Enhancing Emergency Obstetric Care Through Implementation of a Triage Acuity Score: A Quality Improvement Initiative.

Abstract

Background: Maternal morbidity and mortality in the U.S. remain a significant concern, particularly in obstetric emergency settings where inefficient triage delays care and contributes to adverse outcomes.

Local problem: The obstetric emergency department (OBED) faced challenges in aligning triage processes with acuity-based care, leading to delays in provider response times.

Methods: A quality improvement initiative was conducted. Pre/post-implementation data were collected to evaluate the alignment of maternal-fetal triage index (MFTI) scores with provider-at-bedside (PAB) times.

Interventions: The MFTI system was implemented to prioritize patients based on acuity, aligning provider response times with MFTI-advised targets.

Results: Alignment between MFTI scores and PAB times improved from 40% to 90%. Documentation of MFTI scores and PAB times increased, while total visit times remained stable. Overall, survey data suggested providers were satisfied with the MFTI system.

Conclusions: The MFTI system enhanced triage efficiency and care quality in the OBED without extending total visit times, supporting acuity-based triage in obstetric emergencies.