Physician in triage improves emergency department patient throughput

Imperato, Jason; Morris, Darren S.; Binder, David S.; Fischer, Christopher; Patrick, John D.; Sánchez, León D.; Setnik, Gary S.

doi:10.1007/s11739-012-0839-0

Cited by 53 publications

(43 citation statements)

References 22 publications

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“…The major responsibilities of such a team are usually twofold: seeing patients in the waiting room and achieving disposition (usually discharge) when possible, and placing advanced care orders to begin the diagnostic work-up of patients who will ultimately be placed into a bed in the main ED and whose care will be transitioned to a second physician. This configuration has alternatively been described as physician in triage, triage liaison physician, triage rapid initial assessment by doctor, and supplemented triage and rapid treatment (10)(11)(12)(13)(14). Most of the reported experience is with an attending physician as part of the team, although physician assistants and Emergency Medicine residents have also been utilized in this role (15,16).…”

Section: Introductionmentioning

confidence: 99%

Emergency Department Rapid Medical Assessment: Overall Effect and Mechanistic Considerations

Traub

Wood

Kelley

et al. 2015

The Journal of Emergency Medicine

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Section: Introductionmentioning

confidence: 99%

Emergency Department Rapid Medical Assessment: Overall Effect and Mechanistic Considerations

Traub

Wood

Kelley

et al. 2015

The Journal of Emergency Medicine

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“…In a previous study using this same model [12] there was improvement in time to physician evaluation and reduction in length of stay (LOS) and time on diversion following the addition of a physician in triage. In three similar models to the research site, Han et al [4] , Partovi et al [5] , and Holroyd et al [6] showed a reduction in overall LOS and number of patients leaving without being seen (LWBS).…”

Section: Discussionmentioning

confidence: 99%

“…studies in the literature that have investigated the use of a physician in triage [4][5][6][7][8][9][10][11][12] . The majority of these studies have focused on patient flow metrics for measured outcomes.…”

mentioning

confidence: 99%

Improving patient satisfaction by adding a physician in triage

Imperato

Morris

Sánchez

et al. 2013

JHA

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Background: The physician in triage (PIT) model has been proposed as a process improvement to help increase efficiency in the Emergency Department setting. However, its effect on patient satisfaction has not been well established.Methods: An interventional study comparing patient satisfaction scores for the 6-month period before and after implementation of a physician in triage model. In our system an additional attending physician was assigned to triage from 1 p.m. to 9 p.m. daily. Outcome measures were mean scores obtained from respondents to Press Ganey® patient satisfaction surveys for selected questions most likely to be impacted by PIT implementation and those included in the physician section of the survey.Results: Five hundred and eight respondents seen in the six months before the initiation of the PIT team and 458 respondents in the six months after the system change were included in the study. Improvement was noted in the absolute Press Ganey® scores in the Post-PIT time period across all questions analyzed with statistically significant differences noted for 8 of the 10 questions studied. Conclusions:Although seemingly small there was a statistically significant improvement in the absolute patient satisfaction scores after adding a physician in triage. Because small gains in absolute scores can result in large improvements on the percentile rank when using Press Ganey® surveys, physician in triage may be of significant benefit to overall patient satisfaction.

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“…Result of introducing additional physician in triage improved median time to attending physician evaluation, median length of stay (LOS), number of patients who left without being seen (LWBS), and total time and number of days on ambulance diversion. [9] MacKenzie R.et.al. introduced rapid assessment unit [RAU] model, with built-in themes of "team triage" and "parallel evaluation and treatment," which reduced crowding and significantly improve median ED Length of stay in emergency department.…”

Section: Role Of Rat In Foreign Scenariomentioning

confidence: 99%