Improving ‘needless’ waits in an obstetric ER: implementing an obstetric triage system in a tertiary hospital in Ghana

Maternal mortality is the bane of obstetric practice in sub-Saharan Africa. The delay in receiving care upon arrival in a hospital is a significant contributor to maternal mortalities. Obstetric triaging allows the prioritization of care based on patient acuity. This allows orderly access to care and reduces delays in the health facility. This study was a quality improvement project that set out to establish an obstetric triaging system in the department of Obstetrics and Gynaecology of the Korle Bu Teaching Hospital (KBTH) starting in December 2016, and assess its impact primarily on the pre-implementation waiting time of 4.2 hours, one year on after implementation. The project was scheduled in phases which included training, development of an Obstetric Emergency System, development of process maps and reorganization of care, infrastructural works all culminating in the establishment of a Triage System. Results from data collected one year on showed an average reduction in waiting time from 4.2 hours (252 minutes) to an average of 138.8 minutes. Triaging has helped to improve the timeliness and has added a patient-centered approach to care offered in the Obstetric Emergency of the Korle Bu Teaching Hospital.