Canadian Emergency DepartmentTriage and Acuity Scale: Implementation in a tertiary care center in Saudi Arabia

被引：26

作者：

Elkum N.B. ^{[2
,3
]}

Barrett C. ^{[1
]}

Al-Omran H. ^{[1
]}

机构：

[1] Department of Emergency Medicine, King Faisal Specialist Hospital and Research Center, Riyadh 11211

[2] Department of Biostatistics and Epidemiology, Dasman Diabetes Institute, Dasman 15462

[3] Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh 11211

来源：

BMC Emergency Medicine | / 11卷 / 1期

关键词：

Emergency Department; Emergency Department Patient; Emergency Department Physician; Triage Nurse; Triage Level;

D O I：

10.1186/1471-227X-11-3

中图分类号：

学科分类号：

摘要：

Background: The Canadian Emergency Department Triage and Acuity Scale (CTAS) is a well recognized and validated triage system that prioritizes patient care by severity of illness. The aim of this study was to describe the results of Emergency Department (ED) waiting times after the implementation of the CTAS in a major tertiary care hospital emergency department outside of Canada.Methods: A total of 1206 charts were randomly selected and retrospectively reviewed for triage performance. The indicators were: time to triage, triage duration, waiting time to be evaluated by a physician, and proportion of patients who left without being seen by a physician. Waiting times were stratified by triage level and reported as fractile response rates.Results: The approximate time to triage was ≤ 10 minutes for 71% and ≤ 15 minutes for 82.8% of the patients. Fifty-three percent (53.5%) completed their triage process within 5 minutes. Waiting times evaluated by a physician was 100% within CTAS time objectives in category I patients, however, this was not the case for the other 4 categories. The overall left without being seen (LWBS) rate was 9.8%; 11.9% were in Level III, 20.3% in Level IV, and 67.8% in Level V. Median length of stay (LOS) was 144 minutes for the study sample as a whole.Conclusion: The CTAS may be adapted, with achievable objectives, in hospitals outside Canada as well. Time to see physician, total LOS, and LWBS are effective markers of ED performance and the quality of triage. Registration-to-physician time (RTP) and LOS profiles, stratified by triage level, are essential indicative markers for ED performance and should be used in improving patients flow through collaborative efforts. © 2011 Elkum et al; licensee BioMed Central Ltd.

引用

共 25 条

[1]

Thompson D.A., Yarnold P.R., Williams D.R., Adams S.L., Effects of actual waiting time, perceived waiting time, information delivery, and expressive quality on patient satisfaction in the emergency department, Ann Emerg Med, 28, 6, pp. 657-665, (1996)

[2]

Derlet R.W., Richards J.R., Overcrowding in the nation's emergency departments: complex causes and disturbing effects, Ann Emerg Med, 35, 1, pp. 63-68, (2000)

[3]

Derlet R.W., Richards J.R., Emergency department overcrowding in Florida, New York, and Texas, South Med J, 95, 8, pp. 846-849, (2002)

[4]

Pines J.M., Timing of antibiotics for acute, severe infections, Emerg Med Clin North Am, 26, 2, pp. 245-257, (2008)

[5]

Pines J.M., Hollander J.E., Emergency department crowding is associated with poor care for patients with severe pain, Ann Emerg Med, 51, 1, pp. 1-5, (2008)

[6]

McCarthy M.L., Zeger S.L., Ding R., Levin S.R., Desmond J.S., Lee J., Aronsky D., Crowding delays treatment and lengthens emergency department length of stay, even among high-acuity patients, Ann Emerg Med, 54, 4, pp. 492-503, (2009)

[7]

Vertesi L., Does the Canadian Emergency Department Triage and Acuity Scale identify non-urgent patients who can be triaged away from the emergency department?, CJEM, 6, 5, pp. 337-342, (2004)

[8]

Beveridge R., Clarke B., Janes L., Savage N., Thompson J., Dodd G., Canadian emergency department triage and acuity scale: implementation guidelines, Canadian Journal of Emergency Medicine, 1, SUPPL. 3, (1999)

[9]

Jimenez J.G., Murray M.J., Beveridge R., Pons J.P., Cortes E.A., Garrigos J.B., Ferre M.B., Implementation of the Canadian Emergency Department Triage and Acuity Scale (CTAS) in the Principality of Andorra: Can triage parameters serve as emergency department quality indicators?, Cjem, 5, 5, pp. 315-322, (2003)

[10]

Manos D., Petrie D.A., Beveridge R.C., Walter S., Ducharme J., Inter-observer agreement using the Canadian Emergency Department Triage and Acuity Scale, Cjem, 4, 1, pp. 16-22, (2002)

← 1 2 3 →