Case Study: The Birmingham symptom specific triage system (BSOTS)

What is BSOTS?

The Birmingham Symptom-specific Obstetric Triage System (BSOTS) has been developed for midwives, obstetricians and doctors across the NHS as a standardised way to assess women presenting themselves with unexpected pregnancy related problems or concerns, ensuring they are prioritised
in order of clinical urgency.

Prior to the implementation, Birmingham Women’s and Children’s NHS Foundation Trust had approximately 8,000 births a year, with an average triage attendance of 1,200 a month. Women were reviewed often in order of attendance. Women remained in the same room and were cared for by the same midwife which led to potentially ‘blocking’ rooms from those women with high clinical urgency.

What were the aims of BSOTS?

• Implementing a consistent process to define level of clinical urgency, using a four-category colour code allowing hospital staff to quickly prioritise
• Provide midwives and clinicians with a standardised method of safely and efficiently assessing women when they attend with unexpected clinical concerns.

What did we do?

We financially supported an environment where BSOTS could be sustainably rolled out to Trusts that wanted to implement the system.

HIWM moved BSOTS from a paper-based administrative system to a streamlined online process, using the Meridian platform. We enabled BSOTS to be implemented easily and quickly and assigned two midwives and a project manager to the programme to work with other Trusts and share learning.

What were the outcomes?

BSOTS has been adopted by 34 maternity units in the UK with a further 20 in the process of implementation

Participating Trusts have already noticed positive changes in work organisation and practices, along with a reduction in staff anxiety often associated with triage work.