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Emergency department triage revisited

FitzGerald, Gerard, Jelinek, George, Scott, Deborah A., & Gerdtz, Marie F. (2009) Emergency department triage revisited. Emergency Medicine Journal, 27(2), pp. 86-92.

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      Abstract

      Triage is a process that is critical to the effective management of modern emergency departments. Triage systems aim, not only to ensure clinical justice for the patient, but also to provide an effective tool for departmental organisation, monitoring and evaluation. Over the last 20 years, triage systems have been standardised in a number of countries and efforts made to ensure consistency of application. However, the ongoing crowding of emergency departments resulting from access block and increased demand has led to calls for a review of systems of triage. In addition, international variance in triage systems limits the capacity for benchmarking. The aim of this paper is to provide a critical review of the literature pertaining to emergency department triage in order to inform the direction for future research. While education, guidelines and algorithms have been shown to reduce triage variation, there remains significant inconsistency in triage assessment arising from the diversity of factors determining the urgency of any individual patient. It is timely to accept this diversity, what is agreed, and what may be agreeable. It is time to develop and test an International Triage Scale (ITS) which is supported by an international collaborative approach towards a triage research agenda. This agenda would seek to further develop application and moderating tools and to utilise the scales for international benchmarking and research programmes.

      Impact and interest:

      39 citations in Scopus
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      26 citations in Web of Science®

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      ID Code: 29472
      Item Type: Journal Article
      Additional Information: Acknowledgments The authors wish to thank Mr Homayoun Kheyri, then of the University of Queensland, who initially collected literature and provided an overview of issues, Ms Linping Chen of the Queensland University of Technology who collected additional literature (snowballing) and compiled the EndNote library and also Ms Elinor Davis of the Queensland University of Technology who assisted with final editing of the manuscript.
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      Keywords: Triage, Emergency Department, Urgency, Triage Scales
      DOI: 10.1136/emj.2009.077081
      ISSN: 1472-0205
      Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Emergency Medicine (110305)
      Divisions: Current > QUT Faculties and Divisions > Faculty of Health
      Current > Institutes > Institute of Health and Biomedical Innovation
      Current > Research Centres > National Centre for Health Information Research & Training
      Current > Schools > School of Public Health & Social Work
      Copyright Owner: Copyright 2009 BMJ Publishing Group
      Deposited On: 05 Jan 2010 08:51
      Last Modified: 23 Oct 2013 16:11

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