Analysis of effectiveness and safety of a three‐part triage system for the access to dermatology specialist health care

Abstract

The triage system according to clinical need is safe. Correct allocation according to urgency occurs in <75% and leaves space for improvement. General Practitioners address patient's access significantly better than other physicians, therefore are best suited to function as gatekeepers to the access of specialist care in public funded health care systems.

A service evaluation of e-triage in the osteoporosis outpatient clinic—an effective tool to improve patient access?

“…Primary care specialists are in an excellent position to allocate referral urgency as main clinical care provider, however it is important to have a clear framework to guide referring clinicians. In some cases an overestimation of urgency level is noted in the literature [10]. In our series we observed that 22/710 referrals were upgraded, whereas 33/99 of primary care referrals were downgraded by the specialist team.…”

“…Electronic active triage offers an opportunity to address extensive waiting times for access to medical services through a streamlined screening process [9]. Examples of triage exist within a range of high volume referral specialties including orthopaedics, dermatology and in neurological services [4,9,10]. The broad purpose of triage include managing long waiting times and to ensure that individuals are directed to appropriate clinical services [11].…”

“…The broad purpose of triage include managing long waiting times and to ensure that individuals are directed to appropriate clinical services [11]. Triage may ensure timely access to the right patient, within the right service, at the right time [4,9,10]. Screening can occur at various levels across the multi-disciplinary team, and in earlier series high rates of correct allocation, according to urgency, has been achieved [10].…”

Intervalo Entre Agendamento E Atendimento Dermatológico Em Um Hospital Universitário

“…Este dado sugere haver igualdade no processo de agendamento das consultas independente do lugar da moradia e está de acordo com o encontrado em Ohio, EUA (12) , mas difere do observado na Espanha, onde pacientes de áreas rurais aguardaram menos tempo pelas consultas do que os de áreas urbanas (17) . Com a finalidade de reduzir o tempo de demora das consultas dermatológicas, priorizando o atendimento segundo a gravidade da doença, foi a implantado na Itália um sistema de triagem, classificando os pacientes em três grupos conforme a urgência e com meta de tempo de atendimento de 1 dia para os casos urgentes, 8 dias para os prioritários e 60 dias para os demais (18) . Esta estratégia de triagem está de acordo com o princípio de equidade proposto pelo SUS no Brasil, segundo o qual cada caso deve ser tratado conforme suas necessidades.…”

Dermatology outpatient care in the U.K.: modernizing services requires patients as our partners

“…There are multiple examples from dermatology in offering alternatives to face‐to‐face consultations, thereby increasing capacity, and freeing up outpatient clinic slots for those patients needing clinic interaction . These alternatives include teledermatology clinics, triage of e‐referrals to ensure the correct option for each patient, virtual clinics utilizing e‐mail or telephone, nurse‐led Skype clinics, and even patient‐initiated consultations . Additionally, there is now growing insight into the nuances of clinician and patient perspectives on outpatient discharge decisions …”