2023-24 Premier’s Awards for Health and Medical Research - Dr Rob Mitchell

2023-24 Premier’s Awards for Health and Medical Research
Dr Rob Mitchell
Winner, Health Services Researcher Award
PhD Project: Implementation and evaluation of the Interagency Integrated Triage Tool: Lessons from Pacific emergency departments and the COVID-19 pandemic.
Triage is widely regarded as a core function of hospital emergency departments. This is reflected in the World Health Organization Emergency Care Systems Framework, and in resolutions from the World Health Assembly.
A small number of triage scales have been purpose-designed for application in low- and middle-income countries (LMICs). Among these is the Interagency Integrated Triage Tool (IITT), a three-tier triage instrument recently released by the World Health Organization, International Committee of the Red Cross and Médecins Sans Frontières.
This mixed methods research program evaluated the acceptability and performance of the IITT in the Pacific region both prior to and during the COVID-19 pandemic. It also examined the value of triage as a component of Pacific pandemic responses, and the impact of triage implementation on clinical outcomes in LMIC EDs.
Overall, it found that the tool can be reliably and efficiently applied by healthcare workers, and its predictive validity is within the performance range of other triage instruments. It identified that the system is highly regarded by emergency care clinicians.
The research program also evaluated two different implementation models, the first utilising in-person training, and the second, a digital learning strategy coupled with peer mentoring. Both were effective as well as highly acceptable.
This project has generated new knowledge regarding the IITT, but also resulted in the introduction of novel triage, patient flow and data management processes in several Pacific hospitals. In the wake of this research, the IITT is being adopted by emergency departments across Papua New Guinea and the broader region.