Factors influencing normalisation and sustainment of the Birmingham Symptom-specific Obstetric Triage System (BSOTS): a qualitative implementation evaluation study with UK maternity health professionals

Our study found successful implementation and normalisation of BSOTS was driven by contextual factors, particularly organisational buy-in and leadership support. While regulatory requirements enabled the prioritisation of triage within maternity services, our evaluation emphasised the importance of both leadership and frontline staff support for effective integration and sustainment. Evaluation findings were used to inform an implementation toolkit for clinical triage teams seeking to implement or reinvigorate BSOTS in their sites.