ArticleInternational journal for quality in health care : journal of the International Society for Quality in Health Care2018
Decreasing triage time: effects of implementing a step-wise ESI algorithm in an EHR.
Article in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- Using space technology approach to improve quality in emergency departments in India: a quality improvement program.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2026Article
- Article
- Observational
- A summary of eye-related visits to a tertiary emergency department.Scientific reports · 2021Article
- Clinical Implementation of Predictive Models Embedded within Electronic Health Record Systems: A Systematic Review.Informatics (MDPI) · 2020Article
- Factors affecting the accuracy of nurse triage in tertiary care emergency departments.Turkish journal of emergency medicineArticle
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine if adapting a widely-used triage scale into a computerized algorithm in an electronic health record (EHR) shortens emergency department (ED) triage time.
designBefore-and-after quasi-experimental study.
settingUrban, tertiary care hospital ED.
participantsConsecutive adult patient visits between July 2011 and June 2013.
interventionA step-wise algorithm, based on the Emergency Severity Index (ESI-5) was programmed into the triage module of a commercial EHR.
main outcome measuresDuration of triage (triage interval) for all patients and change in percentage of high acuity patients (ESI 1 and 2) completing triage within 15 min, 12 months before-and-after implementation of the algorithm. Multivariable analysis adjusted for confounders; interrupted time series demonstrated effects over time. Secondary outcomes examined quality metrics and patient flow.
resultsAbout 32 546 patient visits before and 33 032 after the intervention were included. Post-intervention patients were slightly older, census was higher and admission rate slightly increased. Median triage interval was 5.92 min (interquartile ranges, IQR 4.2-8.73) before and 2.8 min (IQR 1.88-4.23) after the intervention (P < 0.001). Adjusted mean triage interval decreased 3.4 min (95% CI: -3.6, -3.2). The proportion of high acuity patients completing triage within 15 min increased from 63.9% (95% CI 62.5, 65.2%) to 75.0% (95% CI 73.8, 76.1). Monthly time series demonstrated immediate and sustained improvement following the intervention. Return visits within 72 h and door-to-balloon time were unchanged. Total length of stay was similar.
conclusionThe computerized triage scale improved speed of triage, allowing more high acuity patients to be seen within recommended timeframes, without notable impact on quality.
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