The Effect of Triage Diagnostic Standing Orders on Emergency Department Treatment Time

Improving healthcare delivery with lean thinking

“…However, the finding is in line with other empirical research in healthcare. , Retezar et al (2011) found reductions in patient length of stay of similar order as we found. also found comparable improvements from applications of lean thinking in four EDs.…”

Implementing Triage Standing Orders in the Emergency Department Leads to Reduced Physician-to-Disposition Times

“…As the ED system is overburdened by crowding, the quality and safety of emergency care decline. Direct consequences of crowding include increased wait times [4,5,10,11], increased rates of patients leaving without being seen [7,[9][10][11], prolonged LOS [3,7,8], higher patient dissatisfaction [3, 5, 7-9, 11, 12], poorer clinical outcomes [3,5,7,9], delay in time-sensitive interventions [4,7,10,11,[13][14][15], increased adverse events [7,10], increased ambulance diversion [3-5, 7-11], decreased regional disaster response capacity [3], increased morbidity and mortality [3,4,7,9,10,[16][17][18], increased number of patients returning to the ED [7], and ED staff dissatisfaction and burnout [5,8,10]. Crowding is attributed to 31% of sentinel events in the ED [4].…”

“…Although LOS is not a direct measure of crowding, it is an easily quantifiable surrogate marker for ED crowding. Moreover, LOS is a useful measure associated with ED quality, timeliness, patient-centeredness, safety, patient satisfaction, and efficiency in emergency care [3,8,9,13].…”

“…In response to ED crowding, multiple ED processes have been implemented across the country to target input, throughput, and output factors to increase ED efficiency; standing triage orders are one such process [5,7,8]. Standing triage orders are orders derived from consensus and clinical practice guidelines for specific patient complaints or conditions; they have been implemented in EDs as a strategy to improve ED efficiency.…”

Consultas ambulatorias pediátricas atendidas en el Servicio de Urgencia de un hospital universitario

“…El análisis de la información epidemiológi-ca ha permitido en otros países diseñar e implementar sistemas de estratificación de riesgo (triage), algoritmos de estudio y protocolos de manejo en base a los motivos de consulta más comunes atendidos en los servicios de urgencia 4 . Como parte de un programa académico de medicina de urgencia, el conocimiento de la epidemiología y principales motivos de consulta es esencial para enfocar el currículo académico 2 .…”