Refining an unsuccessful triage process.

Health care moves at such a rapid pace these days that quality improvement (QI) seems to be never-ending. We know these projects can help us to better our care, but it sure does become tiring when yet another new protocol or data responsibility falls on our shoulders. What if you were tasked with an urgent QI project in the midst of responding to a disaster?

Considering our own repeated scrambles to squeeze QI into ordinary workdays, imagine what it would be like to manage QI in a setting of extremely limited resources, where many people were desperate for emergency services—and you had to “get it right,” ASAP.

In “Implementing a Fast-Track Team Triage Approach in Response to Hurricane Maria” (free until November 15), Brittany Parak and colleagues describe their efforts to improve emergency services after their mobile military hospital was deployed to Puerto Rico, just 16 days after Hurricane Maria devastated the island.

“We soon discovered it would be necessary to refine our triage process, as our initial strategy resulted in limited access to care, prolonged wait times, many people leaving without being seen, and patients with acute problems not being cared for in a timely manner.”

QI doesn’t have to be a long, drawn-out affair.

Parak and team began by tweaking their processes, but it soon became clear that they needed an entirely new approach.

“After approximately five days of addressing logistical challenges with small adjustments, we initiated a combined fast-track and team triage system that functioned more efficiently.”

The article is well worth reading: their results could end up making a difference in disaster relief protocols around the world.

This article also illustrates how, if we attend to what we’re trying to accomplish, are deliberate about when the intervention takes place, and make sure we collect data, QI doesn’t have to be a long, drawn-out affair that takes weeks of planning.