2.50
Hdl Handle:
http://hdl.handle.net/10755/162988
Type:
Presentation
Title:
Triage Redesign: Implementing a Five-level Triage System
Abstract:
Triage Redesign: Implementing a Five-level Triage System
Conference Sponsor:Emergency Nurses Association
Conference Year:2005
Author:Kosits, Lisa, RN, MSN, CCRN, CEN
P.I. Institution Name:Montefiore Medical Center
Title:Clinical Inservice Instructor
Contact Address:111 East 210th Street, Bronx, NY, 10467, USA
Contact Telephone:(718) 920-5241
Co-Authors:Mary McLoughlin, RN, MSN, CEN
Clinical Topic: The ultimate goal of triage is to identify and prioritize patient-care needs to determine how soon the patient should see the physician. To meet the demand of the increasing volume of patients at three emergency departments of the Montefiore Medical Center in Bronx, NY, a more efficient method to rapidly and accurately sort patients was needed. To address this issue, the Emergency Severity Index (ESI), a five-level triage system developed by Wuerz and Eitel in 1998, was implemented. The ESI triage acuity rating scale has been shown to be reliable and valid for rapid, accurate triage. Implementation: In 2002, a multidisciplinary team met to discuss the ESI system and potential implementation. Three issues needed to be addressed immediately to implement the five-level triage system: Workflow design, triage policy, and danger zone vital sign parameters. Workflow was assessed and redesigned accordingly and was completed six months prior to implementation of the five-level triage system. Triage policy was revised to improve efficiency and flow. The team agreed to adopt the danger zone vital sign parameters from the well-established Canadian Paediatric Emergency Department Triage and Acuity Scale. The clinical instructors then met to develop curricula for staff in-service training, including versions for nurse, physician, and support personnel. Staff was educated over a two-month period, followed by implementation of the five-level triage system in May 2004. Outcomes: Preliminary results following implementation of the five-level triage system indicate that the institution's three emergency departments have achieved the following: Standardized triage categorization, increased staff satisfaction with regard to triage accuracy, improved accuracy of triage presentations, and improved triage efficiency. Chart reviews identify documentation as an area for improvement. Through the institution?s quality management program, steps are being taken to monitor specific indicators, such as accuracy of triage categorization, triage assessment documentation, and triage wait times. Recommendations: Implementation of a five-level triage system, such as the ESI system, has the potential to increase efficiency and accuracy of patient triage and to improve staff satisfaction. Plans for future research at this institution involve evaluation of improvements in triage wait times, including triage-to-physician contact time for patients. In addition, this institution is currently working on a performance improvement plan that will include education to address areas for improvement, followed by chart reviews to assess accuracy of documentation.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleTriage Redesign: Implementing a Five-level Triage Systemen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162988-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Triage Redesign: Implementing a Five-level Triage System</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kosits, Lisa, RN, MSN, CCRN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Montefiore Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Inservice Instructor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">111 East 210th Street, Bronx, NY, 10467, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(718) 920-5241</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lkosits@montefiore.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Mary McLoughlin, RN, MSN, CEN</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: The ultimate goal of triage is to identify and prioritize patient-care needs to determine how soon the patient should see the physician. To meet the demand of the increasing volume of patients at three emergency departments of the Montefiore Medical Center in Bronx, NY, a more efficient method to rapidly and accurately sort patients was needed. To address this issue, the Emergency Severity Index (ESI), a five-level triage system developed by Wuerz and Eitel in 1998, was implemented. The ESI triage acuity rating scale has been shown to be reliable and valid for rapid, accurate triage. Implementation: In 2002, a multidisciplinary team met to discuss the ESI system and potential implementation. Three issues needed to be addressed immediately to implement the five-level triage system: Workflow design, triage policy, and danger zone vital sign parameters. Workflow was assessed and redesigned accordingly and was completed six months prior to implementation of the five-level triage system. Triage policy was revised to improve efficiency and flow. The team agreed to adopt the danger zone vital sign parameters from the well-established Canadian Paediatric Emergency Department Triage and Acuity Scale. The clinical instructors then met to develop curricula for staff in-service training, including versions for nurse, physician, and support personnel. Staff was educated over a two-month period, followed by implementation of the five-level triage system in May 2004. Outcomes: Preliminary results following implementation of the five-level triage system indicate that the institution's three emergency departments have achieved the following: Standardized triage categorization, increased staff satisfaction with regard to triage accuracy, improved accuracy of triage presentations, and improved triage efficiency. Chart reviews identify documentation as an area for improvement. Through the institution?s quality management program, steps are being taken to monitor specific indicators, such as accuracy of triage categorization, triage assessment documentation, and triage wait times. Recommendations: Implementation of a five-level triage system, such as the ESI system, has the potential to increase efficiency and accuracy of patient triage and to improve staff satisfaction. Plans for future research at this institution involve evaluation of improvements in triage wait times, including triage-to-physician contact time for patients. In addition, this institution is currently working on a performance improvement plan that will include education to address areas for improvement, followed by chart reviews to assess accuracy of documentation.</td></tr></table>en_GB
dc.date.available2011-10-27T10:37:37Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:37:37Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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