022, the data was primarily recovered from digital triage forms. The data was consolidated, analyzed, and interpreted using Microsoft Excel.

Results:

During the thirty-month period, there were 161,848 triage consults, with 2.7% being critically wounded and sick patients, classified “red” according to the triage system. Most cases were triaged as yellow (53%), followed by green (23.6%), and then orange (15.8%). Some triage forms (5%) did not assign classifications. One-third (33.4%) of consults were diverted from the ER to the Triage and Urgent Care Room (SATU for the acronym in Spanish). Trauma-related cases accounted for 26.2% of the consults with 3.6% of the overall being weapon wounded.

Conclusion:

Implementing a triage system in HE enhanced the recognition and treatment of critically wounded and sick patients. This system has improved patient flow and the use of clinical space in the ER by diverting low-acuity patients to the SATU. Multi-disciplinary collaboration among healthcare professionals has also improved and the need to create a centralized Resuscitation Room was recognized.