JOGNN R E S E A R C HWomen’s Satisfaction With ObstetricTr.docx

JOGNN R E S E A R C H
Women’s Satisfaction With Obstetric
Triage Services
Marilyn K. Evans, Nancy Watts, and Robert Gratton
Correspondence
Marilyn K. Evans, RN,
PhD, Arthur Labatt Family
School of Nursing, Health
Sciences Addition, Room
H35, Western University,
London, Ontario, Canada.
[email protected]
Keywords
obstetric triage
patient satisfaction
pregnancy
perinatal nursing
labor
ABSTRACT
Objective: To determine the satisfaction of pregnant women
who presented at a triage unit in an obstetric birthing care
unit with obstetric triage services.
Design: Qualitative descriptive with conventional content
analysis.
Setting: Individual audio recorded telephone interviews with
women after discharge from a tertiary care hospital’s
obstetric triage unit.

Participants: Purposive sample of 19 pregnant women who had
received obstetric triage services.
Methods: A semi-structured interview guide was used for data
collection. All interviews were audio-taped and tran-
scribed verbatim. Data analysis was consistent with qualitative
content analysis with open coding to categorize and
develop themes to describe women’s satisfaction with triage
services and care.
Results: Five themes, Triage Unit Environment, Triage Staff
Attitude and Behavior, Triage Team Function, Nursing Care
Received in Triage and Time Spent in Triage, illustrated the
women’s recent triage experiences. Overall the women were
very satisfied with the triage services. Women appreciated a
caring approach from triage nurses, being informed about
the well-being of themselves and their fetuses, being closely
monitored, and effective teamwork among the members
of the health care team.
Conclusions: The results indicated that a humanizing, caring
approach by the inter-professional team offering obstetric
triage services contributed to women’s satisfaction and woman-
centered care.
JOGNN, 44, 693-700; 2015. DOI: 10.1111/1552-6909.12759
Accepted August 2015
Marilyn K. Evans, RN,
PhD, is an associate
professor, Arthur Labatt

Family School of Nursing,
Western University,
Nancy Watts, RN, MN,
PNC(C), is a clinical nurse
specialist, Women’s and
Infant’s Health Program,
Mount Sinai Hospital,
Toronto, Ontario, Canada.
Robert Gratton, MD, is
Chief of Obstetrics and an
associate professor,
Western University, London
Health Sciences Center,
T riage, in the context of health care, involvesthe process of
determining the priority of pa-
tient care according to the urgency of their need
for treatment and is often associated with emer-
gency and disaster services (McBrien, 2009).
Triage concepts have become part of obstetric
practice to improve utilization of bed capacity, in-
crease immediate and appropriate response to
obstetric emergencies, decrease wait times, pre-
vent unnecessary admissions, and standardize
assessment (Angelini & Howard, 2014). Obstet-
ric triage is defined as the ability to appropriately
prioritize and assess pregnant women in a timely
manner, to improve patient flow, and enhance pa-
tient safety (Paisley, Wallace, & DuRant, 2011). An
increased complexity and acuity as well as volume
of pregnant women being seen in obstetric units
and specifically in triage require that the perinatal

nurse as the first person who meets and assesses
the woman presenting for care be able to deter-
mine who needs to be seen immediately and who
can safely wait.
Background and Significance
In a recent systematic review of literature on ob-
stetric triage published from 1998 to 2013, the au-
thors identified quality improvement strategies that
track acuity, length of stay, and patient satisfaction
as important components of best practice (An-
gelini & Howard, 2014). The obstetric triage unit
functions uniquely as an outpatient assessment
center in an inpatient unit in most hospitals. In an
effort to improve the quality of obstetrical care and
patient flow, the perinatal program team at an ur-
ban tertiary care hospital in Southwestern Ontario
developed and implemented a 5-category Obstet-
ric Triage Acuity Scale (OTAS) in 2012 (Smithson
et al., 2013). The OTAS tool was adapted from
the Canadian Triage and Acuity Scale (CTAS) im-
plemented across Canada in emergency depart-
ments for use with obstetric patients (Canadian
Association of Emergency Physicians, 2015). To
ensure patient safety and consistency of care,
women are assessed by experienced perinatal
nurses within 5–10 minutes of their arrival, are
The authors report no con-
flict of interest or relevant
financial relationships.
http://jognn.awhonn.org C© 2015 AWHONN, the Association of
Women’s Health, Obstetric and Neonatal Nurses 693

