Evaluation of Triage System in Emergency Departments at the Gaza Strip Hospitals

Ashraf Issam Helewa
اشرف عصام محمد حليوة
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Al-Quds University
Triage considered one of the main components of emergency healthcare services at any emergency department. It is an essential element of modern medical care as it is necessary to assign relatively scarce resources to unlimited medical needs. This study focuses on evaluating the emergency department triage system at Gaza Strip hospitals emergency departments. It establishes baseline data and addresses the gaps in order to promote the provision of adequate emergency services meeting users’ needs and expectations and to improve the quality of triage system. The researcher used a descriptive, analytical, cross-sectional design which helped the researcher to collect quantitative and qualitative data. The researcher also adopted an analysis method to evaluate health care providers perceptions regarding to structure and design, human resource, equipment and machines, registration and documentation, communication, and standards and protocols of triage system in Al-Shifa, European Gaza Hospitals, Al-Awda and Al-Quds Hospital. The researcher adopt self-administered questionnaire with 252 health care providers (physicians, nurses, security, and administrators) in four eligible hospitals, in addition to twelve key persons were met through interview. The study result shows that 90.1% of the total samples were males. The prominent age group in the sample was employees whose age between 23-30 years old. Employees who have a bachelor degree are most prominent in the sample. The results also show that average triage system score as perceived by health care providers is 63.7%. The dimensions, which elicited the highest positive ratings, were registration and documentation (65.3%), and communication (65.3%); meanwhile those with the lowest ratings included human resource (62.3%), and standards and protocols (61.6%). The overall perception from administrator point view was reached 78.2%% and security point view was 71.0%. Inferential statistics showed that nurses had elicited higher scores with statistically significant differences (P value less than 0. 05) in comparison to physicians. In addition, Al-Awda and Al-Quds hospitals are elicited higher scores in comparison to their counter groups. The study recommended that the current triage system should be reformed and integrated in Prehospital Emergency Services (EMS) in addition to all hospital EDs, settings as a part of its standardized system. Conducting a periodical drill or simulation for managing a mass causality incident that help for testing the hospital emergency plan and redness of ED. Increase public awareness regarding the concept and importance of triage system. Providing well-trained co-workers (Stretcher workers) for handling and evacuating patients in the triage area. Increasing the functional capacity of triage area as well as providing a well prepared alternative area in case of mass causality triage, including reasonable numbers of beds, trolleys, stretchers and wheel chairs for transporting, carrying and evacuating patients, Staffing the ED with suitable number of security staff 24hr./7 days a week, to overcome and control the crowded in the EDs,