Performance Improvement with Rapid Triage Implementation
Abstract
ABSTRACT
Objective: To modify a US emergency department’s front-end process with the goal of improving the door-to-provider time interval. The hospital employed a comprehensive data collection process at triage; the intent was to redesign the process and implement a rapid triage component.Design: This was a continuous quality improvement initiative utilizing the DMAIC method for process improvement.Setting: All patients presenting at an east-coast hospital’s emergency department with 28,000 annual visits.Results: With all t-test p values less than 0.001, statistically significant improvements existed in all categories examined of both the entire ED patient population as well as when examining just patients arriving by a means other than ambulance. The time intervals with statistically significant improvements were door-to-triage, door-to-provider, and overall ED length-of-stay. Variation with triage categories in both the pre and post intervention groups when compared against the expected spread as published in the triage manual was noted.Conclusions: Rapid triage implementation was effective in producing statistically significant reductions in the identified time intervals. Future research is needed to further evaluate this impact on actual patient outcomes of specific patient populations, diagnoses and/or chief complaints. Further investigation about triage accuracy rates is also needed.
Objective: To modify a US emergency department’s front-end process with the goal of improving the door-to-provider time interval. The hospital employed a comprehensive data collection process at triage; the intent was to redesign the process and implement a rapid triage component.Design: This was a continuous quality improvement initiative utilizing the DMAIC method for process improvement.Setting: All patients presenting at an east-coast hospital’s emergency department with 28,000 annual visits.Results: With all t-test p values less than 0.001, statistically significant improvements existed in all categories examined of both the entire ED patient population as well as when examining just patients arriving by a means other than ambulance. The time intervals with statistically significant improvements were door-to-triage, door-to-provider, and overall ED length-of-stay. Variation with triage categories in both the pre and post intervention groups when compared against the expected spread as published in the triage manual was noted.Conclusions: Rapid triage implementation was effective in producing statistically significant reductions in the identified time intervals. Future research is needed to further evaluate this impact on actual patient outcomes of specific patient populations, diagnoses and/or chief complaints. Further investigation about triage accuracy rates is also needed.