To triage or not to triage? The history and evidence for this model of care in psychiatry

Mariana Pinto Da Costa,James Gary Chivers,Dhanya Salimkumar

doi:10.1192/bja.2021.72

Abstract

SUMMARYTriage wards were introduced as a new model of psychiatric in-patient care in 2004. However, there is limited evidence comparing them with the traditional in-patient models of care. This article reviews the history of triage wards, their principles, the evidence for this model (e.g. length of in-patient stay, readmission rates, staff and patient satisfaction) and the development of assessment wards based on the triage model of care. The evidence shows that the triage model has higher rates of rapid discharge, with a greater proportion of ‘acute care’ performed in the community with the support of home treatment teams. This leads to lower bed occupancy in the triage wards without increased rates of readmission or a worse patient experience of in-patient care. However, overall staff experience was better in the traditional model, given that staff satisfaction rates were lower on locality wards in settings with triage systems in place. Future research should explore the potential impact on home treatment teams, and the rates of serious incidents due to the high number of acutely unwell patients on triage wards.

Highlights

This article reviews the history of triage wards, their principles, the evidence for this model and the development of assessment wards based on the triage model of care
This leads to lower bed occupancy in the triage wards without increased rates of readmission or a worse patient experience of in-patient care
Overall staff experience was better in the traditional model, given that staff satisfaction rates were lower on locality wards in settings with triage systems in place

Summary

Introduction

This article reviews the history of triage wards, their principles, the evidence for this model (e.g. length of in-patient stay, readmission rates, staff and patient satisfaction) and the development of assessment wards based on the triage model of care. This leads to lower bed occupancy in the triage wards without increased rates of readmission or a worse patient experience of in-patient care.

Results

Conclusion