Article Text

Download PDFPDF
Identifying workload and types of admissions in an obstetric triage department
  1. RA Samangaya,
  2. MK Whitworth,
  3. J Mason,
  4. A Brockbank,
  5. J Gillham
  1. St Mary's Hospital, Manchester, UK


Introduction Royal College of Obstetricians and Gynaecologists recommendations are that every pregnant woman attending A&E for other than minor injuries should be seen by a midwife or obstetrician. In the UK, obstetric departments are frequently isolated from A&E. Consequently, in the last decade obstetric triage departments (OTDs) have developed. The only published literature on OTDs comes from the US where roles are to determine whether a woman is in labour. In the UK, remits are wider with obstetric, medical or surgical problems.

Method Prospective survey conducted during March 2009 to determine workload, staffing and admissions in a tertiary referral hospital.

Results There were 751 attendances; mean 24.2 per 24 h (range 13–32). Midwives assessed women in a mean of 15 m (range 0–3 h 30 m). Mean number of telephone calls per shift was 13 (range 4–24). Staffing was below the recommended level on 44% of shifts. Peak time for attendance was 11:00. 57% of women were in labour; 16% suspected ruptured membranes; 11% abdominal pain; 8% vaginal bleeding; 7% reduced fetal movements. Mean time spent in OTD was 2 h 8 m (range 2 m–10 h 30 m). 39.8% were reviewed solely by a midwife. Of those requiring medical review, mean wait was 1 h 7 min (range 0–4 h 25 m). 42% of women went home from the OTD, 22% admitted to an antenatal ward and 24% to delivery suite.

Conclusion This is the first study to describe workload of an OTD and highlights the massive flow of patients through such a department. The study concluded that an obstetric specific triage system is necessary to optimise patient flow.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.