Improving Triage Efficiency in Emergency Departments: A Multidisciplinary Approach Involving Nursing and Medical Teams
Main Article Content
Keywords
Emergency department, triage efficiency, multidisciplinary approach, nursing, medical teams, ED crowding, patient flow
Abstract
Emergency department (ED) crowding is a global healthcare challenge that negatively impacts patient outcomes. Improving triage efficiency is essential to address ED overcrowding. This paper explores a multidisciplinary approach involving collaboration between nursing and medical teams to enhance triage accuracy and reliability. Strategies include refining triage protocols with objective, quantitative criteria, targeted education and training for staff, and integrating specialized providers such as nurse practitioners and paramedics into triage roles. Operational changes like dedicated fast-track units and parallel processing for expedited care initiation can further optimize ED flow. A multifaceted, collaborative approach tailored to local contexts is crucial for transformational change, enabling better patient navigation and frontline care delivery. Implementing these strategies can alleviate ED crowding and improve timely access to care for all patients.
References
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Hayden C., Burlingame P., Thompson H., & Sabol V. K. (2014). Improving patient flow in the emergency department by placing a family nurse practitioner in triage: a quality-improvement project. Journal of emergency nursing, 40(4), 346–351.
Hsia, R. Y., Kellermann, A. L., & Shen, Y. C. (2011). Factors associated with closures of emergency departments in the United States. JAMA, 305(19), 1978–1985.
Iserson K. V., & Moskop, J. C. (2007). Triage in medicine, part I: concept, history, and types. Annals of emergency medicine, 49(3), 275–281.
Jennings, N., Clifford, S., Fox, A. R., O'Connell, J., & Gardner, G. (2015). The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: A systematic review. International journal of nursing studies, 52(1), 421–435.
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Oredsson, S., Jonsson, H., Rognes, J., Lind, L., Göransson, K. E., Ehrenberg, A., Asplund, K., Castrén, M., & Farrohknia, N. (2011). A systematic review of triage-related interventions to improve patient flow in emergency departments. Scandinavian journal of trauma, resuscitation and emergency medicine, 19, 43.
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Tam, H. L., Chung, S. F., Lou, C. K., & Cheung Ngai, S. Y. (2018). A review of triage accuracy and future direction. BMC emergency medicine, 18(1), 58.
Tanabe, P., Gimbel, R., Yarnold, P. R., Kyriacou, D. N., & Adams, J. G. (2004). Reliability and validity of scores on The Emergency Severity Index version 3. Academic emergency medicine, 11(1), 59–65.
Tanabe, P., Travers, D., Gilboy, N., Rosenau, A., & Yuen, H. (2005). Refining Emergency Severity Index Triage Criteria. Academic Emergency Medicine, 12(6), 497-501. doi:10.1197/j.aem.2004.11.049
Trzeciak, S., & Rivers, E. P. (2003). Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emergency medicine journal, 20(5), 402–405.
Tsai, V. W., Sharieff, G. Q., Kanegaye, J. T., Carlson, L. M., & Harley, J. R. (2012). Rapid medical assessment: improving pediatric emergency department time to provider, length of stay, and left without being seen rates. Pediatric emergency care, 28(4), 354–356.
Bullard, M. J., Musgrave, E., Warren, D., Unger, B., Skeldon, T., Grierson, R., van der Linde, E., & Swain, J. (2017). Revisions to the Canadian Emergency Department Triage and Acuity Scale (CTAS) Guidelines 2016. CJEM, 19(S2), S18–S27.
Celona, C. A., Amaranto, A., Ferrer, R., Ritter, E., Abraham, I., & Miner, J. (2018). Interdisciplinary design to improve fast track in the emergency department. Journal of emergency nursing, 40(3), 198–203.
Crumplin, M. K. (2002). The Myles Gibson military lecture: surgery in the Napoleonic Wars. Journal of the Royal College of Surgeons of Edinburgh, 47(3), 566–578.
Day, T. E., Al-Roubaie, A. R., & Goldlust, E. J. (2013). Decreased length of stay after addition of healthcare provider in emergency department triage: a comparison between computer-simulated and real-world interventions. Emergency medicine journal, 30(2), 134–138.
Ebrahimi, M., Heydari, A., Mazlom, R., & Mirhaghi, A. (2015). The reliability of the Australasian Triage Scale: a meta-analysis. World journal of emergency medicine, 6(2), 94–99.
FitzGerald, G., Jelinek, G. A., Scott, D., & Gerdtz, M. F. (2010). Emergency department triage revisited. Emergency medicine journal, 27(2), 86–92.
Ghanbarzehi, N., Balouchi, A., Sabzevari, S., Darban, F., & Khayat, N. H. (2016). Effect of Triage Training on Concordance of Triage Level Between Triage Nurses and Emergency Medical Technicians. Journal of clinical and diagnostic research, 10(5), IC05–IC07.
Gilboy N., Tanabe T., Travers D., Rosenau A. M., & Eitel D. R. (2011). Emergency Severity Index, Version 4: Implementation Handbook. AHRQ Publication No. 05-0046-2. Rockville, MD: Agency for Healthcare Research and Quality.
