A systematic review of triage-related interventions to improve patient flow in emergency departments

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Volumn 19, Issue , 2011, Pages

  Oredsson, Sven ^a   Jonsson, Håkan ^b   Rognes, Jon ^c   Lind, Lars ^b   Göransson, Katarina E ^d,e   Ehrenberg, Anna ^f   Asplund, Kjell ^g   Castrén, Maaret ^h   Farrohknia, Nasim ^b  

^a HELSINGBORG HOSPITAL   (Sweden)

^b UPPSALA UNIVERSITY HOSPITAL   (Sweden)

^c STOCKHOLM SCHOOL OF ECONOMICS   (Sweden)

^d KAROLINSKA UNIVERSITY HOSPITAL   (Sweden)

^e KAROLINSKA INSTITUTE   (Sweden)

^f DALARNA UNIVERSITY   (Sweden)

^g UMEÅ UNIVERSITY HOSPITAL   (Sweden)

^h STOCKHOLM SÖDER HOSPITAL   (Sweden)

Author keywords

[No Author keywords available]

Indexed keywords

CROWDING; EMERGENCY; EMERGENCY HEALTH SERVICE; HOSPITALIZATION; HUMAN; ORGANIZATION AND MANAGEMENT; REVIEW; STANDARD; STATISTICS; SWEDEN;

CROWDING; EMERGENCIES; EMERGENCY SERVICE, HOSPITAL; HOSPITALIZATION; HUMANS; SWEDEN; TRIAGE;

EID: 79960555526     PISSN: None     EISSN: 17577241     Source Type: Journal    
DOI: 10.1186/1757-7241-19-43     Document Type: Review

References (67)

