Abstract
BackgroundThe Canadian Triage and Acuity Scale is a valid triage system. The system was translated and implemented in the Japanese emergency departments (EDs) from 2012. This system was named the Japanese Triage and Acuity Scale; however, the validation studies of the Japanese Triage and Acuity Scale have been limited. In addition, for a patient with multiple complaints, it could become challenging, due to its requirement of a single complaint. Therefore, we hypothesized that a modified version of the Japanese Triage and Acuity Scale using first-order modifiers without chief complaint detection is accurate.MethodsA retrospective cohort study evaluated a correlation between the modified triage scale level and outcomes of all adult emergency department patients at a Japanese hospital.Construct validity of the modified triage scale level was assessed based on comparisons of total admission rate (including hospitalizations, emergency department deaths) and length of stay between triage levels.ResultsThe distributions of five levels of the triage scale (level 1 is the most urgent) among the 17,121 cases are as follows: 1:451, 2:1148, 3:7703, 4:7652, and 5:167. Total admission rates by each level were 1:89.8, 2:68.2, 3:26.4, 4:6.6, and 5:0.6 %, which progressively increased from level 5 to 1 and were significant (p < 0.01). Compared with patients in level 3, the odds of total admission rates were 14.4, 5.1, 0.27, and 0.030 for the patients in levels 1, 2, 4, and 5. The length of stay was longer in the patients with the more urgent levels except for those with level 1.ConclusionsThe modified version of the Japanese Triage and Acuity Scale is a valid predictor of total admission and length of stay and may enable the nurses to triage patients without detecting the chief complaints.
Highlights
The Canadian Triage and Acuity Scale is a valid triage system
A triage system should be valid and reliable and prompt. From this point of view, there are challenges associated with using the Japanese Triage and Acuity Scale (JTAS) for triage staff, because the system requires the evaluation of a single chief complaint, even though many patients, especially older patients, have multiple complaints
Out of the eligible patients, 13,485 patients who were under 18 years of age, and 425 patients who arrived at the emergency department (ED) to be seen directly by the specialist were excluded
Summary
The system was translated and implemented in the Japanese emergency departments (EDs) from 2012 This system was named the Japanese Triage and Acuity Scale; the validation studies of the Japanese Triage and Acuity Scale have been limited. We hypothesized that a modified version of the Japanese Triage and Acuity Scale using first-order modifiers without chief complaint detection is accurate. A triage system should be valid and reliable and prompt From this point of view, there are challenges associated with using the JTAS for triage staff, because the system requires the evaluation of a single chief complaint, even though many patients, especially older patients, have multiple complaints. When a patient is triaged based on the JTAS, the triage nurse initially identifies the patient’s single chief complaint. Most of the first-order modifiers are common among chief complaints
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