Aims

To better understand the reasons that pregnant women and new mothers attend the Emergency Department (ED) and determine whether they could benefit from being assessed differently to woman who are not pregnant.

Background

In EDs there is an established triage system which has been in place for many years and that enables those who attend to be assessed by a healthcare professional soon after arrival. This triage assessment prioritises the order in which patients are seen, so that they are seen according to their clinical need.

For pregnancy and newly postnatal related health concerns, women usually attend maternity services, but sometimes they need to attend the ED if the issue is not pregnancy related (chest pain, breathing difficulties or acute mental health issues or concerns etc) or if there is no emergency maternal unit nearby. When pregnant or newly postnatal women attend EDs there is currently no specific system which accounts for the different health needs of these women. In some cases, staff may be less familiar with caring for pregnant women or new mothers. This might lead to delays in treatment or referral to pregnancy services and sometimes poor outcomes.

Research

This project will establish how many pregnant or newly postnatal women attend ED and why. It will also establish why they have come to hospital, how unwell they are, whether they are referred to other health services (for example obstetrics/ gynaecology/ mental health services for pregnant women) and whether they are transferred, discharged or admitted. This will help understand whether a specific triage process is required for pregnant women.

Patient involvement

There has been patient and public involvement and engagement throughout the development, implementation and dissemination of the maternity triage system developed in Birmingham, called the Birmingham Symptom specific Obstetric Triage System (BSOTS). This new project has been discussed with the same patient involvement group who were very supportive.

Approval

This project was supported unanimously by the PIONEER Data Trust Committee.

Principal investigator

Professor Sara Kenyon, University of Birmingham and the NIHR Applied Research Collaboration (ARC) West Midlands

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