1. Eitel DR, Rudkin SE, Malvehy MA, Killeen JP, Pines JM. Improving service quality by understanding emergency department flow: a White Paper and position statement prepared for the American Academy of Emergency Medicine. J Emerg Med 2010, 38(1):70-9. 10.1016/j.jemermed.2008.03.038, 18514465.
2. Institute of Medicine Committee on the Future of Emergency Care in the US Health System The future of emergency care in the United States health system. Ann Emerg Med 2006, 48:115-20. Institute of Medicine Committee on the Future of Emergency Care in the US Health System.
3. Bernstein SL, D'Onofrio G. Public health in the emergency department: Academic Emergency Medicine consensus conference executive summary. Acad Emerg Med 2009, 16:1037-9. 10.1111/j.1553-2712.2009.00548.x, 20053218.
4. Moskop JC, Sklar DP, Geiderman JM, Schears RM, Bookman KJ. Emergency department crowding, part 1-concept, causes, and moral consequences. Ann Emerg Med 2009, 53:605-11. 10.1016/j.annemergmed.2008.09.019, 19027193.
5. Trout A, Magnusson AR, Hedges JR. Patient satisfaction investigations and the emergency department. Acad Emerg Med 2000, 7:695-709. 10.1111/j.1553-2712.2000.tb02050.x, 10905652.
6. Vieth TL, Rhodes KV. The effect of crowding on access and quality in an academic ED. Am J Emerg Med 2006, 24:787-94. 10.1016/j.ajem.2006.03.026, 17098098.
7. Derlet RW, Richards JR. Overcrowding in the nations emergency departments: complex causes and disturbing effects. Ann Emerg Med 2000, 35:63-8. 10.1016/S0196-0644(00)70105-3, 10613941.
8. Magalski AE, Benenson RS, Cavanaugh SH, Williams ED. A pneumonia clinical pathway decreases time to antibiotic treatment, length of stay and mortality. Acad Emerg Med 1999, 6:1243-8. 10.1111/j.1553-2712.1999.tb00140.x, 10609926.
9. Erickson C, McErlean M, Bartfield J, Verdile V. Relationship between maloccurrence and ED census and staffing. Acad Emerg Med 2001, 8:499.
10. Ciesielski G, Clark N. Safety in the emergency department: it's about time. Kans Nurse 2007, 82:3-6.
11. Miro O, Antonio MJ, Jimenez S, De Dios A, Sanchez M, Borras A, Millá J. Decreased health care quality associated with emergency department overcrowding. Eur J Emerg Med 1999, 6:105-7. 10.1097/00063110-199906000-00003, 10461551.
12. Pearce L. Complete turnaround Tears, long trolley waits and a hostile local press characterised A&E in Bath. Nurs Stand 2002, 16:16-7.
13. Walley P. Designing the accident and emergency system: Lessons from manufacturing. Emerg Med J 2003, 20:126-30. 10.1136/emj.20.2.126, 1726065, 12642523.
14. Yoon P, Steiner I, Reinhardt G. Analysis of factors influencing length of stay in the emergency department. Can J Emerg Med 2003, 5:155-61.
15. Rotstein Z, Wilf-Miron R, Lavi B. The dynamics of patient visits to a public hospital ED: a statistical model. Am J Emerg Med 1997, 15:596-9. 10.1016/S0735-6757(97)90166-2, 9337370.
16. Green LV, Kolesar PJ. On the validity and utility of queuing models of human service. Ann Op Res 1987, 9:469-79.
17. Harvey M, Al Shaar M, Cave G, Wallace M, Brydon P. Correlation of physician seniority with increased emergency department efficiency during a resident doctors'strike. N Z Med J 2008, 121:59-68.
18. Åhlström P. Lean service operations: translating lean production principles to service operations. Int J Serv Tech Manag 2004, 5:545.
19. George M, Rolands D, Kastle B. What is Lean Six Sigma? 2004, New York: McGraw-Hill.
20. de Koning H, Verver JPS, van den Heuvel J, Bisgaard S, Does RJ. Lean six sigma in healthcare. J Helathcare Qual 2006, 28(2):4-11.
21. Horwitz LI, Green J, Bradley EH. US emergency department performance on wait time and length of visit. Ann Emerg Med 2010, 55(2):133-41. 10.1016/j.annemergmed.2009.07.023, 2830619, 19796844.
22. Banerjee A, Mbamalu D, Hinchley G. The impact of process re-engineering on patient throughput in emergency departments in the UK. Int J Emerg Med 2008, 1(3):189-92. 10.1007/s12245-008-0055-x, 2657273, 19384514.
23. Statens beredning för medicinsk utvärdering (SBU) Triage och flödesprocesser på akutmottagningen. En systematisk litteraturöversikt 2010, 197. Stockholm, ISBN 978-91-85413-33-1, Statens beredning för medicinsk utvärdering (SBU).
