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Improved Pediatric Patient Flow in a General Emergency Department by Altering Triage Criteria
Author(s) -
Cain Patrick,
Waldrop Ron D.,
Jones John
Publication year - 1996
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.1996.tb03306.x
Subject(s) - triage , medicine , observational study , emergency department , emergency medicine , vital signs , prospective cohort study , neonatal intensive care unit , medical emergency , pediatrics , anesthesia , nursing
Objective: To evaluate the effect of altering pediatric triage criteria on ED triage scoring and patient flow. Methods: A prospective observational study of a pediatric triage modification was performed. Data for all pediatric patients presenting to an urban general ED during a six‐month study period were collected. After the first three months, pediatric triage criteria were altered by elevating the acuity of several historical items and specifically listing abnormal signs and symptoms. Outcome measures included triage score assignment, criteria making the patient emergent, proportion of emergent or urgent triage assignments, and times to examination, disposition, and admission. Results: Altering pediatric triage criteria resulted in a significant (p < 0.05) increase in the number of patients triaged as emergent (2% vs 15%) or urgent (48% vs 55%). In addition, for emergent and urgent patients there was a significant decrease (p < 0.05) in the mean times to ED examination (50 vs 44 min), floor admission (355 vs 245 min), and intensive care unit admission (221 vs 132 min). The triage changes that had a significant impact on these results were a history of color change, decreased activity, and prematurity with complications. Conclusions: A significant improvement in pediatric patient flow occurred after posting age‐specific abnormal signs and symptoms as well as elevating triage acuity for specific historical clues.