Compliance on Triaging Traumatic Patients Attending Emergency and Outpatient Surgery Department at University Teaching Hospital of Butare (CHUB), Rwanda: A Quasi-Experimental Study

Purpose: The World Health Organization (WHO) defined triage as the action of sorting and prioritizing patients based on the estimation of the urgency for intervention. This approach is used as the basis for identification of those patients who require immediate medical intervention and those who can safely wait. Locally triage is the process including the initial assessment followed by the prioritization of patients needing emergency care and assigns them according to their actual need or likely benefit from immediate medical treatment. To assess the compliance with triage protocols among healthcare providers managing traumatic patients attending the emergency and outpatient surgery department at University Teaching Hospital of Butare. Methodology: The total sample size were 109 but the participants enrolled in the study were 101because 8 participants voluntary did not want to participate to the study (they refused to sign consent form) a prospective cross-sectional study was conducted among health workers in the surgical department (CHUB staff 70), and the emergency department (CHUB staff 31), making a total of 101 participants across both departments. The participants ’knowledge of triage tool was assessed and their level of compliance with triaging. The training on the triage tool was provided among healthcare providers managing traumatic patients attending the emergency and outpatient surgery department at University Teaching Hospital of Butare, and after one moth of intervention the reassessment was also done about the level of compliance with triage tool following training received. Findings: A total of 101 participants were included, the majority being nurses (63.4%). Most respondents reported that the current triage protocols effectively addressed the needs of trauma patients (86.1%) and that adherence to these protocols significantly or somewhat improved patient outcomes (95%). Compliance monitoring was limited, with over one-third (36.6%) stating that outcomes were never reviewed. However, urgent cases were largely well prioritized (89.1%). About one-fifth (20.8%) acknowledged adverse outcomes due to non-compliance with triage protocols. Nearly half (49.5%) of participants reported challenges to implementation, mainly related to lack of training, monitoring, and updated tools. Training interventions were associated with improvements in outcome review practices, prioritization of urgent cases, and reduction of adverse outcomes related to non-compliance. Unique Contribution to Theory, Practice and Policy: In both department participants emphasized the need for ongoing training and to increase staffing as key strategies for further enhance level of compliance and strengthen the triage process in both the emergency and outpatient surgery departments.