R E S E A R C H Women’s Satisfaction With Obstetric Triage
Services
Further research regarding obstetric triage in clinical practice
settings is needed to improve patient care, flow, and safety.
asked consistent questions (primary assessment),
are assigned OTAS scores, and receive care fol-
lowing a more thorough assessment (secondary
assessment) based on acuity level (Association of
Women’s Health, Obstetric and Neonatal Nurses
[AWHONN], 2014). The OTAS scores range from 1
(resuscitative) and 2 (emergent) to 5 (nonurgent)
with guidelines for time of health care provider ini-
tial and nursing reassessment. The obstetrician,
family doctor, or midwife collaborate to determine
need for transfer to the labor and birth area or
antenatal unit, or discharge home based on the
OTAS assessment, plan of care, and required in-
terventions.
In an evaluative study conducted by Smithson
et al. (2013), the OTAS demonstrated acceptable
interrater reliability when used by triage nurses
to assess obstetric acuity. Collaboration between
triage nurses and obstetricians was critical to the
initial modification of the tool as was independent
testing to ensure the validity on multiple occa-
sions. Triage nurses challenged with an unpre-
dictable flow of patients who present with various
complaints can use the tool to prioritize acuity for
pregnant women. Perinatal nurses who provide
care in triage struggle with numbers of patients
who present simultaneously in their desire to pro-
vide competent nursing care to all. The volume of

obstetric triage patient visits has been estimated
as ranging from a ratio of 1.2 to 1.5 to the overall
birth volume (Paisley et al., 2011). Data collection
at the study hospital supports volume of obstetric
triage patients at the ratio 1.5 or greater to overall
birth volume with little or no predictability.
Patient satisfaction has become an increasingly
important and commonly used indicator for evalu-
ating the quality of health care (Wen & Schulman,
2014). Furthermore, patient satisfaction measures
are often used by hospital administration to in-
form planning and development of health care
services at various levels (Britton, 2012). Women’s
satisfaction with obstetric care is recognized as a
key component in assessing and monitoring the
quality of maternal and newborn health care ser-
vices being provided (World Health Organization
[WHO], 2013). Although women’s satisfaction with
care they received throughout labor and birth is
shown to be related to overall maternal health,
well-being, and positive transition to postpartum,
the concept is poorly understood and defined
(Sawyer et al., 2013).
Obstetric triage has been implemented in prac-
tice over the past decade and its effect on length
of stay, efficiency, and patient flow has been pos-
itive, yet little is known about pregnant women’s
satisfaction with receiving triage services. Obstet-
ric triage services have been shown to increase
patient satisfaction through having access to ap-
propriate health providers and shortened length
of stay (Molloy & Mitchell, 2010; Paul, Jordan,
Duty, & Engstrom, 2013).The process improve-

ments within the Triage unit have been evaluated
with various data measures, including length of
stay and time to health care provider. In order to
continually enhance and provide quality and safe
obstetric care to pregnant women, eliciting their
satisfaction with triage medical and nursing care
is needed. The purpose of this study was to de-
termine women’s satisfaction with obstetric triage
services from the perspective of pregnant women
presenting at a Triage Unit within an Obstetric
Birthing Care Unit. Research questions included:
What aspects of triage care do pregnant women
consider valuable? What components of obstetric
triage require improvement? Greater understand-
ing of women’s satisfaction with obstetric services
is an effective means to ensure implementation of
obstetric triage services align with woman- and
family-centered care.
Methods
Study Design and Sampling
A qualitative descriptive design with semi-
structured interviews was considered the most
appropriate approach to gain insight regarding
pregnant women’s satisfaction with the obstetric
triage experience. Qualitative inquiry serves to in-
crease understanding of the individual’s health ex-
periences and behaviors (Patton, 2015). The local
research ethics board granted ethical approval for
this study prior to commencement of data collec-
tion.
Using purposive sampling (Morse, 1999), a sam-
ple of 39 pregnant women who met the inclusion
criteria was initially approached and recruited by
two research assistants directly from the triage

