Triage for prioritisation in the emergency department

Ringström C, Andersson B, Bergh C, Börjesson M, Carlström E, Eriksson M, Lönnbark M, Persson J, Sjövall H, Svanberg T, Strandell A
Record ID 32018011355
English
Original Title: [Triage för prioritering på akutmottagningen]
Authors' objectives: Background Triage in the emergency department (ED) is a system, where waiting time is based on the patient´s individual medical urgency. Despite the use of triage systems, streaming processes and other interventions to decrease waiting times, many EDs are faced with severe overcrowding and prolonged waiting times. Objective To evaluate, in adult somatic emergency departments - whether triage is more effective than no formal triage - whether any profession or team is superior to another in conducting triage - whether any triage system is superior to another - what is the predictive capacity of triage systems compared with true outcomes regarding clinical outcomes (mortality, unscheduled return, admission), correct prioritisation, patient satisfaction and process outcomes (length of stay at the ED, waiting time to physician assessment, time for prioritisation process).
Authors' results and conclusions: The main conclusions from this report are based on low certainty of evidence (GRADE ⊕⊕); -triage may increase correct prioritisation, and may reduce length of stay and waiting time to physicianassessment, compared with no triage -physician-led triage may reduce mortality, unscheduled return, length of stay and waiting time to physician assessment, compared with nurse-led triage -the use of SATS may increase correct prioritisation, compared with the other studied triage systems. If physician-led team triage is to be implemented at the Sahlgrenska University Hospital, the added cost for triage during weekdays would be approximately 14.6 million SEK per year. In summary, this report has highlighted that triage per se may be beneficial and that inclusion of a physician in the triage team may improve clinical and process outcomes, although the certainty of evidence was low. The comparisons between triage models were sparse and no specific triage system can be inferred to be superior.
Details
Project Status: Completed
Year Published: 2018
English language abstract: An English language summary is available
Publication Type: Full HTA
MeSH Terms
  • Triage
  • Emergency Service, Hospital
  • Emergency Medical Services
  • Waiting Lists
  • Health Services Accessibility
Contact
Organisation Name: The Regional Health Technology Assessment Centre
Contact Address: The Regional Health Technology Assessment Centre, Region Vastra Gotaland, HTA-centrum, Roda Straket 8, Sahlgrenska Universitetssjukhuset, 413 45 GOTHENBORG, Sweden
Contact Name: hta-centrum@vgregion.se
Contact Email: hta-centrum@vgregion.se
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.