24. Eldridge S, Ashby D, Bennett C, Wakelin M, Feder G. Internal and external validity of cluster randomised trials: systematic review of recent trials. BMJ 2008, 336(7649):876-80. 10.1136/bmj.39517.495764.25, 2323095, 18364360.
25. Akobeng AK. Assessing the validity of clinical trials. J Pediatr Gastroenterol Nutr 2008, 47(3):277-82. 10.1097/MPG.0b013e31816c749f, 18728521.
26. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, Schünemann HJ, . GRADE Working Group GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008, 336(7650):924-6. 10.1136/bmj.39489.470347.AD, 2335261, 18436948, GRADE Working Group.
27. Rogers T, Ross N, Spooner D. Evaluation of a 'See and Treat' pilot study introduced to an emergency department. Accid Emerg Nurs 2004, 12:24-7. 10.1016/j.aaen.2003.08.005, 14700568.
28. Fernandes CM, Christenson JM, Price A. Continuous quality improvement reduces length of stay for fast-track patients in an emergency department. Acad Emerg Med 1996, 3:258-63. 10.1111/j.1553-2712.1996.tb03430.x, 8673783.
29. Darrab AA, Fan J, Fernandes CM, Zimmerman R, Smith R, Worster A, Smith T, O'Connor K. How does fast track affect quality of care in the emergency department?. Eur J Emerg Med 2006, 13:32-5. 10.1097/00063110-200602000-00008, 16374246.
30. Kwa P, Blake D. Fast track: has it changed patient care in the emergency department?. Emerg Med Australas 2008, 20:10-5. 10.1111/j.1742-6723.2007.01021.x, 17999686.
31. Cooke MW, Wilson S, Pearson S. The effect of a separate stream for minor injuries on accident and emergency department waiting times. Emerg Med J 2002, 19:28-30. 10.1136/emj.19.1.28, 1725754, 11777867.
32. Bond PA. A staffed ED assessment room: impact on wait times for nonurgent patients at a Saudi Arabian hospital. J Emerg Nurs 2001, 27:394-5. 10.1067/men.2001.116248, 11468636.
33. Ardagh MW, Wells JE, Cooper K, Lyons R, Patterson R, O'Donovan P. Effect of a rapid assessment clinic on the waiting time to be seen by a doctor and the time spent in the department, for patients presenting to an urban emergency department: a controlled prospective trial. N Z Med J 2002, 115:U28.
34. Kilic YA, Agalar FA, Kunt M, Cakmakci M. Prospective, double-blind, comparative fast-tracking trial in an academic emergency department during a period of limited resources. Eur J Emerg Med 1998, 5:403-6.
35. O'Brien D, Williams A, Blondell K, Jelinek GA. Impact of streaming "fast track" emergency department patients. Aust Health Rev 2006, 30:525-32. 10.1071/AH060525, 17073548.
36. Sanchez M, Smally AJ, Grant RJ, Jacobs LM. Effects of a fast-track area on emergency department performance. J Emerg Med 2006, 31:117-20. 10.1016/j.jemermed.2005.08.019, 16798173.
37. Rodi SW, Grau MV, Orsini CM. Evaluation of a fast track unit: alignment of resources and demand results in improved satisfaction and decreased length of stay for emergency department patients. Qual Manag Health Care 2006, 15:163-70.
38. Ieraci S, Digiusto E, Sonntag P, Dann L, Fox D. Streaming by case complexity: evaluation of a model for emergency department Fast Track. Emerg Med Australas 2008, 20:241-9. 10.1111/j.1742-6723.2008.01087.x, 18462407.
39. Considine J, Kropman M, Kelly E, Winter C. Effect of emergency department fast track on emergency department length of stay: a case-control study. Emerg Med J 2008, 25:815-9. 10.1136/emj.2008.057919, 19033498.
40. Kelly AM, Bryant M, Cox L, Jolley D. Improving emergency department efficiency by patient streaming to outcomes-based teams. Aust Health Rev 2007, 31:16-21.
41. King DL, Ben-Tovim DI, Bassham J. Redesigning emergency department patient flows: application of Lean Thinking to health care. Emerg Med Australas 2006, 18:391-7. 10.1111/j.1742-6723.2006.00872.x, 16842310.
42. Patel PB, Vinson DR. Team assignment system: expediting emergency department care. Ann Emerg Med 2005, 46:499-506. 10.1016/j.annemergmed.2005.06.012, 16308063.
43. Holroyd BR, Bullard MJ, Latoszek K, Gordon D, Allen S, Tam S, Blitz S, Yoon P, Rowe BH. Impact of a triage liaison physician on emergency department overcrowding and throughput: a randomized controlled trial. Acad Emerg Med 2007, 14:702-8. 10.1111/j.1553-2712.2007.tb01864.x, 17656607.
44. Subash F, Dunn F, McNicholl B, Marlow J. Team triage improves emergency department efficiency. Emerg Med J 2004, 21:542-4. 10.1136/emj.2002.003665, 1726448, 15333524.