unit in the obstetric birthing care unit after the
women had been initially assessed by triage staff
using the 5-level OTAS scale. This sampling tech-
nique was used to ensure the participants had
experienced obstetric triage services and would
have knowledge related to the research questions.
694 JOGNN, 44, 693-700; 2015. DOI: 10.1111/1552-
6909.12759 http://jognn.awhonn.org
Evans, M. K., Watts, N., and Gratton, R. R E S E A R C H
None of the 39 women approached declined to
participate in the study. Eligibility criteria included
women who were at >20 weeks gestation at the
time of enrollment and > 18 years of age, as-
sessed in the triage unit, and could communicate
in English. Women who were identified as hav-
ing experienced an adverse event while in triage
or prior to arrival, such as suspected intrauterine
death or development of a clinical condition requir-
ing emergency interventions, were not eligible to
participate. The decision to exclude these women
was to avoid creating any additional stress. All
participants were recruited during May and June,
2014.
Data Collection
Eligible women initially assessed in the triage unit
were identified by the triage nurses and then ap-
proached by the research assistants and informed
about the study. Written informed consent and
contact information was obtained from interested
and eligible women while they were in the triage

unit. One-on-one telephone interviews were con-
ducted with the women within two weeks after
they were discharged from the triage unit at a
time convenient to the women. All interviews were
conducted by telephone for the convenience of
participants and lasted approximately 20 minutes.
Consent was reconfirmed at the time of the tele-
phone contact and prior to conducting interviews.
A semi-structured interview guide was adapted,
with permission, from a previously published pa-
tient obstetric triage satisfaction questionnaire to
include more open ended questions (Paul et al.,
2013). Guiding interview questions pertained to
topics such as why the women came to the triage
unit, their expectations of triage and initial impres-
sions, satisfaction with information and care re-
ceived from staff, time spent in triage, what was
most helpful about the care received, and how
could triage services be improved. Some of the
questions include the following: What happened
when you first arrived at triage? What were your
first impressions of the triage unit? What made you
phone or come to the hospital? How did you feel
about the care you received during triage?
All the interviews were audio taped with the par-
ticipants’ permission and transcribed verbatim by
one of the researcher assistants. Data collection
was terminated after the 19th interview when the
research team determined that data saturation
had been reached; that is no new information
or themes emerged from the interviews and data
analysis (O’Reilly & Parker, 2013).
Data Analysis
Data collection and analysis occurred con-

currently throughout the research process. All
transcripts were initially read while listening
to the audio tapes to ensure accuracy. Data
were subsequently analyzed consistent with
conventional, qualitative content analysis (Hsieh
& Shannon, 2005) to identify patterns and themes
from the text.Transcripts were read in their entirety
by research team members to gain a sense of
what the women were saying. Next, line by line
open coding of the transcribed interviews was
conducted by the two research assistants to
independently develop a preliminary descriptive
code chart of terms within the transcripts. To
enhance interrater reliability of coding, transcripts
were subsequently coded independently by two
other research team members using the initial
coding guide. Using an inductive, iterative pro-
cess, the researchers compared codes, focused
on key terms and recurring phrases within each
interview, and refined the initial coding chart.
Open coding continued, and then as patterns
were identified, the codes were grouped into
categories which in turn were developed into
final themes. Discrepancies in the coding and
the development of categories and themes were
resolved through collective reflection and open
dialogue among the research team members until
consensus was reached on the final themes.
Results
Study Sample
The final sample included 19 women, and the
majority (n = 11) reported being referred to the
triage unit by their physicians or midwives or hav-
ing scheduled appointments. Two women men-
tioned having contacted telehealth (confidential

telephone health service provided by registered
nurses) and were advised to go to triage. Other
women (n = 6) self-referred to triage for con-
ditions such as headache, minor motor vehi-
cle collision, or contractions. The majority of the
women were assigned OTAS scores that were
less urgent, OTAS = 4 (n = 6), and non-urgent,
OTAS = 5 (n = 8) categories, and none were
scored as emergent. The eligibility criteria used
for recruitment likely contributed to these results.
The average perceived time women reported as
spent in triage was approximately 2.5 hours (range
5 minutes to14 hours).
Themes
Five themes emerged from the data that described
the participants’ satisfaction with obstetric triage
JOGNN 2015; Vol. 44, Issue 6 695
Services
Participants expressed that being closely monitored and
receiving information was comforting and valuable.
services and the care they received: Triage Unit
Environment, Triage Staff Attitude and Behavior,
Triage Team Function, Nursing Care Received
in Triage, and Time Spent in Triage. Although
presented separately, the five themes together
demonstrated that the participants were satisfied
with their recent triage experiences.

