Implementation of the South African Triage Scale (SATS) in a New Ambulance System in Beira, Mozambique: A Retrospective Observational Study

Andrea Conti (), Daniela Sacchetto, Giovanni Putoto, Marcello Mazzotta, Giovanna De Meneghi, Emanuela De Vivo, Lorenzo Lora Ronco, Ives Hubloue, Francesco Della Corte, Francesco Barone-Adesi, Luca Ragazzoni and Marta Caviglia
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Andrea Conti: CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
Daniela Sacchetto: CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
Giovanni Putoto: Doctors with Africa CUAMM, 35121 Padua, Italy
Marcello Mazzotta: Doctors with Africa CUAMM, 35121 Padua, Italy
Giovanna De Meneghi: Doctors with Africa CUAMM, 35121 Padua, Italy
Emanuela De Vivo: Doctors with Africa CUAMM, 35121 Padua, Italy
Lorenzo Lora Ronco: CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
Ives Hubloue: Research Group on Emergency and Disaster Medicine, Vrije Universiteit Brussels, 1050 Brussels, Belgium
Francesco Della Corte: CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
Francesco Barone-Adesi: CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
Luca Ragazzoni: CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy
Marta Caviglia: CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy

IJERPH, 2022, vol. 19, issue 16, 1-12

Abstract: In 2019, an urban ambulance system was deployed in the city of Beira, Mozambique to refer patients from peripheral health centres (HCs) to the only hospital of the city (Beira Central Hospital—HCB). Initially, the system worked following a first-in–first-out approach, thus leading to referrals not based on severity condition. With the aim of improving the process, the South African Triage Scale (SATS) has been subsequently introduced in three HCs. In this study, we assessed the impact of SATS implementation on the selection process and the accuracy of triage performed by nurses. We assessed 552 and 1608 referral charts from before and after SATS implementation, respectively, and we retrospectively calculated codes. We compared the expected referred patients’ codes from the two phases, and nurse-assigned codes to the expected ones. The proportion of referred orange and red codes significantly increased (+12.2% and +12.9%) while the proportion of green and yellow codes decreased (−18.7% and −5.8%). The overall rates of accuracy, and under- and overtriage were 34.2%, 36.3%, and 29.5%, respectively. The implementation of SATS modified the pattern of referred patients and increased the number of severe cases receiving advanced medical care at HCB. While nurses’ accuracy improved with the routine use of the protocol, the observed rates of incorrect triage suggest that further research is needed to identify factors affecting SATS application in this setting.

Keywords: emergency medical service; triage; prehospital care; low- and middle-income country; South African Triage Scale (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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