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Republished paper: Emergency department triage revisited
  1. Gerard FitzGerald1,
  2. George A Jelinek2,3,
  3. Deborah Scott1,4,
  4. Marie Frances Gerdtz5
  1. 1School of Public Health, Queensland University of Technology, Brisbane, Australia
  2. 2Emergency Medicine, University of Western Australia, Nedlands, Australia
  3. 3Department of Medicine, The University of Melbourne, Fitzroy, Australia
  4. 4Queensland Injury Surveillance Unit (QISU), Brisbane, Australia
  5. 5School of Nursing and Social Work, The University of Melbourne, Fitzroy, Australia
  1. Correspondence to Professor Gerry FitzGerald, Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Queensland 4059, Australia; gj.fitzgerald{at}qut.edu.au

Abstract

Triage is a process that is critical to the effective management of modern emergency departments. Triage systems aim, not only to ensure clinical justice for the patient, but also to provide an effective tool for departmental organisation, monitoring and evaluation. Over the last 20 years, triage systems have been standardised in a number of countries and efforts made to ensure consistency of application. However, the ongoing crowding of emergency departments resulting from access block and increased demand has led to calls for a review of systems of triage. In addition, international variance in triage systems limits the capacity for benchmarking. The aim of this paper is to provide a critical review of the literature pertaining to emergency department triage in order to inform the direction for future research. While education, guidelines and algorithms have been shown to reduce triage variation, there remains significant inconsistency in triage assessment arising from the diversity of factors determining the urgency of any individual patient. It is timely to accept this diversity, what is agreed, and what may be agreeable. It is time to develop and test an International Triage Scale (ITS) which is supported by an international collaborative approach towards a triage research agenda. This agenda would seek to further develop application and moderating tools and to utilise the scales for international benchmarking and research programmes.

  • Clinical assessment
  • effectiveness
  • management
  • emergency department management
  • mental health
  • operational research
  • resuscitation research

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Footnotes

  • This is a reprint of a paper that first appeared in Emergency Medicine Journal, February 2010, volume 27, pages 86–92.

  • Competing interests None to declare.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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