Impact of the ABCDE triage on the number of patient visits to the emergency department
<p>Abstract</p> <p>Background</p> <p>Many Finnish emergency departments (ED) serve both primary and secondary health care patients and are therefore referred to as combined emergency departments. Primary care specialists are responsible for the initial assessment and tr...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2010-06-01
|
| Series: | BMC Emergency Medicine |
| Online Access: | http://www.biomedcentral.com/1471-227X/10/12 |
| _version_ | 1819058575672082432 |
|---|---|
| author | Menezes Ricardo Mattila Juho Kaartinen Johanna Kantonen Jarmo Malmila Mia Castren Maaret Kauppila Timo |
| author_facet | Menezes Ricardo Mattila Juho Kaartinen Johanna Kantonen Jarmo Malmila Mia Castren Maaret Kauppila Timo |
| author_sort | Menezes Ricardo |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Many Finnish emergency departments (ED) serve both primary and secondary health care patients and are therefore referred to as combined emergency departments. Primary care specialists are responsible for the initial assessment and treatment. They, thereby, also regulate referral and access to tertiary care. Primary health care EDs are easy for the public to access, leading to non-acute patient visits to the emergency department. This has caused increased queues and unnecessary difficulties in providing immediate treatment for those patients who need it the most.</p> <p>Methods</p> <p>A face-to-face triage system based on the letters A (patient directly to secondary care), B (to be examined within 10 min), C (to be examined within 1 h), D (to be examined within 2 h) and E (no need for immediate treatment) for assessing the urgency of patients' treatment needs was applied in the main ED in the City of Vantaa, Finland (Peijas Hospital) as an attempt to provide immediate treatment for the most acute patients. The first step was an initial patient assessment by a health care professional (triage nurse). If the patient was not considered to be in need of immediate care (i.e. A-D) he was allocated to group E and examined after the more urgent patients were treated. The introduction of this triage system was combined with information to the public on the "correct" use of emergency services. The primary aim of this study was to assess whether the flow of patients was changed by implementing the ABCDE-triage system in the combined ED. To study the effect of the intervention on patient flow, numbers monthly visits to doctors were recorded before and after intervention in Peijas ED and, simultaneously, in control EDs (Myyrmäki in Vantaa, Jorvi and Puolarmetsä in Espoo). To study does the implementation of the triage system redirect patients to other health services, numbers of monthly visits to doctors were also scored in the private health care and public office hour services of Vantaa primary care.</p> <p>Results</p> <p>The number of patient visits to a primary care doctor in 2004 decreased by up to eight percent (340 visits/month) as compared to the previous year in the Peijas ED after implementation of the ABCDE-triage system. Simultaneously, doctor visits in tertiary health care ED increased by ten percent (125 visits/month). ABCDE-triage was not associated with a subsequent increase in the number of patient visits in the private health care or office hour services. The number of ED visits in the City of Espoo, used as a control where no triage was applied, remained unchanged.</p> <p>Conclusions</p> <p>The present ABCDE-triage system combined with public guidance may reduce patient visits to primary health care EDs but not to the tertiary health care EDs.</p> |
| first_indexed | 2024-12-21T13:57:23Z |
| format | Article |
| id | doaj.art-26649481dff248eeb27b7135aa5da038 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-12-21T13:57:23Z |
| publishDate | 2010-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-26649481dff248eeb27b7135aa5da0382022-12-21T19:01:29ZengBMCBMC Emergency Medicine1471-227X2010-06-011011210.1186/1471-227X-10-12Impact of the ABCDE triage on the number of patient visits to the emergency departmentMenezes RicardoMattila JuhoKaartinen JohannaKantonen JarmoMalmila MiaCastren MaaretKauppila Timo<p>Abstract</p> <p>Background</p> <p>Many Finnish emergency departments (ED) serve both primary and secondary health care patients and are therefore referred to as combined emergency departments. Primary care specialists are responsible for the initial assessment and treatment. They, thereby, also regulate referral and access to tertiary care. Primary health care EDs are easy for the public to access, leading to non-acute patient visits to the emergency department. This has caused increased queues and unnecessary difficulties in providing immediate treatment for those patients who need it the most.</p> <p>Methods</p> <p>A face-to-face triage system based on the letters A (patient directly to secondary care), B (to be examined within 10 min), C (to be examined within 1 h), D (to be examined within 2 h) and E (no need for immediate treatment) for assessing the urgency of patients' treatment needs was applied in the main ED in the City of Vantaa, Finland (Peijas Hospital) as an attempt to provide immediate treatment for the most acute patients. The first step was an initial patient assessment by a health care professional (triage nurse). If the patient was not considered to be in need of immediate care (i.e. A-D) he was allocated to group E and examined after the more urgent patients were treated. The introduction of this triage system was combined with information to the public on the "correct" use of emergency services. The primary aim of this study was to assess whether the flow of patients was changed by implementing the ABCDE-triage system in the combined ED. To study the effect of the intervention on patient flow, numbers monthly visits to doctors were recorded before and after intervention in Peijas ED and, simultaneously, in control EDs (Myyrmäki in Vantaa, Jorvi and Puolarmetsä in Espoo). To study does the implementation of the triage system redirect patients to other health services, numbers of monthly visits to doctors were also scored in the private health care and public office hour services of Vantaa primary care.</p> <p>Results</p> <p>The number of patient visits to a primary care doctor in 2004 decreased by up to eight percent (340 visits/month) as compared to the previous year in the Peijas ED after implementation of the ABCDE-triage system. Simultaneously, doctor visits in tertiary health care ED increased by ten percent (125 visits/month). ABCDE-triage was not associated with a subsequent increase in the number of patient visits in the private health care or office hour services. The number of ED visits in the City of Espoo, used as a control where no triage was applied, remained unchanged.</p> <p>Conclusions</p> <p>The present ABCDE-triage system combined with public guidance may reduce patient visits to primary health care EDs but not to the tertiary health care EDs.</p>http://www.biomedcentral.com/1471-227X/10/12 |
| spellingShingle | Menezes Ricardo Mattila Juho Kaartinen Johanna Kantonen Jarmo Malmila Mia Castren Maaret Kauppila Timo Impact of the ABCDE triage on the number of patient visits to the emergency department BMC Emergency Medicine |
| title | Impact of the ABCDE triage on the number of patient visits to the emergency department |
| title_full | Impact of the ABCDE triage on the number of patient visits to the emergency department |
| title_fullStr | Impact of the ABCDE triage on the number of patient visits to the emergency department |
| title_full_unstemmed | Impact of the ABCDE triage on the number of patient visits to the emergency department |
| title_short | Impact of the ABCDE triage on the number of patient visits to the emergency department |
| title_sort | impact of the abcde triage on the number of patient visits to the emergency department |
| url | http://www.biomedcentral.com/1471-227X/10/12 |
| work_keys_str_mv | AT menezesricardo impactoftheabcdetriageonthenumberofpatientvisitstotheemergencydepartment AT mattilajuho impactoftheabcdetriageonthenumberofpatientvisitstotheemergencydepartment AT kaartinenjohanna impactoftheabcdetriageonthenumberofpatientvisitstotheemergencydepartment AT kantonenjarmo impactoftheabcdetriageonthenumberofpatientvisitstotheemergencydepartment AT malmilamia impactoftheabcdetriageonthenumberofpatientvisitstotheemergencydepartment AT castrenmaaret impactoftheabcdetriageonthenumberofpatientvisitstotheemergencydepartment AT kauppilatimo impactoftheabcdetriageonthenumberofpatientvisitstotheemergencydepartment |