Triage rapid initial assessment by doctor (TRIAD) improves waiting time and processing time of the emergency department

Aim: To evaluate the effect of triage rapid initial assessment by doctor ( TRIAD) on waiting time and processing time of an emergency department (ED) without extra staff. Method: A senior emergency doctor was put into triage instead of a consultation cubicle for seven shifts of 9 hours each. All the patients were assessed and necessary interventions started at the time of triage. Waiting time and processing time of various categories of patients were compared with a control group that was sampled during the week before the trial period. Results: In total, there were 1310 cases in the trial period and 1355 controls. Over a quarter (27%) of the patients received triage doctor interventions. The average waiting time was reduced by 38% and the average processing time by 23%. Patients without triage intervention also had a 24% shorter waiting time because of overall improvement in efficiency. Trauma patients and patients needing radiography particularly benefited from the new system. The waiting time and processing time of category 4 and 5 patients improved significantly as a result of more efficient processing of more urgent cases. Conclusion: The waiting time and processing time of the ED were greatly reduced by TRIAD without extra manpower.