TCI Hospital restructures the Emergency Department Triage Process

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TCI Hospital restructures the Emergency Department Triage Process

(Providenciales, Turks and Caicos Islands – Wednesday 09th January, 2019): InterHealth Canada – Turks and Caicos Islands Hospital has restructured the process for triage in the Emergency Department to create faster access to medical care for patients and more efficient use of resources.

The restructured approach features a moderate adjustment to the current process whereby a clinician will be a patient’s first point of contact. Walk-in patients will be required to undergo triage prior to visiting the Patient Services desk. The new process is scheduled to commence at Cheshire Hall Medical Centre and Cockburn Town Medical Centre on January 11, 2019 and February 4, 2019, respectively.

Patients will be called by a triage nurse in the order of arrival and clinically assessed. Patient verification and registration will also be conducted during the triage assessment. Each patient is assigned a CTAS triage score, which may range from Level 1 to 5. The Canadian Triage Acuity Scale (CTAS) is a five level scale with Level 1 (Resuscitation) representing the most critical patients and Level 5 (Non urgent) representing the least ill.

Any patient requiring urgent intervention (CTAS 1 and 2) will be accompanied to an assessment room or the resuscitation room and treatment initiated immediately. These patients will be registered during treatment. Other patients will continue to be prioritized and seen by a doctor based on the severity of their condition (CTAS Score). The triage nurse will direct ambulatory patients (CTAS 3) to the Patient Services desk to complete the NHIP-eligibility verification and payment process, and then wait to be seen by an emergency doctor.

Non-urgent patients (CTAS 4 and 5) may be transferred to the Outpatient Department or Ministry of Health Primary Health Care clinic, which is located on the hospital property. The clinical transfer is also dependent upon the type of resources required to treat the condition. As a result, some non-urgent cases may remain in the Emergency Department.

Once the Ministry of Health clinics are closed, all patients will be registered and treated in the Emergency Department or Outpatient Department in accordance with their triage score and a payment (co-pay fee or private fees) shall be applied. Payment also applies to any patient transferred to the hospital’s Outpatient Department.

The Emergency Department at Turks and Caicos Islands Hospital treats cases of various acuity levels, including benign conditions that can be treated by a primary care doctor. Patients are therefore encouraged to consider the seriousness of an illness or injury in advance and determine the most beneficial and appropriate place for care, where possible. Primary care clinics operated by the TCI Government Ministry of Health are primarily free of charge and are open during extended hours.

Medical conditions suitable for treatment at a primary care clinic include common illnesses, such as colds, the flu, earaches, sore throats, migraines, low-grade fevers, prescription refills and limited rashes. Minor injuries, such as sprains, back pain, minor cuts and burns, minor broken bones, or minor eye injuries. Patients are encouraged to visit the Primary Health Clinics directly during their opening hours.

Patients should visit the emergency department for emergency and urgent complaints such as: Trouble breathing; Unresponsive and not breathing; Suddenly not able to speak, see, walk, or move; Suddenly weak or drooping on one side of the body; Sudden confusion; Heavy bleeding; Severe allergic reaction with trouble breathing, swelling, hives; High fever with headache and stiff neck; High fever that does not get better with medicine; Poisoning or overdose of drug or alcohol and Seizure. The symptoms above are not a complete, specific listing, but rather guidelines.

ENDS

Key Points:

– A clinician (triage nurse) will be a patient’s first point of contact under the restructured triage process.
– Any patient requiring urgent intervention (CTAS 1 and 2) will be accompanied to an assessment room or the Rhesus room and treatment initiated immediately.
– Patients categorised as CTAS 3 will remain in the Emergency Department.
– Patients are only seen by a triage nurse in the order of arrival as a means of prioritising patients based on their acuity level (CTAS Score). It is important to understand that each patient is seen by a doctor based on the severity of their condition (CTAS Score). Hence, urgent cases will be seen faster than non-urgent patients;
– Non-urgent cases (CTAS 4 & 5) may be transferred to Ministry of Health – Primary Health Care Clinics, depending on the resources required. Patients may also be transferred to the hospital’s Outpatient Department.
– Payment shall be applied to any patient treated by a hospital-based physician, whether in the Emergency Department or Outpatient Department.
– The Ministry of Health – Primary Health Care clinics are conveniently located on the hospital property and patients with non-urgent conditions are encouraged to visit the clinic directly.
– The Ministry of Health – Primary Healthcare clinics are operated by the Turks and Caicos Islands Government and is open during the following hours:
· Mon-Fri 8:30am-9:00 pm
· Lunch (Closed) 12:30pm-2:00 pm
· Sat 9:00 am-1:00 pm
· Public Holidays 9:00 am-1:00 pm
· Once the Ministry of Health clinics are closed, all patients will be registered and treated in the Emergency Department or Outpatient Department in accordance with their triage score.