Physician in Triage Versus Rotational Patient Assignment.

Area of Science:

• Emergency Medicine
• Healthcare Operations Research

Background:

• Emergency departments (EDs) utilize various front-end processes like physician in triage and rotational patient assignment to optimize patient flow.
• Limited comparative data exists for these distinct patient assignment strategies.

Purpose of the Study:

• To compare the operational efficiency of physician in triage versus rotational patient assignment in an emergency department setting.
• To evaluate the impact of these models on critical ED metrics.

Main Methods:

• A retrospective cohort review design was employed.
• Data were collected over 23 days for physician in triage and 23 matched days for rotational patient assignment.
• A total of 1,869 visits (physician in triage) and 1,906 visits (rotational patient assignment) were analyzed.

Main Results:

• While rotational patient assignment showed a slightly lower median length of stay (LOS) in simple comparison (219 min vs. 233 min), multivariate analysis revealed a nonsignificant reduction in geometric mean LOS (204 min vs. 217 min).
• No statistically significant differences were observed between the two models regarding patients leaving without being seen, leaving after being seen, or early returns within 72 hours (with or without admission).
• Complaint ratios also did not differ significantly between the physician in triage and rotational patient assignment groups.

Conclusions:

• This single-site study indicates no statistically significant differences in key emergency department operational metrics between physician in triage and rotational patient assignment models.
• The findings suggest that after adjusting for confounders, neither model offers a distinct advantage in terms of the measured operational outcomes.