Multi-criteria analysis in the health area: selection of the most appropriate triage system for the emergency care units in natal

Abstract

Background: Multiobjective decision-making processes present a high degree of complexity in their solution, and tools such as multicriteria decision analysis appear as a way to facilitate the decision-makers' solution and ensure that the decision is made cohesively and efficiently. In the public health sector, decisions are even more delicate because they work not only with the direct influence of human needs, but also with limited financial resources. An important point for the emergency care units is the triage system, which consists of a pre-evaluation of the patients, classifying them according to the degree of life risk. Through triage, the patient can be attended more quickly and efficiently, streamlining the whole process. Thus, the present research endeavored to determine the most appropriate triage protocol for emergency healthcare units in Natal-RN city in Brazil and may help others less advanced countries to determine the most appropriate triage protocol for emergency healthcare. Methods: In this study, we used the multicriteria analysis method known as FITradeoff. In addition, interviews and structured questionnaires applied with nurses, specialists and directors. Results: Based on the questionnaires and preferences presented by the decision-makers, the Spanish Triage System was the most suitable protocol for the emergency care units, which presented with high ease of use and implementation. Conclusions: This study reached its main objective, which was to determine the most appropriate triage protocol. In addition, it was observed the possibility of new research, such as the development of a specific protocol for this emergency care units and the creation of an application software for this new protocol.

Metaheuristics in the Decentralization of Emergency Care.

“…[19] The scenario is aggravated by several factors such as the lack of resources to carry out the routine activities of the Emergency Medical Service, the growing urban violence, the maladministration of public hospitals. [20] The average response time quantified by the SSO systemthe Online Health System consulted daily by the medical regulation team, which is the main indicator to evaluate the SAMU Natal service efficiencywas 44 minutes in 2018. Such performance indicators, given the approximate area of the city of Natal (160 km²), reveal a clear need to restructure the services in order to satisfactorily meet current and future demand.…”

Triagem e ativação da via verde do acidente vascular cerebral: dificuldades sentidas pelos enfermeiros

“…Por meio deste sistema é possível a identificação das prioridades no atendimento e a subsequente definição dos tempos limites recomendados até à avaliação clínica. O STM tem sido utilizado em muitos países, podendo ser realizado por médicos ou enfermeiros habilitados mais frequentemente enfermeiros (8,9) . Segundo alguns autores estes últimos profissionais, ao direcionar a sua avaliação para a pessoa com sinais e sintomas e não para um possível diagnóstico clínico, são os que melhor se adequam a esta ferramenta (10) .…”

Model to support intervention prioritization for the control of Aedes aegypti in Brazil: a multi-criteria approach

“…In order to address the inherent complexity of health decisions derived from factors such as uncertainty, conflicts of interest and subjectivity in the assessment of health technologies, amongst other aspects [ 1 , 2 ], the multi-criteria decision analysis (MCDA) emerges as a structured methodology to support the decision-making processes, differing from other formal approaches due to its characteristic of mathematically modelling the subjectivity present in the f decision-makers’ judgement [ 3 ]. Hence, this methodological approach analytically guides decision support in a rational and transparent manner by aiming at the best choice in face of a set of alternatives, based on the decision maker’s preferences [ 4 , 5 ].…”