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A simplified trauma triage system safely reduces overtriage and improves provider satisfaction: a prospective study
Robert R Shawhan1, Derek P McVay1, Linda Casey1
1Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
American Journal of Surgery
|March 19, 2015
Summary
A new simplified trauma triage system significantly reduced overtriage from 79% to 44% while maintaining a low undertriage rate of 1.6%. This improved trauma patient management without compromising patient safety.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Healthcare Systems Analysis
Background:
- Standard trauma triage systems often lead to high overtriage rates to ensure low undertriage.
- Previous validation identified optimal triage variables for improved accuracy.
- A new simplified triage system (NEW) was implemented to address these issues.
Purpose of the Study:
- To evaluate the effectiveness of a new simplified triage system.
- To assess the impact of the NEW system on overtriage and undertriage rates.
- To determine if the NEW system safely maintained low undertriage.
Main Methods:
- Prospective review of trauma entries from May 2010 to Feb 2013.
- Calculation of undertriage and overtriage rates based on the need for urgent or life-saving interventions.
- Comparison of the NEW system with the previous (OLD) triage system.
Main Results:
- The NEW system reduced Level 1 activations from 32% to 19% (P < .05).
- Overtriage decreased significantly from 79% (OLD) to 44% (NEW) (P < .01).
- Undertriage remained low at 1.6% in the NEW system, comparable to 1.2% in the OLD system (P = nonsignificant).
Conclusions:
- The NEW simplified triage system effectively reduced overtriage rates.
- The system safely maintained a low undertriage rate, ensuring patient safety.
- This simplified approach offers a more efficient and accurate method for trauma patient triage.
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