Why is BSOTS needed?

Health Services Safety Investigations Body (HSIB) and Care Quality Commission (CQC) recommend that maternity triage departments should use a structured approach to prioritise pregnant women to be seen in order of clinical need.

The benefits of BSOTS include...

• A user-friendly system that standardises care among clinicians, regardless of level of experience
• Improves the safety of women and babies attending triage (proven as a reliable way of assessing clinical priority)
• Standardised assessments and excellent inter-rator reliability means variation in clinical assessment of women between midwives is minimal, and documentation is consistent
• Allows staff to more effectively manage care when there is limited space, by allowing women with less clinical urgency to wait in the waiting area
• Facilitates efficient handover between shifts and departments, using a shared language
• Enables clear escalation should workload become too heavy or there are delays in care
• Manages women's expectations regarding waiting times
• Improves management of the triage area by allowing staff to easily see…
  • how many women are in attendance in the department
  • the clinical urgency of each woman
  • when each woman will require further assessment.

BSOTS can also help address common findings from CQC inspections of maternity units:

• Lack of dedicated triage department (triage staff also covering Day Assessment Unit)
• Poor telephone triage (lack of dedicated phoneline, poor record of phone calls, triage phone answered by clinical staff within the clinical area)
• Lack of robust, consistent systems to triage women and prioritise care in a timely manner
• Poor record keeping and inconsistent documentation
• Insufficient or inconsistent staffing by midwives and doctors
• No clear guidance for escalation
• Lack of audit to maintain oversight of triage department and assess delays