Triage Unit Environment. Many participants noted
the physical characteristics and overall atmo-
sphere of the triage unit when they first arrived
and throughout their stays and described it as
“warm,” “comfortable,” and “welcoming.” Most
participants described being met by “friendly”
staff. Some participants explained that although
the unit appeared very busy, they were greeted
right away. One participant commented that the
overall environment “was very calming . . . and
quiet when it needed to be.”
Interestingly many participants expected the
triage unit to be similar to an emergency depart-
ment, crowded and highly emotional, and that they
would have to wait to be seen. They were pleased
that this was not the case: “I kinda thought it would
be like an emerg type thing where tons of people
are sitting around crying and waiting.”
It is important to disclose that the hospital was
implementing a major change in the computerized
infrastructure system at the same time this study
was being conducted, and all medical and nursing
staff was learning a new software system. One
participant mentioned being aware of this change
and its potential effect on wait times, but she was
understanding of the implications on care:
I know there’s a new software system they
were telling me they were all trying to get
used to. They just kept apologizing pro-
fusely because things seem to take a little
bit longer than what they expected. . . . I am
sure once that is up and running smoothly
it will be a fantastic flow.

In addition, the unit itself was fairly new and had
only been open for three years; many participants
commented that it was “beautiful” compared to
other hospital units they experienced.
Triage Staff Attitude and Behavior. The triage staff
was described as showing respect, kindness, and
understanding of the concerns participants had
about themselves and their fetuses. Participants
commented on feeling valued and acknowledged
by nursing staff: “They didn’t make it seem like it
wasn’t a big deal . . . and wanting to just get to the
bottom and see why I was feeling the way I was
feeling.” The participants indicated that staff mem-
bers were “personable,” accommodating, gen-
uine, and attentive to their needs: “It felt more
human. It felt more, ‘Okay how can we help you’
rather than “what are you doing here.’” Another
woman described she felt being looked after as
an individual and not “thrown with a bunch of peo-
ple in the waiting room.” Participants described a
caring approach used by the triage nurses: “It was
just her approach with me and the way she han-
dled me, the way she grabbed my arm. The way
she was, ‘Don’t worry, we’ll find out what’s wrong
or what’s going on.’’
The participants felt that the nursing staff under-
stood the amount of pain they were experiencing
and their support needs, particularly if they were
first time mothers. The participants described hav-
ing their questions answered and not made to feel
“silly” or that they should know the answers.
Triage Team Function. While receiving care in the

triage unit, the participants observed the staff go-
ing about their tasks and noted how they appeared
to work together effectively as a team. Many par-
ticipants commented on how well the nurses and
physicians communicated with each other and
kept them informed about treatments, test results,
and what was happening. One woman stated, “I
actually had like the same nurse there that was
there the day before. So I didn’t have her but she
communicated with the nurse that was seeing me
what was going on.” Others appreciated that their
regular physicians or obstetricians external to the
triage unit were made aware of their test results by
the triage staff:
They did some blood work and they were
able to give me the results for that, but I can’t
remember exactly what it was. But when
they took my blood pressure they were able
to tell me what it was. They told me that they
were reporting back to my physician every
time to make sure that she was updated with
that as well.
Another woman was in the triage unit during shift
change and was impressed by the “seamless”
696 JOGNN, 44, 693-700; 2015. DOI: 10.1111/1552-
transition between the day nurse and physician
and the night nurse and physician.

Care Received in Triage. Most participants had
their immediate needs promptly met by the nurs-
ing triage staff and were made to feel comfortable
throughout their stays: “They made sure I had ev-
erything that I needed, that I was comfortable.”
Others described the simple actions performed
by the nurses, such as offering them a warm blan-
ket, a drink of water, or a pillow. One woman ex-
pressed that being made to feel comfortable was
vital to her ability to understand what was hap-
pening: “It was the comfort I would say, because
if you don’t have that then it doesn’t mat’er the in-
formation that you get ’cause you’re not going to
process it.”
Being closely monitored and informed about their
own well-being and the well-being of their fetuses
was very reassuring and helpful for the partici-
pants. They indicated that staff shared test results
and answered their questions in a timely manner,
so they were not “deprived of any information.”
One woman described being continually moni-
tored: “The most helpful would be probably just
the monitoring, like the nurse I would say, the
nurses coming in and out explaining . . . where my
contractions were and how the baby was doing.”
The participants commented on the availability of
staff to answer any questions they had in a timely
manner and mentioned that being in triage was
a stressful situation. Knowing everything was fine
kept their anxiety from “escalating.”
Time Spent in Triage. The perceived length of time
the participants spent in triage varied, but they
were initially seen and assessed by a triage nurse