45. Travers JP, Lee FC. Avoiding prolonged waiting time during busy periods in the emergency department: Is there a role for the senior emergency physician in triage?. Eur J Emerg Med 2006, 13:342-8.
46. Richardson JR, Braitberg G, Yeoh MJ. Multidisciplinary assessment at triage: a new way forward. Emerg Med Australas 2004, 16:41-6. 10.1111/j.1742-6723.2004.00541.x, 15239754.
47. Partovi SN, Nelson BK, Bryan ED, Walsh MJ. Faculty triage shortens emergency department length of stay. Acad Emerg Med 2001, 8:990-5. 10.1111/j.1553-2712.2001.tb01099.x, 11581086.
48. Grant S, Spain D, Green D. Rapid assessment team reduces waiting time. Emerg Med 1999, 11:72-77.
49. Kendall J, Reeves B, Clancy M. Point of care testing: randomised controlled trial of clinical outcome. BMJ 1998, 316:1052-7. 28507, 9552905.
50. Murray RP, Leroux M, Sabga E, Palatnick W, Ludwig L. Effect of point of care testing on length of stay in an adult emergency department. J Emerg Med 1999, 17:811-4. 10.1016/S0736-4679(99)00107-9, 10499694.
51. Lee-Lewandrowski E, Corboy D, Lewandrowski K, Sinclair J, McDermot S, Benzer TI. Implementation of a point-of-care satellite laboratory in the emergency department of an academic medical center. Impact on test turnaround time and patient emergency department length of stay. Arch Pathol Lab Med 2003, 127:456-60.
52. Parvin CA, Lo SF, Deuser SM, Weaver LG, Lewis LM, Scott MG. Impact of point-of-care testing on patients' length of stay in a large emergency department. Clin Chem 1996, 42:711-7.
53. Tsai WW, Nash DB, Seamonds B, Weir GJ. Point-of-care versus central laboratory testing: an economic analysis in an academic medical center. Clin Ther 1994, 16:898-910.
54. Singer AJ, Viccellio P, Thode HC, Bock JL, Henry MC. Introduction of a stat laboratory reduces emergency department length of stay. Acad Emerg Med 2008, 15:324-8. 10.1111/j.1553-2712.2008.00065.x, 18370985.
55. Lindley-Jones M, Finlayson BJ. Triage nurse requested x rays-are they worthwhile?. J Accid Emerg Med 2000, 17:103-7. 1725357, 10718230.
56. Parris W, McCarthy S, Kelly AM, Richardson S. Do triage nurse-initiated X-rays for limb injuries reduce patient transit time?. Accid Emerg Nurs 1997, 5:14-5. 10.1016/S0965-2302(97)90056-4, 9069728.
57. Thurston J, Field S. Should accident and emergency nurses request radiographs? Results of a multicentre evaluation. J Accident & Emerg Med 1996, 13:86-9. 3127318, 21772699.
58. Karpiel M, Williams ME. Developing a fast track program. J Amb Care Manage 1998, 2:35-48.
59. Sjönell G. Effect of establishing a primary health care centre on the utilization of primary health care and other out-patient care in a Swedish urban area. Fam Pract 1986, 3:148-54. 10.1093/fampra/3.3.148, 3770334.
60. Washington DL, Stevens CD, Shekelle PG, Baker DW, Fink A, Brook RH. Safely directing patients to appropriate levels of care: Guideline-driven triage in the emergency service. Ann Emerg Med 2000, 36:15-22. 10.1067/mem.2000.107003, 10874230.
61. Derlet RW, Kinser D, Ray L, Hamilton B, McKenzie J. Prospective identification and triage on nonemergency patients out of an emergency department: A five-year study. Ann Emerg Med 1995, 25:215-23. 10.1016/S0196-0644(95)70327-6, 7832350.
62. Lowe RA, Bindman AB, Ulrich SK. Refusing care to emergency department patients: evaluation of published triage guidelines. Ann Emerg Med 1994, 23:286-93. 10.1016/S0196-0644(94)70042-7, 8304610.
63. Widgren BR, Jourak M. Medical Emergency Triage and Treatment System (METTS): A new protocol in primary triage and secondary priority decision in emergency medicine. J Emerg Med 2008,
64. Nordberg M, Castrén M. The validity of the triage system ADAPT. Scand J Trauma Resus Emerg Med 2010, 18(Suppl 1):36.
65. Askenasi R, Lheureux PE, Gillet JB. Infuence of tests on patient time in the emergency department. Reanimation Soins Intensifs Medecine d'Urgency 1989, 5:201-2.
66. Schimke I. Quality and timeliness in medical laboratory testing. Anal Bioanal Chem 2009, 393:1499-504. 10.1007/s00216-008-2349-5, 18791707.
67. Kollberg B, Dahlgaard J, Brehmer P-O. Measuring lean initiatives in health care services: issues and findings. Int J Productivity & Performance Management 2007, 56:7-24.