Manchester triage system version II and resource utilisation in the emergency department

Abstract

Emergency department (ED) triage systems aim to direct the best clinical assistance to those who are in the greatest urgency and guarantee that resources are efficiently applied. The study's purpose was to determine whether the Manchester Triage System (MTS) second version is a useful instrument for determining the risk of hospital admission, intrahospital death and resource utilisation in ED and to compare it with the MTS first version. This was a prospective study of patients that attended the ED at a large hospital. It comprised a total of 25 218 cases that were triaged between 11 July and 13 October 2011. The MTS codes were grouped into two clusters: red and orange into a ‘high acuity/priority’ (HP) cluster, and yellow, green and blue into a ‘low acuity/priority’ cluster. The risk of hospital admission in the HP cluster was 4.86 times that of the LP cluster for both admission route and ages. The percentage of patient hospital admission between medical and surgical specialties, in high and low priority clusters, was similar. We found the risk of death in the HP cluster to be 5.58 times that of the risk of the low acuity/priority cluster. The MTS had an inconsistent association relative to the utilisation of x-ray, while it seemed to portray a consistent association between ECG and laboratory utilisation and MTS cluster. There were no differences between medical and surgical specialities risk of admission. This suggests that improvements were made in the second version of MTS, particularly in the discriminators of patients triaged to surgical specialties, because this was not true for the first version of MTS.

Outcome assessment of patients classified through the Manchester Triage System in emergency units in Brazil and Portugal

“…This result is similar to studies carried out in Brazil (13) and in Portugal. (14) In Brazil, the mean age of the population was lower (32 years) than in Portugal (53 years). A study conducted in Brazil found that the mean age was also 32 years.…”

Sistema Manchester: tempo empregado na classificação de risco e prioridade para atendimento em uma emergência

“…However, in the pediatrics and European context, the classification of patients in standard categories ranged from 34.6% (13) to 45.3% (14) to 52% (15) . In this scenario (15) , even adding patients from category white to those with lower priority, the proportion remained lower than that found in the present study.…”

Determinants of non-urgent emergency department use

“…O contexto internacional é semelhante, sendo apontada uma taxa de utilização inadequada dos SU entre 20% e 40% (Carret, Fassa, & Domingues, 2009). De salientar a elevada variabilidade da taxa de recorrências inadequadas ao SU devido à falta de consenso sobre os critérios a considerar (Santos, Freitas, & Martins, 2014). Face ao exposto este estudo tem como objetivo geral avaliar os determinantes do acesso ao serviço de urgência por utentes não urgentes.…”