quite quickly upon their arrival to the unit. Although
some participants commented on having to wait
to be seen again by the triage staff after the initial
assessment, many attributed this to the unit being
busy:
I know that waiting time is a problem. Like
you sometimes wait for a long time to see a
nurse and then she does see you. You wait
a long time to see her again because they
are so busy.
A few participants commented that having to wait
to be seen by triage staff after their initial assess-
ments was likely due to the fact that other women
had more urgent needs. Some participants felt
their situations were not emergencies. However,
some participants described lengthy wait times
between initial screening and being seen by a
nurse again and then the physician. The partici-
pants also commented that the length of time staff
spent with them seemed short, and some would
have appreciated more time with the physician.
However, participants were satisfied with the qual-
ity of the time spent with staff and did not feel
“rushed.” They also appreciated being told the
reasons for the wait.
Discussion
Our results were encouraging and indicated that
overall the participants in this study were very sat-
isfied with their triage experiences, the informa-
tion provided about the fetus and their own well-
being, and the overall care they received from
triage nursing staff. The caring, holistic approach

demonstrated by nursing triage staff was a key
contributor to the participants’ satisfaction with ob-
stetric triage care. Encountering genuine, caring,
and attentive staff was highly valued by all the par-
ticipants. The actual presence of nursing staff was
therapeutic for the participants and helped to di-
minish any anxiety associated with uncertainties
they had about the well-being of their fetuses and
themselves.
Similar to previous research regarding patient sat-
isfaction with maternity care, our results indicated
that emotional and informational support from
nurses and physicians is significant for women
when receiving obstetric triage services (Britton,
2012; Jenkins, Ford, Morris, & Roberts, 2014).
Providing physical comfort, addressing emotional
needs, and ensuring positive patient-health care
provider interactions are supportive strategies
for women in labor (Bowers, 2002; Paul et al.,
2013). Comfort measures and having their con-
cerns heard in a triage environment contributed to
women’s satisfaction during latent labor (Hosek,
Faucher, Lankford, & Alexander, 2014). Simple
caring actions, such as providing a pillow or offer-
ing a glass of water, contributed significantly to the
women’s feelings of satisfaction. Larkin, Begley,
and Devane (2009) proposed that implementing a
social model of care rather than a medical model
of care embodies the notion of being with woman
and facilitates individual, emotional, physical, spir-
itual, and psychological presence/support by the
caregiver. Others advocated humanistic perinatal
care, such as the provision of emotional support,
information about progress, advice, comfort mea-
sures, and advocacy (Hodnett, Gates, Hofmeyr,

Sakala, & Weston, 2011).
Services
Collaboration among triage team members and using a holistic,
caring approach contributed to women’s satisfaction with triage
services.
Lack of communication with triage nursing staff is
a major source of patient dissatisfaction (Nielson,
2004). In our study, the participants’ satisfaction
with triage care was associated with being kept
informed about what was going on and why,
knowing about the health status of the fetus, hav-
ing questions answered by staff, and having tests
results readily shared with them. An explanation
of why they are waiting was important to the
participants. These findings concur with previous
findings that having access to and exchange of
information, support, and a trusting relationship
with caregivers contributed to women’s satisfac-
tion with their childbirth experiences (Madejic,
Milicevic, Vasic, & Djikanovic, 2014; Meyer,
2013). Providing opportunities for women to ask
questions and receive explanations about their
care was critical to a positive prenatal experi-
ence (Novick, 2009).Although the women were
impressed with the physical characteristics of the
triage unit, positive interactions with staff were the
most comforting. Similarly, findings from a study

conducted with laboring women from a range of
settings in Australia indicated that women were
more concerned with their interactions with staff
than the physical environment (Jenkins et al.,
2014).
An effective relationship between a woman and
her health care providers is fundamental for the
quality of care provided throughout pregnancy,
childbirth, and the postpartum period (Aston,
Saulnier, & Robb, 2010). Health care providers
need to devote time to their patients and show
genuine concern for their well-being to positively
influence patient satisfaction (Senić & Marinković,
2013). Relational continuity or process and the
quality of patient-health provider relationships are
critical for a positive pregnancy and childbirth ex-
perience and patient empowerment (Dahlberg &
Aune, 2013).
Our results suggest ensuring effective and ongo-
ing communication between health care providers
and patients is imperative within the triage setting
to enhance patient satisfaction. The concept of
team collaboration has been clearly identified in
the literature as an integral component of a health
care environment that produces optimal birth out-
comes and patient satisfaction (Kapov, Wright,
& Kean, 2014; Putnam, Ikeler, Raup, & Cantu,
2014). Furthermore, inter-professional collabora-
tion improves patient care outcomes, promotes
patient centeredness, and assists continuity of
care (Posthumus et al., 2013; Raab, Brown-Will,
Richards, & O’Mara, 2013). Results of our study
also suggest that effective communication and

