TY - JOUR
T1 - Implementation of a novel three-tier triage tool in Papua New Guinea
T2 - A model for resource-limited emergency departments
AU - Mitchell, Rob
AU - McKup, John Junior
AU - Bue, Ovia
AU - Nou, Gary
AU - Taumomoa, Jude
AU - Banks, Colin
AU - O'Reilly, Gerard
AU - Kandelyo, Scotty
AU - Bornstein, Sarah
AU - Cole, Travis
AU - Ham, Tracie
AU - Miller, Jean Philippe
AU - Reynolds, Teri
AU - Körver, Sarah
AU - Cameron, Peter
N1 - Funding Information:
The authors would like to acknowledge all of the EC clinicians at GGH and MHPH who participated in the IITT training and implementation process. Thanks also go to the Executive of the Western Highlands Provincial Health Authority, including Hospital Manager Jane Holden, and the staff on the Global EC Desk at the Australasian College for Emergency Medicine, including Sally Reid, for actively supporting and championing the project. The authors also acknowledge the efforts of those WHO, MSF and ICRC staff who contributed to development of the IITT. The project was funded through a Friendship Grant from the Australian Government Department of Foreign Affairs and Trade and an International Development Fund Grant from the Australasian College for Emergency Medicine Foundation. RM is supported by a National Health and Medical Research Council Postgraduate Scholarship and a Monash Graduate Excellence Scholarship.
Funding Information:
At both sites, the new system went live within 48 h of the classroom teaching sessions. Roll-out was supported by the visiting Australian clinicians. Nurses provided one-on-one mentoring at the triage desk and to senior nursing staff managing flow within the ED. This intense mentoring was utilised for all day shifts for one week following implementation. Changes to flow and ED design were also initiated during this period.
Publisher Copyright:
© 2020
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - In emergency departments (EDs), demand for care often exceeds the available resources. Triage addresses this problem by sorting patients into categories of urgency. The Interagency Integrated Triage Tool (IITT) is a novel triage system designed for resource-limited emergency care (EC) settings. The system was piloted by two EDs in Papua New Guinea as part of an EC capacity development program. Implementation involved a five-hour teaching program for all ED staff, complemented by training resources including flowcharts and reference guides. Clinical redesign helped optimise flow and infrastructure, and development of simple electronic registries enabled data collection. Local champions were identified, and experienced EC clinicians from Australia acted as mentors during system roll-out. Evaluation data suggests the IITT, and the associated change management process, have high levels of acceptance amongst staff. Subject to validation, the IITT may be relevant to other resource-limited EC settings.
AB - In emergency departments (EDs), demand for care often exceeds the available resources. Triage addresses this problem by sorting patients into categories of urgency. The Interagency Integrated Triage Tool (IITT) is a novel triage system designed for resource-limited emergency care (EC) settings. The system was piloted by two EDs in Papua New Guinea as part of an EC capacity development program. Implementation involved a five-hour teaching program for all ED staff, complemented by training resources including flowcharts and reference guides. Clinical redesign helped optimise flow and infrastructure, and development of simple electronic registries enabled data collection. Local champions were identified, and experienced EC clinicians from Australia acted as mentors during system roll-out. Evaluation data suggests the IITT, and the associated change management process, have high levels of acceptance amongst staff. Subject to validation, the IITT may be relevant to other resource-limited EC settings.
UR - http://www.scopus.com/inward/record.url?scp=85103960495&partnerID=8YFLogxK
U2 - 10.1016/j.lanwpc.2020.100051
DO - 10.1016/j.lanwpc.2020.100051
M3 - Review Article
C2 - 34327395
AN - SCOPUS:85103960495
SN - 2666-6065
VL - 5
JO - The Lancet Regional Health - Western Pacific
JF - The Lancet Regional Health - Western Pacific
M1 - 100051
ER -