Hayden C., Burlingame P., Thompson H., & Sabol V. K. (2014). Improving patient flow in the emergency department by placing a family nurse practitioner in triage: a quality-improvement project. Journal of emergency nursing, 40(4), 346–351.
Hsia, R. Y., Kellermann, A. L., & Shen, Y. C. (2011). Factors associated with closures of emergency departments in the United States. JAMA, 305(19), 1978–1985.
Iserson K. V., & Moskop, J. C. (2007). Triage in medicine, part I: concept, history, and types. Annals of emergency medicine, 49(3), 275–281.
Jennings, N., Clifford, S., Fox, A. R., O'Connell, J., & Gardner, G. (2015). The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: A systematic review. International journal of nursing studies, 52(1), 421–435.
Lee, W. W., Filiatrault, L., Abu-Laban, R. B., Riegert, A., Shepherd, N., & Lang, E. (2016). Effect of Triage Nurse Initiated Radiography Using the Ottawa Ankle Rules on Emergency Department Length of Stay at a Tertiary Centre. CJEM, 18(2), 90–97.
Lindley-Jones, M., & Finlayson, B. J. (2000). Triage nurse requested x rays--are they worthwhile?. Journal of accident & emergency medicine, 17(2), 103–107.
Love, R. A., Murphy, J. A., Lietz, T. E., & Jordan, K. S. (2012). The effectiveness of a provider in triage in the emergency department: A quality improvement initiative to improve patient flow. Advanced emergency nursing journal, 34(1), 65–74.
Nash, K., Nguyen, H., & Tillman, M. (2009). Using medical screening examinations to reduce emergency department overcrowding. Journal of emergency nursing, 35(2), 109–113.
Oredsson, S., Jonsson, H., Rognes, J., Lind, L., Göransson, K. E., Ehrenberg, A., Asplund, K., Castrén, M., & Farrohknia, N. (2011). A systematic review of triage-related interventions to improve patient flow in emergency departments. Scandinavian journal of trauma, resuscitation and emergency medicine, 19, 43.
Pitts, S. R., Pines, J. M., Handrigan, M. T., & Kellermann, A. L. (2012). National trends in emergency department occupancy, 2001 to 2008: effect of inpatient admissions versus emergency department practice intensity. Annals of emergency medicine, 60(6), 679-686.e3.
Richardson, D. B. (2006). Increase in patient mortality at 10 days associated with emergency department overcrowding. The Medical journal of Australia, 184(5), 213–216.
Rowe, B. H., Villa-Roel, C., Guo, X., Bullard, M. J., Ospina, M., Vandermeer, B., Sinclair, D., Holroyd, B. R., Innes, G., & Schull, M. J. (2011). The role of triage nurse ordering on mitigating overcrowding in emergency departments: a systematic review. Academic emergency medicine, 18(12), 1349–1357.
Schull, M. J., Szalai, J. P., Schwartz, B., & Redelmeier, D. A. (2001). Emergency department overcrowding following systematic hospital restructuring: trends at twenty hospitals over ten years. Academic emergency medicine, 8(11), 1037–1043.
Tam, H. L., Chung, S. F., Lou, C. K., & Cheung Ngai, S. Y. (2018). A review of triage accuracy and future direction. BMC emergency medicine, 18(1), 58.
Tanabe, P., Gimbel, R., Yarnold, P. R., Kyriacou, D. N., & Adams, J. G. (2004). Reliability and validity of scores on The Emergency Severity Index version 3. Academic emergency medicine, 11(1), 59–65.
Tanabe, P., Travers, D., Gilboy, N., Rosenau, A., & Yuen, H. (2005). Refining Emergency Severity Index Triage Criteria. Academic Emergency Medicine, 12(6), 497-501. doi:10.1197/j.aem.2004.11.049
Trzeciak, S., & Rivers, E. P. (2003). Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emergency medicine journal, 20(5), 402–405.
Tsai, V. W., Sharieff, G. Q., Kanegaye, J. T., Carlson, L. M., & Harley, J. R. (2012). Rapid medical assessment: improving pediatric emergency department time to provider, length of stay, and left without being seen rates. Pediatric emergency care, 28(4), 354–356.
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Published
Apr 25, 2022
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How to Cite
Mansour Saud Fahhad Alharbi1, Abdullah Hudairem Muaybid Al Harbi2, Wayel Omair Saleh Altowaijri3, Abdulaziz Abdullah J Alruways4, Sultan Mishal Owais Al Otaibi5, Khald Ziyad Qutaym Alotaibi6. (2022). Improving Triage Efficiency in Emergency Departments: A Multidisciplinary Approach Involving Nursing and Medical Teams. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1383-1390. https://doi.org/10.53555/jptcp.v29i04.5833
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Mansour Saud Fahhad Alharbi1, Abdullah Hudairem Muaybid Al Harbi2, Wayel Omair Saleh Altowaijri3, Abdulaziz Abdullah J Alruways4, Sultan Mishal Owais Al Otaibi5, Khald Ziyad Qutaym Alotaibi6. (2022). Improving Triage Efficiency in Emergency Departments: A Multidisciplinary Approach Involving Nursing and Medical Teams. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1383-1390. https://doi.org/10.53555/jptcp.v29i04.5833