Using the South African Triage Scale for prehospital triage: a qualitative study
| dc.contributor.author | Dixon, Julia | |
| dc.contributor.author | Burkholder, Taylor | |
| dc.contributor.author | Pigoga, Jennifer | |
| dc.contributor.author | Lee, Michael | |
| dc.contributor.author | Moodley, Kubendhren | |
| dc.contributor.author | de Vries, Shaheem | |
| dc.contributor.author | Wallis, Lee | |
| dc.contributor.author | Mould-Millman, Nee-Kofi | |
| dc.date.accessioned | 2021-11-02T13:33:26Z | |
| dc.date.available | 2021-11-02T13:33:26Z | |
| dc.date.issued | 2021-10-30 | |
| dc.date.updated | 2021-10-31T04:18:28Z | |
| dc.description.abstract | Background Triage is a critical component of prehospital emergency care. Effective triage of patients allows them to receive appropriate care and to judiciously use personnel and hospital resources. In many low-resource settings prehospital triage serves an additional role of determining the level of destination facility. In South Africa, the Western Cape Government innovatively implemented the South African Triage Scale (SATS) in the public Emergency Medical Services (EMS) service in 2012. The prehospital provider perspectives and experiences of using SATS in the field have not been previously studied. Methods In this qualitative study, focus group discussions with cohorts of basic, intermediate and advanced life support prehospital providers were conducted and transcribed. A content analysis using an inductive approach was used to code transcripts and identify themes. Results 15 EMS providers participated in three focus group discussions. Data saturation was reached and four major themes emerged from the qualitative analysis: Implementation and use of SATS; Effectiveness of SATS; Limitations of the discriminator; and Special EMS considerations. Participants overall felt that SATS was easy to use and allowed improved communication with hospital providers during patient handover. Participants, however, described many clinical cases when their clinical gestalt triaged the patient to a different clinical acuity than generated by SATS. Additionally, they stated many clinical discriminators were too subjective to effectively apply or covered too broad a range of clinical severity (e.g., ingestions). Participants provided examples of how the prehospital environment presents additional challenges to using SATS such as changing patient clinical conditions, transport times and social needs of patients. Conclusions Overall, participants felt that SATS was an effective tool in prehospital emergency care. However, they described many clinical scenarios where SATS was in conflict with their own assessment, the clinical care needs of the patient or the available prehospital and hospital resources. Many of the identified challenges to using SATS in the prehospital environment could be improved with small changes to SATS and provider re-training. | en_US |
| dc.identifier.apacitation | Dixon, J., Burkholder, T., Pigoga, J., Lee, M., Moodley, K., de Vries, S., ... Mould-Millman, N. (2021). Using the South African Triage Scale for prehospital triage: a qualitative study. <i>BMC Emergency Medicine</i>, 21(Article number: 125), http://hdl.handle.net/11427/35305 | en_ZA |
| dc.identifier.chicagocitation | Dixon, Julia, Taylor Burkholder, Jennifer Pigoga, Michael Lee, Kubendhren Moodley, Shaheem de Vries, Lee Wallis, and Nee-Kofi Mould-Millman "Using the South African Triage Scale for prehospital triage: a qualitative study." <i>BMC Emergency Medicine</i> 21, Article number: 125. (2021) http://hdl.handle.net/11427/35305 | en_ZA |
| dc.identifier.citation | Dixon, J., Burkholder, T., Pigoga, J., Lee, M., Moodley, K., de Vries, S., Wallis, L. & Mould-Millman, N. et al. 2021. Using the South African Triage Scale for prehospital triage: a qualitative study. <i>BMC Emergency Medicine.</i> 21(Article number: 125) http://hdl.handle.net/11427/35305 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Dixon, Julia AU - Burkholder, Taylor AU - Pigoga, Jennifer AU - Lee, Michael AU - Moodley, Kubendhren AU - de Vries, Shaheem AU - Wallis, Lee AU - Mould-Millman, Nee-Kofi AB - Background Triage is a critical component of prehospital emergency care. Effective triage of patients allows them to receive appropriate care and to judiciously use personnel and hospital resources. In many low-resource settings prehospital triage serves an additional role of determining the level of destination facility. In South Africa, the Western Cape Government innovatively implemented the South African Triage Scale (SATS) in the public Emergency Medical Services (EMS) service in 2012. The prehospital provider perspectives and experiences of using SATS in the field have not been previously studied. Methods In this qualitative study, focus group discussions with cohorts of basic, intermediate and advanced life support prehospital providers were conducted and transcribed. A content analysis using an inductive approach was used to code transcripts and identify themes. Results 15 EMS providers participated in three focus group discussions. Data saturation was reached and four major themes emerged from the qualitative analysis: Implementation and use of SATS; Effectiveness of SATS; Limitations of the discriminator; and Special EMS considerations. Participants overall felt that SATS was easy to use and allowed improved communication with hospital providers during patient handover. Participants, however, described many clinical cases when their clinical gestalt triaged the patient to a different clinical acuity than generated by SATS. Additionally, they stated many clinical discriminators were too subjective to effectively apply or covered too broad a range of clinical severity (e.g., ingestions). Participants provided examples of how the prehospital environment presents additional challenges to using SATS such as changing patient clinical conditions, transport times and social needs of patients. Conclusions Overall, participants felt that SATS was an effective tool in prehospital emergency care. However, they described many clinical scenarios where SATS was in conflict with their own assessment, the clinical care needs of the patient or the available prehospital and hospital resources. Many of the identified challenges to using SATS in the prehospital environment could be improved with small changes to SATS and provider re-training. DA - 2021-10-30 DB - OpenUCT DP - University of Cape Town IS - Article number: 125 J1 - BMC Emergency Medicine KW - Prehospital KW - Triage KW - EMS KW - SATS; South African Triage Scale KW - Focus groups LK - https://open.uct.ac.za PY - 2021 T1 - Using the South African Triage Scale for prehospital triage: a qualitative study TI - Using the South African Triage Scale for prehospital triage: a qualitative study UR - http://hdl.handle.net/11427/35305 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s12873-021-00522-3 | |
| dc.identifier.uri | http://hdl.handle.net/11427/35305 | |
| dc.identifier.vancouvercitation | Dixon J, Burkholder T, Pigoga J, Lee M, Moodley K, de Vries S, et al. Using the South African Triage Scale for prehospital triage: a qualitative study. BMC Emergency Medicine. 2021;21(Article number: 125) http://hdl.handle.net/11427/35305. | en_ZA |
| dc.language.iso | en | en_US |
| dc.language.rfc3066 | en | |
| dc.publisher.department | Division of Emergency Medicine | en_US |
| dc.publisher.faculty | Faculty of Health Sciences | en_US |
| dc.rights.holder | The Author(s) | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_US |
| dc.source | BMC Emergency Medicine | en_US |
| dc.source.journalissue | Article number: 125 | en_US |
| dc.source.journalvolume | 21 | en_US |
| dc.source.uri | https://bmcemergmed.biomedcentral.com/ | |
| dc.subject | Prehospital | en_US |
| dc.subject | Triage | en_US |
| dc.subject | EMS | en_US |
| dc.subject | SATS; South African Triage Scale | en_US |
| dc.subject | Focus groups | en_US |
| dc.title | Using the South African Triage Scale for prehospital triage: a qualitative study | en_US |
| dc.type | Journal Article | en_US |