Labor and Delivery Triage Acuity Assignment Log

Logs labor and delivery triage arrival, MFTI acuity assignment, and provider notification timing for clinical tracking and audit trail purposes.

Triage Encounter Details

• Triage Date
• Arrival Time
• Patient Identifier
  Use the unit-approved medical record number or encounter ID. Do not enter SSN or other unnecessary PII.
• Triage Location
• Arrival Mode

MFTI Acuity Assignment

• MFTI Acuity Level
  Select the acuity level assigned per MFTI protocol.
• Reason for Acuity Assignment
  Briefly document the observable clinical findings or presenting concern that supported the assigned acuity level.
• Protocol Used
• Reassessment Needed
  Check if the patient requires repeat triage assessment or escalation based on changing condition.

Provider Notification

• Provider Notified
• Provider Notification Date and Time
• Notification Method
• Reason for Notification Delay
  Complete only if provider notification was delayed beyond expected workflow timing.

Escalation and Verification

• Urgent Escalation Required
  Check if the assigned acuity or clinical presentation required immediate escalation per unit policy.
• Escalation Details
  Provide a concise summary of the escalation, including who was contacted and the response received.
• Documented By
  Enter the staff member completing the log.
• Verification Complete
  Confirm the entry is complete, accurate, and ready for the unit audit trail.