collaboration between triage health team mem-
bers and community-based health providers con-
tributes to women’s satisfaction and should be
supported and encouraged. Our findings align
with evidence pertaining to inter-professional col-
laboration and woman-centered care.
Our results also illustrate the importance of com-
municating with health care professionals ex-
ternal to the triage department, as needed, to
ensure continuity of care. Ensuring continuity of
care and consistency in sharing information have
been identified as essential to quality care provi-
sion in obstetric triage (Molloy & Mitchell, 2010).
Implications for Practice and Fur ther
Research
Our study findings contribute to the understand-
ing of women’s satisfaction with obstetric triage
and serves to inform quality intrapartum care.
While care is provided by an interdisciplinary
team throughout a triage visit, the nurse the eyes
and ears of the team and provides ongoing as-
sessment, intervention, and communication that
is critical to the woman’s care (Behling & Re-
naud, 2015). Timely assessment and close moni-
toring are integral parts of the OTAS scoring sys-
tem and are current quality measures for triage
(Association of Women’s Health, Obstetric and
Neonatal Nurses [AWHONN], 2014). Our results
indicated that nurses, despite experiencing in-
creased volumes in the triage unit, still find time
to develop therapeutic relationships and provide
patient-centered care. Quality measures currently
being used to measure outcomes such as the pro-
cesses related to OTAS do not commonly mea-

sure communication, documentation, and team-
work but they are critical to the success and
perceived patient satisfaction (Howard & Jolles,
2015).
Interestingly, the women initially expected to find
that the triage unit would be similar to an emer-
gency department and were pleased to find the
unit, although at times busy, was calm and quiet.
Further research is needed on how environmen-
tal characteristics of an emergency department
that offers obstetric triage services influence preg-
nant women’s satisfaction. Further research is also
698 JOGNN, 44, 693-700; 2015. DOI: 10.1111/1552-
warranted to explore satisfaction with triage care
from the perspective of women whose initial as-
sessment places them in a more acute OTAS
category. In addition, it would be interesting to
determine how women’s satisfaction of care re-
lates to their specific OTAS score. As the OTAS
tool is implemented in other obstetric triage set-
tings, such as small non tertiary care hospitals
offering maternity services and in emergency de-
partments within hospitals, determining women’s
satisfaction within these other practice settings is
warranted.
Effective interprofessional collaboration within the
obstetric triage unit contributes to women’s satis-

faction. Our findings support triage staff embrac-
ing a caring and inter-professional approach for
providing care to women admitted to a triage unit.
More research is warranted to determine what
aspects of interprofessional practice relate to
patient’s satisfaction of triage care.
Strengths and Limitations
To our knowledge this is the first strictly qualitative
study to determine pregnant women’s satisfaction
with obstetric triage service. Open ended inter-
viewing allowed the women’s voices to be heard
and enhanced our understanding of their satis-
faction with the care they received. In addition,
our results provided some insight about the role
inter-professional team work may play to enhance
patient satisfaction.
Limitations to this study included a small sam-
ple that was recruited from one large urban ter-
tiary care setting offering obstetric triage services.
Smaller facilities or those in nonurban settings of-
fering maternity services might implement triage
operations in a different and unique manner. In
addition, most of the women included in the study
had less urgent or nonurgent triage acuity scores.
Women who are assessed as urgent, emergent
or resuscitative may have provided different re-
sponses regarding satisfaction. The study was
also retrospective in nature and asking women
to recall a past event invites the potential for
recall bias. Since all the women needed to be
English-speaking, applicability of the results to
non-English-speaking women is limited. Finally,
our findings are largely limited, as demographic
characteristics of the participants are unknown,

leaving our results open to bias. Our study would
have benefited from including more descriptors
about the sample.
Conclusion
Obstetric triage offers a health service whereby
pregnant women can be assessed and treated
by qualified health professionals for labor and
non-labor related conditions in a timely and safe
manner. Our results indicated the significance of
implementing a humanizing approach in obstet-
ric triage services. Women’s satisfaction of care
received while in triage involved an initial and on-
going caring approach from nursing staff and the
interdisciplinary team. Although obstetric triage
involves effective time management and prompt
assessment, nurses, physicians and other team
members are capable of exhibiting a holistic car-
ing approach and effective communication. Such
behaviors contributed to women’s satisfaction and
fortunately have not been lost.
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