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Prioritising the care of critically ill children: a pilot study using SCREEN reduces clinic waiting times
  1. Bhakti Hansoti1,
  2. Mohammed Dalwai2,
  3. Joanne Katz1,
  4. Martin Kidd3,
  5. Ian Maconochie4,
  6. Alain Labrique1,
  7. Lee Wallis2
  1. 1Johns Hopkins University, Baltimore, Maryland, USA
  2. 2Department of Surgery, University of Cape Town, Cape Town, South Africa
  3. 3Stellenbosch University, Cape Town, South Africa
  4. 4St Mary's Hospital, Imperial College, London, UK
  1. Correspondence to Dr Bhakti Hansoti; bhansot1{at}


Objective In low-resource settings, childhood mortality secondary to delays in triage and treatment remains high. This paper seeks to evaluate the impact of the novel Sick Children Require Emergency Evaluation Now (SCREEN) tool on the waiting times of critically ill children who present for care to primary healthcare clinics in Cape Town, South Africa.

Methods We used a pre/postevaluation study design to calculate the median waiting times of all children who presented to four randomly chosen clinics for 5 days before, and 5 days after, the implementation of SCREEN.

Findings The SCREEN programme resulted in statistical and clinically significant reductions in waiting times for children with critical illness to see a professional nurse (2 hours 45 min to 1 hour 12 min; p<0.001). There was also a statistically significant reduction in the proportion of children who left without being seen by a professional nurse (25.8% to 18.48%; p<0.001).

Conclusions SCREEN is a novel programme that uses readily available laypersons, trained to make a subjective assessment of children arriving at primary healthcare centres, and provides a low cost, simple methodology to prioritise children and reduce waiting times in low-resource healthcare clinics.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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