Improving Physical Examination in the Central Triage at Outpatient Department, University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2017

Abstract

Abstract Introduction: The baseline assessment in this study showed that the implementation of Central Triage physical examination procedure was too low In Outpatient Department at University of Gondar Comprehensive Specialized Hospital. Objectives: To increase the proportion of patients physical examining procedures from 1.1% to 40 % in the Central Triage at Outpatient Department at UoGCSH, by the end of January / 2017. Method: A facility based pre- post interventional study was conducted from March/2016 to January/2017 in the University of Gondar Comprehensive Specialize Hospital, Ethiopia The interventions included 1) Training of Central Triage health personnel and other multi disciplinary concerned department heads 2) Establish and availing policy supported Central Triage protocol 3) Accelerate scale-up best experience from similar hospital 4) Fulfill requirement of medical equipment and furniture 5) Strengthening internal supportive supervision. The sample consisted of 267 patients’ medical record review and observations of patients who got appropriate Physical Examination by using simple random sampling techniques. Independent T- Test used to compare the difference in the outcome of interest between the pre – and post –intervention periods with equal sample size and the same variable. Results: The percentage of physical examination, measurement of vital sign, quick problem oriented system examination and linkage of emergency patient from Central Triage to Emergency Room showed an improvement from 1.1% to 43.4%, 1.4% to 47.5%, 4.3 to 39.1% and 1.4% to 11.6% respectively. Intervention results established and make availing policy supported Central Triage protocol, and percentage of medical equipment and furniture and CT standards showed an improvement from 11.8% to 76.5 %.and 40% to 80 % respectively,(P value.<05). Conclusion: Establish and availing organizational Central Triage protocol and resources based on national standards and hospital context, resulted in improving physical examination. Recommendations: Continuous internal Supportive Supervision of health personals followed by on job training related to protocol can improve the implementation of physical examination.