Diaz: ER triage bottleneck delays emergency admissions

By Dolly Yasa

BACOLOD CITY — Negros Occidental Provincial Administrator Atty. Rayfrando Diaz II said delays tied to the One Hospital Command (OHC) are being driven by how hospital emergency room triage is implemented, not by the OHC system itself.

Diaz told reporters Wednesday that emergency patients should not be denied admission because of referral issues.

He said ER triage — the process of prioritizing patients based on the severity of their medical condition — has become the real bottleneck in hospital admissions rather than the OHC platform.

Diaz described the OHC as a management and monitoring tool meant to organize hospital referrals and optimize health care delivery, particularly during emergencies.

He acknowledged there have been instances where ambulance-transported patients were refused admission for lack of referrals, but he emphasized that referrals are not required for emergency cases.

“It is very clear that for emergency cases, there is no need for a referral,” Diaz said, adding that the problem is “human in nature.”

Diaz said the OHC is a computer-based application that shows hospital bed availability and helps assess how facilities and health personnel are performing.

“It should not be used to say ‘no’ to our patients,” he said.

His remarks came amid complaints from several local chief executives over reported delays in patient admissions under the referral system.

Cadiz City Mayor Salvador Escalante Jr., president of the Negros Association of Chief Executives (Negros ACE), said some delays have allegedly resulted in deaths, with patients forced to wait in ambulances or even tricycles while clearances are processed.

Toboso Mayor Richard Jaojoco has suggested scrapping the OHC altogether, a move Diaz cautioned against.

“If we remove the OHC, we will go back to the time when there was no monitoring and management tool,” he said.

Escalante said Gov. Eugenio Jose Lacson asked Negros ACE to conduct an independent assessment of the OHC and submit a consolidated position paper on its current implementation and impact.

While acknowledging shortcomings, Escalante said the OHC has advantages but needs urgent fine-tuning.

He cited a case involving a motorcycle accident victim brought to Cadiz District Hospital who later died due to delays linked to the referral process, which he said underscored the need for immediate corrective measures.

Diaz reiterated that improving ER triage is the key fix and described it as the primary bottleneck in hospital admissions.

He said he will present an action plan to the governor using data analytics on the performance of provincial government-managed hospitals.

Diaz said the provincial government is investing PHP 1.5 billion to upgrade health facilities, procure equipment and medicines, and enhance salaries and benefits of health personnel.

“What we need is to improve the quality of service,” he said.

He also said the province is working to strengthen primary health care units, including rural health units and municipal and city health offices, so they can act as effective first responders and manage cases that do not require hospital admission.

In Cadiz City, Escalante said the local government is proceeding with construction of a hospital worth about PHP 270 million.

He said the city government has already secured a loan for the project, which is expected to be completed in around 667 days and is intended to improve local health services and emergency response capacity.