Triage Vitals & Emergency Acuity Scoring

1. Overview & Business Value#

This comprehensive operational guide details the architecture, business workflows, configuration parameters, and execution steps for Triage Vitals & Emergency Acuity Scoring within SmartERP.

Operational guide for triage nurses to capture vital signs, calculate early warning scores, and prioritize patients by emergency acuity.

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2. Prerequisites & Security Access Groups#

• Required Modules: smarterp_healthcare, smarterp_clinical_core, smarterp_pharmacy
• Security Groups:
  • Healthcare Receptionist (Technical ID: smarterp_healthcare.group_medical_receptionist)
  • Physician / Attending Doctor (Technical ID: smarterp_healthcare.group_medical_doctor)
  • Pharmacy Dispenser (Technical ID: smarterp_healthcare.group_medical_pharmacist)
• Master Data Dependencies: Patient master registry (Medical Record Number - MRN), EFDA drug formulary, Ethiopian Ministry of Health (MoH) HMIS disease codes, and EHIS insurance tariffs.

3. Step-by-Step Configuration & Execution#

Step 1: Navigating to the Module Interface#

1. Log into your SmartERP instance at https://smarterp.et/odoo.
2. Open the main App Switcher (grid icon in the top-left corner).
3. Select the Healthcare app icon.
4. From the top navigation bar, open Healthcare → Clinical Dashboard → OPD Triage / Inpatient ADT / EMR / Pharmacy Dispensing.

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Step 2: Creating and Parameterizing Records#

1. Click the New button in the top-left control panel.
2. Complete the mandatory fields in the record form:
   • Medical Record Number (MRN) (Mandatory): Unique national health identifier or generated hospital record code
   • Patient Demographics (Mandatory): Full legal name, gender, date of birth, and Kebele residential location
   • Encounter Type (Mandatory): Outpatient (OPD), Inpatient (IPD), Emergency, or Triage consultation
   • Attending Physician (Mandatory): Licensed healthcare practitioner responsible for clinical encounter
3. Configure optional operational parameters and localized tags as required:
   • Insurance Provider & Policy (Optional): EHIS CBHI/SHI policy or corporate credit contract
   • Triage Vital Signs (Optional): Blood pressure, pulse rate, respiratory rate, temperature, and SpO2
   • ICD-11 / HMIS Diagnosis Code (Optional): Standardized diagnosis category for statutory health reporting
4. Click the Save icon in the control bar to commit the record.

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Step 3: Validating and Processing Transactions#

• State Transitions: Execute operational state progression (Reception / Triage → Consultation → Lab / Radiology → Prescription → Billing / Discharge).
• Ledger & System Impact: Patient billing registers medical service revenue, debits patient or insurance accounts receivable, and debits pharmaceutical inventory upon prescription dispensing.
• Audit Verification: Automated recording of author ID, timestamp, and immutable revision history.

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Triage Station Workflow#

Upon arrival, all non-immediate resuscitation walk-in patients report to the Triage Station. The triage nurse assesses physiological stability, records vital signs, and assigns an acuity category that dictates clinical response times.

Recording Physiological Vital Signs#

1. In Healthcare > Nursing > Triage Workstation, select the patient from the arrival queue.
2. Enter the vital signs:
   • Blood Pressure ($mmHg$): Systolic and Diastolic.
   • Heart Rate ($bpm$): Radial or apical pulse.
   • Respiratory Rate ($breaths/min$).
   • Axillary or Tympanic Temperature ($^\circ C$).
   • Pulse Oximetry ($SpO_2 \%$) on room air or supplemental oxygen.
   • Blood Glucose ($mg/dL$): Mandatory for altered mental state or diabetic patients.
   • Pain Score: Numerical rating scale (0 to 10) or Wong-Baker faces for pediatric patients.
3. Record anthropometrics: Weight ($kg$) and Height ($cm$). The system computes Body Mass Index ($BMI$) and pediatric z-scores automatically.

National Early Warning Score (NEWS2) Automation#

SmartERP automatically computes the NEWS2 aggregate score based on physiological derangements:

Emergency Acuity Escalation#

If a patient exhibits red flags (e.g., $SpO_2 < 88\%$, Systolic BP $< 80\, mmHg$, GCS $< 9$):

1. Click Emergency Red Flag Override.
2. Select the primary indicator (e.g., Anaphylaxis, Severe Respiratory Distress, Acute Hemorrhage).
3. The system bypasses standard OPD queues, sends an instantaneous audio-visual broadcast to the Resuscitation Bay workstation, and reserves an emergency trauma bed immediately.

4. Advanced Configuration Points#

• Automated Actions & Scheduled Tasks (Crons):
  • Healthcare: Generate daily MoH HMIS aggregate tally (smarterp_healthcare.ir_cron_hmis_sync): Runs daily at 23:00 to prepare DHIS2 health data summaries
  • Pharmacy: Flag expiring EFDA medicine batches (smarterp_healthcare.ir_cron_fefo_expiry): Runs daily at 06:00 to alert dispensers of lots expiring within 60 days
• Custom Print Templates & Reports:
  • Official Patient Encounter Summary & Medical Certificate
  • Electronic Prescription Order Form (Model 19 Compliant)
  • Ethiopian Health Insurance Service (EHIS) Claim Dossier
  • Daily MoH Outpatient / Inpatient Morbidity Tally Sheet
• Multi-Company Rules: Record-level security isolation under Company 1 (Ashewa Technology Solutions S.C.), preventing cross-company ledger leakage across parent and subsidiary legal entities.

5. Comprehensive Troubleshooting Matrix#