Consultant triage of minor cases in an accident and emergency department.

Redmond, A D; Buxton, Neil

doi:10.1136/emj.10.4.328

Cited by 17 publications

(5 citation statements)

References 3 publications

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“…Although additional medical staff were present in the department at the time no doctor was diverted from non-clinical duties. 2 Medical staff were pressurised at times when case mix was heavy. However, all patients were seen within 15 minutes, although doctors did miss their breaks at times.…”

Section: Discussionmentioning

confidence: 99%

Team triage improves emergency department efficiency

Subash

Dunn²,

McNicholl³

et al. 2004

Emergency Medicine Journal

120

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Objective: To see whether three hours of combined doctor and nurse triage would lead to earlier medical assessment and treatment and whether this benefit would carry on for the rest of the day when normal triage had resumed. Method: Eight days were randomly selected; four for team triage and four for the normal nurse led triage. Team triage was coordinated by a middle grade or consultant from 9 am to 12 noon. Times to triage, to see a doctor, radiology, admission, and discharge were recorded. No additional medical or nursing staff were used and staffing levels were similar each day. All patients including blue light emergencies and minor injuries were included. Results: Median times were significantly reduced (p,0.05) during the intervention to triage (2 min v 7 min, p = 0. 029), to see a doctor (2 min v 32 min, p = 0.029), and to radiology (11.5 min v 44.5 min, p = 0.029). Waiting times at midday were longer for patients in the non-intervention group. More patients were seen and discharged within 20 minutes in the intervention group (18 of 95 (19%) v 2 of 69 (3%) p = 0.0043). No significant knock on effect was demonstrable for the remaining 21 hours after the intervention ceased. Conclusion: Three hours of combined doctor and nurse triage significantly reduces the time to medical assessment, radiology, and to discharge during the intervention period. Waiting times at midday were shorter in the triage group. There was no significant knock on effect the rest of the day.

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Section: Discussionmentioning

confidence: 99%

Team triage improves emergency department efficiency

Subash

Dunn²,

McNicholl³

et al. 2004

Emergency Medicine Journal

120

View full text Add to dashboard Cite

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“…10 We sought to replace the triage process of initial nurse consult to assign a waiting priority with a model of early senior clinician assessment, which has more recently been termed ''see and treat''. Such models have been previously assessed in the UK, 11 Australia, 12 and the USA, 13 although the literature is sparse.…”

mentioning

confidence: 99%

Making an IMPACT on emergency department flow: improving patient processing assisted by consultant at triage

Terris

Leman²,

O’Connor³

et al. 2004

Emergency Medicine Journal

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Objectives: To assess whether initial patient consult by senior clinicians reduces numbers of patients waiting to be seen as an indirect measure of waiting time throughout the emergency department (ED). Methods: An emergency medicine consultant and a senior ED nurse (G or F grade), known as the IMPACT team, staffed the triage area for four periods of four hours per week, Monday to Friday between 9 am to 5 pm for three months between December 2001 and February 2002 when staffing levels permitted. Patients normally triaged by a nurse in this area instead had an early consultation with the IMPACT team. Data were collected prospectively on all patients seen by the IMPACT team. The number of patients waiting to be seen (for triage, in majors and in minors) was assessed every two hours during the IMPACT sessions and at corresponding times when no IMPACT team was operational. Results: There was an overall reduction in the number of patients waiting to be seen in the department from 18.3 to 5.5 (p,0.0001) at formal two hourly assessments. The largest difference was seen in minors. Of the patients seen at triage by the IMPACT team, 48.9% were discharged home immediately after assessment and treatment. With the IMPACT team present, no patient waited more than four hours for initial clinical consult. Conclusions: By using a senior clinical team for initial patient consultation, the numbers of patients waiting fell dramatically throughout the ED. Many patients can be effectively treated and discharged after initial consult by the IMPACT team.

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“…After patients are triaged, the electronic medical records (EMR) generate an icon that alerts the ED physician regarding the acuity of the patient [11]. Our study proves that in our ED, a direct verbal communication between the triage nurse and ED physician is superior to EMR alerts in reducing the patient wait times.…”

Section: Discussionmentioning

confidence: 62%

Rapid assessment and treatment (RAT) of triage category 2 patients in the emergency department

Rahmatullah¹,

Chamseddin²,

Farfour³

et al. 2017

Trauma Emerg Care

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Objectives: Our study aims to assess the effect of implementing direct verbal communication between the triage nurse and Emergency Department (ED) physician and providing Rapid Assessment and Treatment of Canadian Triage and Acuity Scale (CTAS) category 2 (RAT2) patients presenting to a tertiary care ED.Methods: This is a retrospective, pre and post RAT2 intervention study of periods in our ED using the Enterprise Reporting System and records from ED quality section. The data collected consisted of patient demographics, length of stay, waiting time (Door to Doctor Time), door to triage time, and triage to doctor time (physician initial assessment time) for CTAS category 2 patients, and any sentinel events reported during the study periods.Results: The total number of patients included in this study was 97,472 from which 10,024 were CTAS category 2 and 4,825 were post-RAT2 intervention. Using the T-Test, our results showed pre-RAT mean door-to-doctor time of 61.8 minutes (median: 61.5) and post-RAT time of 31.6 minutes (median: 32). This reduction was statistically significant (p<0.001). There was no significant difference in patient demographics, length of stay, door to triage time, or the door-to-doctor time for other category patients. There were no sentinel events reported during the RAT2 intervention period.Conclusion: Direct verbal nurse-physician communication with early physician assessment and treatment of category 2 patients reduces patient door-to-doctor time without delaying care of other patients or causing any sentinel events.

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Consultant triage of minor cases in an accident and emergency department.

Cited by 17 publications

References 3 publications

Team triage improves emergency department efficiency

Team triage improves emergency department efficiency

Making an IMPACT on emergency department flow: improving patient processing assisted by consultant at triage

Rapid assessment and treatment (RAT) of triage category 2 patients in the emergency department

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