Time Survey of Triage Emergency Department Patients during Rush and Non-Rush Periods

Abstract

Study Objective: The aims of this study were to analysis the relationship between the various severity triage levels and time expenditure in an emergency department (ED). This involved the analysis of time expended on the different triage level patients during rush or non-rush periods. Materials and Methods: The medical records of 400 patients were collected from the ED at the Mackay Memorial Hospital and retrospectively reviewed. The subjects were divided into different stages based on their progress through the ED. Recorded data included triage assessment, the different times expended at the different stages of treatment in the ED including triage assessment, registration, doctor's attendance and laboratory data examination and the arrival/departure times ofr the patients. Results: When the study groups were compared, there were significant differences between triage levels 1 patients compared to triage level 2 and 3 patients (p＜0.05) for all treatment stage times other than triage/ registration and the wait for initial physician attendance. In addition, overall, triage/registration and waiting for attendance times did not differ between the rush and non-rush periods. However, Level 1 triage patients took longer for all other timings during rush periods compared to non-rush periods (p＜0.05). Furthermore, level 2 and 3 triage patients took longer for triage and registration during rush periods compared to non-rush periods (p＜0.05). Conclusion: Typically, triage level 1 patients are more complex and require a longer diagnostic times than either level 2 or level 3 patients. Although disease/injury severity determines treatment priority, no such discrimination is used in less severe cases. This study indicates that level 1 cases use up much more time than level 2 and 3 for both doctor and laboratory examinations, but there is no increase in the waiting time for doctors during rush periods. Triage level 2 or 3 patients seem to have similar times for most activities except registration whether the ED is busy or not. It can therefore be concluded that improving procedures or setting up a team specifically for patients who are severely injured and who arrive during a busy periods may be helpful and reduce the risk of any delay in treatment of these patients, which is very important to every ED physician.